EFM KNOWLEDGE AND KNOWLEDGE-SHARING Thirdly, the study found that Data &


Information Management is a regressive knowledge area, holding the greatest significance at the operational level, and diminishing in relevance as individuals move from Technician to Manager roles. This change is attributed to reduced responsibilities for manual data recording and organisation at higher levels. Despite this, the NHS Long Term Plan of 2019 emphasises that ‘people, data and technology are crucial to the ongoing evolution of our NHS’.16


To achieve this


vision, developing digital skills at senior organisational levels is essential to effectively utilise technology and data in enhancing healthcare services.


Reliance on AEs for specialist knowledge Fourthly, Professional Development, Technical Expertise & Experience, and Benchmarking & New Technologies, are of highest importance for Authorised Engineers (AEs). A Director of EFM notes that ‘most Directors will have one specialist knowledge from the route they developed through [but they] cannot have operational knowledge of all services’, indicating the reliance on AEs for specialised knowledge. Heads of EFM particularly value AEs’ expertise for compliance and assurance, despite AEs being technically required only for annual audits. In Benchmarking & New Technologies, AEs’ extensive client portfolios enable them to effectively compare NHS Trusts’ performances. However, their role as independent experts presents challenges in advising on future technologies and suppliers. A Manager highlighted a gap in support for exploring new technologies: ‘It is left to my own personal reading – I never see any guidance on [future technologies].’ This reliance on outdated systems carries significant financial risks, as a Government Security analysis projected a potential cost of £13-22 bn over the next five years for the public sector,17


a substantial portion


of which affects the NHS, emphasising the crucial role of AEs in navigating technological changes and financial management within the NHS. Lastly, the study reveals a concerning gap: no Delphi participants suggested any knowledge types in the area of Environmental & Sustainability Awareness, which is alarming given the NHS’s commitment to being the first healthcare system to achieve a Net Zero carbon target. The NHS recognises the need for an ‘upskilled workforce to drive and implement the interventions’ [18, p. 41] for this goal. However, this sustainability agenda seems not to have become a priority for EFM staff yet. The limited guidance from central NHS authorities has contributed to a gap between the NHS’s high-level environmental goals and


Feedback on system & guidance quality


Direct link to relevant page in reference


Figure 5: User interface showing the proposed guidance retrieval functionality of AI-powered knowledge-sharing solution innex.ai


the day-to-day management focus. This disparity highlights a critical need both for immediate attention, and better strategic alignment in integrating sustainability into the core objectives of the NHS.


SUMMARY – Key knowledge gaps to address in NHS EFM development The study sheds light on how the importance of different knowledge areas shifts as EFM professionals move through the ranks, with Figure 4 offering a clear visual representation of this dynamic. Figure 4 illustrates how the priorities for different knowledge areas change at different stages of the EFM career path. Additionally, it points out a significant oversight in Environmental & Sustainability Awareness, a key area that has yet to receive due on-the-ground attention within the field. These insights into the knowledge priorities of EFM professionals provide valuable information for those in the field, suggesting areas for development and potential focus in professional training and education. NHS staff rely significantly on external


Authorising Engineers (AEs) for Technical Expertise & Experience and Benchmarking & New Technologies, along with Professional Development. The study uncovers a notable decrease in the prioritisation of Technical Expertise & Experience as EFM professionals move from Head of EFM to Director roles. This trend poses critical questions about


‘‘


the sufficiency of in-house technical knowledge for high-level decision- making and advocacy within EFM. The heavy reliance on AEs, particularly for understanding and adopting cutting-edge technology and practices, is concerning, as AEs spend very limited time in the Trusts, and also do not necessarily understand the local building context to the same degree as internal EFM staff. It suggests potential challenges in effectively operating advanced systems, and in making informed decisions about technology investments, especially at the Director level. Enhancing internal technical understanding, and aligning it with organisational needs at the top management levels, are thus essential for strategic and informed allocation of resources and technology adoption within NHS EFM. Collaborative Proficiency emerges as crucial for Managers and Heads of EFM, underlining the necessity of interdisciplinary and inter-organisational collaboration. However, challenges in networking and prioritisation become evident, particularly at the Director of EFM level, despite the NHS’s emphasis on strategic alignment via Integrated Care Systems. This will need to be addressed to turn around the ‘continued failure to embrace integrated care systems’. [19, p.2]. The study reveals that Environmental &


Sustainability Awareness is not sufficiently prioritised at any organisational level in


The study reveals a concerning gap: no Delphi participants suggested any knowledge types in the area of Environmental & Sustainability Awareness, which is alarming given the NHS’s commitment to being the first healthcare system to achieve a Net Zero carbon target


February 2024 Health Estate Journal 49


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