Health Service Focus

02.03.17

Capital investment critical to help weather the storm

Peter WardWriting on behalf of NHS Providers, Peter Ward, director of healthcare projects at John Laing, explains why trusts need a new approach to get the best value from their assets.

Our NHS providers are sailing into a perfect storm. Increasing volume and complexity of demand has not been matched by the money available, and there has been almost no capital investment over the last decade. After long careers, some of our most experienced leaders have left the bridge, taking with them knowledge gleaned from previous economic cycles. And as if that weren’t enough, parts of the health and social care system that have helped manage demand in the past have stopped working or can’t keep pace, and the supply of professional staff is diminishing even if the money is available to recruit them. 

Despite the gloomy outlook, there are flickers of light. One is the storm itself: the government recognises the need for change, and is concerned that it won’t happen at the necessary scale and pace. The second is historically low borrowing rates, and a wall of institutional funding seeking sustainable investment in infrastructure that could help transform the way services are delivered.  The third is that the status quo is not giving patients the best quality of care, even if it is outstanding in parts. If providers can use this goodwill and good credit to focus on improving care quality, they will garner public support for measures to join up fragmented services that will ultimately cost less. 

As William Edwards Denning, who led the reconstruction of the Japanese economy following World War Two, said: “Innovation comes from the producer – not from the customer”.  As the ‘producers’, our providers will need to prepare by: 

  • Acknowledging that things can’t continue as they are, and taking a system-wide view of the need for change
  • Building a culture of innovation and support for change amongst staff and partner organisations
  • Taking specific, visible and immediate measures to invest in people and services, to demonstrate that change is actually happening 

Infrastructure investment 

Physical infrastructure – whether it is new buildings, IT systems or equipment – can help transform the way staff work and care for patients, and make clear that things will be different in future. 

For example, the central and systematic management of resources to maximise throughput is often used in airports, power networks and in other complex logistical environments. In our hospitals it is often managed in a much more ad hoc and piecemeal way. It doesn’t have to be this way: investment in real-time asset tracking has transformed the way hospitals manage patient flow and use medical equipment and staff resources in US hospitals over the last decade.  

As well as investing to improve productivity, trusts will also need to get the best value from their assets. In the past, one common response to a financial shortfall has been the sale of land or other assets for non-recurrent capital. The effect of that approach is to lose control of assets that could help solve operational problems, and, of course, it can only be done once. Rather than selling land, trusts could use partnerships to develop extra care and key worker housing which they let at affordable rents to help solve problems with delayed transfers of care and staff retention, and generate revenue income in the process. Alternatively, they could develop facilities that complement their services and create revenue income such as hotels, rehabilitation centres, diagnostic facilities or care homes operated by their partners or third parties. 

Three key factors, then, will improve the chances of success in sustainably transforming our NHS: 

  • Be brave: We should be ambitious in our thinking, practical in our objectives, clear in our measures of success and ready to implement ideas quickly, to avoid ‘project fatigue’ amongst our staff, partners and investors
  • Believe in ourselves: Providers know the kind of partners they need to deliver transformational change. To deliver this change we should maintain faith in our own knowledge, expertise and systems of governance, rather than always falling back on a culture of exhaustive consultation with government and other national stakeholders
  • Trust our partners: Once they are on board, we should trust our partners for the duration of a programme of projects rather than taking a ‘transactional’ approach to each one. In that way, we will incentivise them to clearly understand and adapt to our needs, keep project overheads to a minimum and encourage them to innovate alongside us, and work collaboratively to solve problems when things go wrong 

There is hope that providers will weather this storm, but they must acknowledge the forecast, be brave and equip themselves with the best help they can find.

Have you got a story to tell? Would you like to become an NHE columnist? If so, click here 

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

RCGP: Comprehensive plan for handling winter pressures ‘vital’

14/07/2020RCGP: Comprehensive plan for handling winter pressures ‘vital’

With annual winter pressures and a potential second wave of the coronavirus risking coinciding, the Royal College of GPs (RCGP) has called f... more >
Manchester University NHS FT health innovation campus takes forward steps

14/07/2020Manchester University NHS FT health innovation campus takes forward steps

A world-leading health innovation and precision medicine campus being established in Manchester, as part of a joint venture between Manchester Un... more >
NHS Confederation partner in new report to level up health in Yorkshire

14/07/2020NHS Confederation partner in new report to level up health in Yorkshire

NHS Confederation, Yorkshire & Humber Academic Health Sciences Network (AHSN) and Yorkshire Universities have combined their expertise to pub... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NHS at 72: Managing mental health services going forward

03/07/2020NHS at 72: Managing mental health services going forward

Sean Duggan, Chief Executive of the Mental Health Network Let’s take this opportunity to reflect on the amazing achievements of our health system over the past few months. But as we recognise the best of the NHS and its response to the Covid-19 crisis we must not forget that for mental health the peak has yet to come. Covid-19 has placed enormous pressure on the entire health and care system. Despite the very real hardships f... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

interviews

Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >