Health Service Focus

24.03.17

A holistic approach is needed to tackle estate issues

Source: NHE Mar/Apr 17

Julian Amey, chief executive of the Institute of Healthcare Engineering and Estate Management (IHEEM), reflects on the challenges facing NHS estates teams.

In the Jan/Feb issue of NHE, Paul Fenton, national chairman of the Health Estates and Facilities Management Association (HefmA), explained why he thought collaboration would be the single most important factor in achieving the objectives of the Carter programme and sustainability and transformation plans (STPs). 

Following this, Julian Amey, chief executive of IHEEM, told NHE that one of the biggest challenges facing NHS estates teams in the next 12 months, which isn’t often discussed, is the skills shortage. 

“We have a lot of good people retiring with experience, and the supply chain is pretty fragile,” he said. “It is one of the things we are addressing.” 

Discussing the national drive on apprenticeships, and looking at the skills challenge in a holistic way — as the shortage in engineers is a national problem, not just limited to health — Amey said: “There is a big focus on skills and CPD, because unless you have a qualified workforce your trust and estates team will struggle.” 

The challenge is here and now, he noted, as the country doesn’t have the pipeline coming out of colleges and universities of people studying STEM subjects. However, through IHEEM’s work with the Royal Academy of Engineering, and efforts being made elsewhere, Amey believes that the tide can be turned, but “this has to be a joined-up exercise; it has to be a holistic effort”. 

Funding and STPs 

Recently, the Health Select Committee called on STPs to include an assessment of the infrastructure investment needed to ensure type 1 emergency departments – or major consultant-led A&E departments open 24 hours a day, seven days a week – are fit for purpose. 

The influential committee added that the government must ensure that there is sufficient capital funding available for trusts to develop their infrastructure. 

Reflecting on this, Amey said: “It is a no-brainer. The more funding you have available the better it is likely to be, but efficiencies have to come into the equation. 

“Post-project analysis and making sure things have worked effectively or not is of the essence. It is a no-brainer to say that with more funding we could make things much better. I think the challenge that we have is to use innovation and efficiency alongside investment; without that joined-up thinking we are not going to get the most effective result for the taxpayer.” 

Discussing the changes to NHS estates and using innovation, Amey argued that Lord Carter’s productivity report provided a very useful framework. 

“We need other parts of the industry to be working in the same direction,” he said. “The strategic plans that are being put together by March gives us this real incentive, and indeed an open door with the trusts, to get involved. I think progress is pretty good.” 

Key themes that he believes can still be addressed fall into two key categories: energy and rationalisation. 

“Over the last few years some estates have been installing combined heat and power plant to really generate change in their energy and carbon reduction,” he said, adding that more work can still be done in this area.

However, rationalisation, which Amey admitted is a very sensitive topic, is still one area that must be discussed even though it is unpopular. 

“It is very much in the public domain when your A&E is closed because it is being merged with several others in the area you live,” he said. “The press doesn’t help with this, as it is always painted in the blackest terms. The rationale for it to happen is usually not reported there. But we have to work out how we do the right things rather than being in then national press and not doing anything.” 

He added that IHEEM is also offering a web portal which highlights and compares the best practice and problem areas identified in delivering estate changes. 

Also, in April, IHEEM will be playing a key role in delivering the Hospital Innovations 2017 exhibition, which will demonstrate how innovation can be introduced rapidly into the working practice of healthcare estates and infrastructure to achieve efficiency and improved patient care. 

Lord Carter, honorary patron of IHEEM, will be giving the keynote presentation at the event, and presenting the first ‘Carter Innovation Award’ during the proceedings. At the time of publication, entry to the awards had just closed.

FOR MORE INFORMATION

To attend the Hospital Innovations 2017, visit:

W: www.hospital-innovations.com 

To learn more about IHEEM’s work, visit:

W: www.iheem.org.uk

 

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