ESTATES & FACILITIES
estate requirements such as CIAMS, which can be both time- consuming and challenging but which can actually highlight how NHS estates can or do make the best use of space and services.
There is also a key role for LIFT in working with PCTs and local authorities to realise efficiency savings and deriving maximum value from the NHS and health related local authority estate by ensuring estate management closely aligns with commissioning strategy and local need.
Tim Litherland
While the NHS might be more protected than other public services when it comes to state funding, a degree of belt tightening is inevitable and the health service will be expected to make the best of what it has over the next three to five years by way of efficiency savings. This will require a refocusing of services in favour of community/ local delivery.
At the same time, expectations and demands on the NHS will continue to rise all the while as pressure mounts for solutions to facilities unfit for purpose.
The NHS will not be able to ignore such estate management issues and utilising joint venture models such as LIFT will provide health and local authorities with private capital to replace public resources – thereby helping movement to a more community and patient led delivery of services.
If this juggling act is to be achieved, successful models of public-private partnership need to be part of the solution – and equally the health service must learn from these schemes as to the best methods of estate management and consolidation of services in order to maintain infrastructure at cost.
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The demands put upon facilities managers in the NHS has changed beyond recognition over the last twenty years, reports Richard Mackillican
F
acilities management didn’t exist in its current form twenty years ago,” says Tim
Litherland, national chairman of the Health Estate Facilities Management Association. “There was estate management and then other services, which we called the ‘hotel services’.
“These included the food, the cleaning, laundry, linen and front of house services. So one of the major changes over the last twenty years has been pooling all of these resources together under one management system.
“There has also been an increase in the professionalism of many individuals, which has been brought about in the last ten years by the need for much higher standards than ever before.”
This constant driving up of standards, along with additional responsibilities, has meant that the role of a facilities manager
“I think that we are only just beginning to realise the full potential of how much technology can help us in our role. The recent programmes of innovation in HCAI, such as Design the Bugs Out and Smart Solutions are great examples of where technology is really beginning to help us now.
“There are also certain parts of environmental engineering which had been left on the back burner, which are beginning to come through now and will be available to help facilities managers in the future.
“Overall, technology is iterative in a lot of the services which we provide and develops a small step at a time. This can mean that the benefits of it are lost on us sometimes because we are always moving on from one step to the next. Therefore, to quantify all that it has done for us is difficult. However, I feel that we are simply on the cusp.”
The NHS has become an organisation driven by targets and due to the attention being paid to the human contribution to global warming, those targets now include environmental ones.
“We are very much part of the health service’s efforts on sustainability especially with
Jul/Aug 10
Facilitating change
in the NHS has become far more complex than that of their equivalents in the past.
Health service facilities management is an area which is currently being revolutionised by technology, making it faster and easier to take on ever more complicated tasks. However, according to Tim, this is just the beginning.
work which needs to be done in the first five to ten years, given that these targets are mainly around reducing energy consumption and unnecessary travel. Both of these need to be reduced by around twenty per cent in terms of their carbon production.
“We can also have an effect through procurement where the target is a sixty per cent reduction. However, we will only play a small part in this area.”
One area which has come under a lot of scrutiny with sustainability has been around the use of NHS assets.
“We need to make sure that we are using these assets effectively and efficiently, which means continually monitoring usage and asking questions, such as ‘is this asset in the right place for the service it provides?’”
This leads us onto the subject of reconfiguring services to develop more effective community based healthcare.
The example which Tim gives is where services are being provided by an acute hospital which would be much more effective being delivered by community health services.
“This will have benefits all round if you consider that we can cut the amount of travelling needed to reach services, whilst making it more convenient for patients who can get care closer to home.”
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