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08.08.18

NHS estates: Running the show

Source: NHE July/August 2018

Martin Steele, chief operating officer at NHS Property Services (NHSPS), discusses what his organisation has been doing to improve the efficiency of estates in the NHS, and explains why it is more than just a commercial landlord.

Given the scale of the financial challenges facing the NHS, optimising the use of its estate has never been more important.

Alongside the 1.3 million people that make up the NHS workforce and the development of digital health tools and services, property is arguably the third key enabler of positive change to improve patient care.

It is also the reason NHSPS was formed in 2013 by the Department of Health, taking ownership of more than 3,500 NHS facilities previously owned by the strategic health authorities  and primary care trusts – roughly 10% of the entire NHS estate. 

NHSPS has since disposed of 348 properties declared surplus by CCGs, raising £293m for reinvestment, saving £120m in running costs, and releasing land for more than 4,700 much-needed new homes in the process.

Its role in bringing property and facilities management expertise to the NHS estate, as well as ensuring all cost savings and capital receipts it generates are reinvested in the NHS estate, is quite straightforward – or at least I thought it was.

After almost a year with NHSPS, I am aware that some people think differently. In such instances, we are not viewed as the responsive property partner and facilities provider we work hard to be, but rather as a commercial landlord disconnected from the demands of delivering frontline care. 

Some NHS customers have told us our service levels are inconsistent and we are not focused enough on their needs. In many cases, they may have a point. As an organisation, NHSPS has arguably been too internally-focused on sorting out problems inherited from the parts of the primary care estate, to the detriment of customer service provision.

A key difference now, though, is data: better data and more of it. Slowly but surely, we are starting to leverage the data from one of the largest property portfolios in Europe, installing industry-standard systems to offer insight and advice across the health economy.

By March next year, we’ll have introduced an operational technology platform, a commercial grade CAFM system, to underpin operational delivery and provide near real-time reporting.

FM service delivery costs are not where we need them to be, and so we’re in the middle of inflight contract renegotiations and exploring different methods of service delivery, including rebalancing the insource/outsource models. We know we can improve service whilst reducing cost and deliver improved value for money.

Our capital construction teams will deliver projects in excess £100m in this financial year and approximately half will be directed at backlog maintenance. A prioritised programme has been developed and I’m encouraging the teams to collaborate with customers to ensure alignment on priorities.

Common challenges we face concern our customer investment schemes, with considerable time spent developing schemes with customers and commissioners, which are ‘shovel-ready,’ only for them to be abandoned at the last minute. Collectively, we need to be more joined-up, with common investment goals.

We are also working at increasing the number and types of ways customers can use the estate to support them on a day-to-day basis such as an easy-to-use online booking system for sessional space, which provides a new, flexible and cost-effective way of accessing convenient, good-quality, well-managed clinical and non-clinical spaces.

This scheme also helps commissioners identify underutilised space, in addition to vacant space, which is estimated to cost the NHSPS estate in excess of £10m a year. Handing back such surplus space to NHSPS frees up budgets for frontline care and supports future improvements.

No one in the NHS needs reminding that capital is scarce, but the NHSPS model doesn’t call for more; it relies on recycling existing asset capital to deliver more, and provides opportunities for property people to play their part in delivering a better NHS.

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