ESTATE MANAGEMENT
The case for an effective Operations Manual
Simon Everett, a Senior lecturer in the Built Environment and Programme Leader at Wrexham University, and Dr Scott Brown, managing director and lead consultant for Health Tech Solutions, discuss the importance of healthcare estate management teams maintaining up-to-date and sufficiently comprehensive Operations Manuals for each key engineering and EFM discipline, and some of the main elements to include.
Maintaining compliance is an important facet in the effective management of any healthcare estate.
Maintaining compliance is an important facet in the effective management of any healthcare estate. Teams managing the estate are responsible for delivering a safe and comfortable environment, and providing spaces for clinicians and associated support services to facilitate efficient and effective patient care, while minimising revenue costs and carefully planning and implementing capital schemes. The primary goal is, and should be, safety and effectiveness. Because of this, ensuring effective dissemination of information, and robustly recording and evidencing operational activities, are important for being able to provide assurance to senior leadership and Trust management, and for demonstrating compliance for external audit. To address these challenges, Estates teams should adopt the use of comprehensive ‘Operations Manuals’ for each discipline. This systematised approach can significantly improve consistency and transparency across estates disciplines by maintaining a library of current, relevant documents that both the in-house team and external stakeholders can access, improving communication and efficiency in both day-to-day operations, and for compliance and audit purposes. This article will outline the framework in which Estates teams might build their own library of compliance documents and regularly update and maintain them. The Health Technical Memorandum (HTM) and Health Building Note (HBN) suites are libraries of documents
published by the Department of Health, and provide overarching guidelines and principles for managing and designing healthcare facilities. The overarching document, HTM 00, was published in 2014, and outlines standards and best practices for building construction, maintenance, and operation within the healthcare sector. It covers various aspects, including infection control, sustainability, and compliance, with regulatory requirements. HTM 00 serves as a parent document for other specific HTMs, ensuring consistency and coherence in the design, use, management, and disposal, of healthcare infrastructure. This document reiterates the NHS pledge of all healthcare organisations to ‘ensure that services are provided in a clean and safe environment that is fit for purpose, based on national best practice’.1
Furthermore, Paragraph 2.4 sets
out what patients should expect: ‘Patients and staff have a right to expect that engineering systems and equipment will be designed, installed, operated and maintained to standards that will enable them to function efficiently, reliably and safely.’ Therefore, the suite is published to ensure that healthcare environments are safe, efficient, and support high-quality patient care.
Discipline-specific guidance Discipline-specific HTMs provide guidance on what type of documentation and drawings Estates teams should keep on file, but the overarching guidance in HTM 00 is more ambiguous. Paragraph 3.34 of the guidance states that ‘the organisation should have accurate and up-to- date records and/or drawings’, and that ‘where possible, these should be backed up electronically.’ However, the guidance does not provide a definitive system of record- keeping. Later, Building Information Modelling (BIM) is
highlighted as an industry standard being adopted, and now – 10 years after the HTM was published – BIM is well established, and should be a key consideration for estates management teams when assembling a library of records. It is recommended that an Estates Contingency Plan (ECP) and Facilities Contingency Plan (FCP) – documents which are a series of crib sheets used in the event of Estates and Facilities-related emergency situations, be drawn up. Some guidance is given in Appendix A of HTM 00 (2014a). Copies of these documents should be kept at the Estates and Facilities offices, at the site switchboard, and in the bronze/silver/gold command posts. These are flexible and adaptable, and can form the basis of dynamic risk assessment during situations which are fluid and developing, similar to those used by Incident Control in the Fire and Rescue Service.2
76 Health Estate Journal January 2025
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