FUTURE ESTATE STRATEGY
Changes in prospect as we return to ‘the new normal’
Emma Bolton, Area director (North East and Leeds), Community Ventures (Management), and Louise English, Capital Planning and Property manager, North Tees and Hartlepool Solutions, consider how the physical healthcare environment can continue to provide a safe, fit-for-purpose setting for high quality care as services start to be recommissioned, and planned care recommences, in the wake of the coronavirus outbreak. The authors also consider whether the COVID-19 pandemic might permanently change how existing healthcare estates are utilised, and additional measures that may need to be implemented, as well as the potential impact on future health estate strategies and developments.
The COVID-19 pandemic has fundamentally impacted the healthcare sector estate, changing the way that buildings are utilised, and necessitating a change in approach to what has traditionally been a face-to-face service delivery model. While some sectors are giving consideration to restoring their standard workforce practices, or adapting the workplace to minimise the risk of infection, caring for patients with COVID- 19 will become part of ‘business as usual’ for healthcare providers for the foreseeable future, and, as such, the built environment that they operate in needs to adapt, both now and in the future, in order to continue to effectively and safely support the provision of healthcare services for all.
This article explores how the physical healthcare environment can continue to protect and meet the needs of its workforce and patients as services start to be recommissioned, and planned care – which was paused as the pandemic took hold – recommences. Additionally, it considers whether the COVID-19 pandemic might permanently change how existing healthcare estates are utilised, and explores what this might mean for future health estate strategies and developments.
‘A new normal’
It is anticipated that a continuation of a number of recently implemented measures, introduced in response to the current pandemic, will become standard practice. These include: n Increased focus on hand hygiene. n Greater utilisation of remote care, including telephone, video, and online consultation and triage.
n Building segregation into ‘hot’ (symptomatic / suspected COVID-19 patients) and ‘cold’ (usual, non-COVID- 19 patients).
n Increased levels of physical distancing.
Tape being applied to floors to ensure physical distancing in a health centre’s corridors. Such practices could be commonplace for some time.
Physical estate Statutory compliance
Regardless of whether healthcare estate space has been fully utilised in the response to the COVID-19 pandemic, or temporarily closed, it should have continued to have been managed and maintained to ensure statutory compliance during the prescribed lockdown period.
The Health & Safety Executive has been clear that: ‘Despite the demanding circumstances, compliance with occupational health and safety legal requirements remains with duty-holders, and HSE will continue its regulatory oversight of how duty-holders are meeting their responsibilities in the context of the current public health risk and based on our available regulatory capacity.’1
Hand sanitiser – whose use, along with a renewed emphasis on handwashing, have assumed ever greater importance during the coronavirus crisis.
Duty to protect
All employers are required by law to protect employees and others from harm under the Health and Safety at Work Regulations, 1999. Any estates maintenance work undertaken during the COVID-19 pandemic is likely to have included both previously identified planned preventative maintenance, and any additional compliance measures that may have been required as a result of the pandemic – for example the identification of an increased number of little used outlets that require a flushing regime to be implemented while areas have been closed off.
As a matter of good practice, any unused areas during the pandemic response will need to be checked for continued compliance prior to recommissioning, and planned
July 2020 Health Estate Journal 37
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