ESTATE MANAGEMENT
NHS Estates teams face numerous demands, and estate optimisation ‘often takes a back seat’, say the authors, ‘despite its potential to deliver significant improvements in outcomes and efficiency’.
Jamie Marsh
Jamie Marsh, a Partner at RLB, leads the Asset Investment Service within Built Asset Consultancy. With over 30 years’ construction industry experience, he has spent the last 15 specialising in the PFI/PPP sector, providing technical advisory services to both public and private sector clients throughout the operational and expiry phases of PFI concessions. He has a
comprehensive knowledge and experience of all aspects of PFI contracts – including technical due diligence, building pathology, surveying and reporting, project management, building regulations, planned preventive maintenance programmes, lifecycle modelling, statutory/ contractual compliance, and risk management. Before joining RLB,
he worked for WSP as Technical director, and HCP Social Infrastructure (UK). Under his leadership, his teams have delivered building surveying, lifecycle modelling, and strategic asset management advice, to investors, Project directors, and operational project staff, throughout an extensive PFI portfolio of healthcare, education, and MOD projects in the UK and Canada. He is an MRICS Chartered Building Surveyor, and holds a BSc (Hons) in Building Surveying.
a back seat, despite its potential to deliver significant improvements in outcomes and efficiency. Project expiry demands significant resources from all parties, which is in addition to the routine management and monitoring of projects, and failure to provide this will hamper delivery of outcomes.
n The solution: invest in Expiry Teams with the skillset to consider estate optimisation and drive better patient outcomes
Transition and optimisation teams are critical to unlocking the potential of NHS PPP assets. These teams should focus on: 1. Asset knowledge and understanding: identifying and analysing utilisation, efficiency, and performance of the estate. Most PPP contracts will need a survey to be undertaken towards the end of the concession. However, this will likely focus on condition and compliance, and will generally not consider other elements of the six- facet survey or the needs of the users. Condition and compliance data which form part of the wider project base data will be invaluable for the transition of the assets back to the public sector. Trusts need to consider what services will be provided going forward, and whether the existing facility meets those services’ needs. In many cases, this will be obvious, but in local or community facilities, this could be more variable. 2. Optimisation strategies: identifying underutilised or poorly utilised spaces and developing plans that will maximise their use. For example, converting a part-time consultation space into a full-time usable area with another service could reduce waiting times and enhance service delivery. There may even be an opportunity to generate income, potentially through letting the space to a private provider. Clearly, the parties would need to remember to consider the contractual implications of any changes being made. 3. Lifecycle analysis: identifying opportunities in the lifecycle fund to facilitate repurposing elements of the fund which could deliver technological and environmental gains that may be outside the contract. For instance, questioning whether redecorating a ward 18 months before handback, or repurposing a space for improved service delivery or environmental upgrades, is a better use
of those funds. Similarly, ensuring that known obsolescence issues are addressed to avoid an unexpected cost to the public sector. An example of this is having to replace the nurse call or fire alarm system shortly after the end of the concession. It should be noted that some of these items would need to be agreed between the parties depending on the specific contractual requirements. 4. Net Zero opportunities: where the PPP contractor is undertaking lifecycle works, there will likely be opportunities to influence the specification of products to be more energy-efficient. For example, rather than installing ‘like for like’ fossil fuel boilers, air source heat pumps could be used, or pumps with the latest control technology installed to minimise energy consumption. In some cases, these will be at no additional cost to the contractor, but in others there may be a contribution required by the public sector to offset against increased energy costs in the future. Engaging early with the project teams to build trust and understanding is essential for informed decision-making that will result in positive outcomes. 5. Investment in a skilled team: the importance of this cannot be underestimated. This could be achieved in a number of different ways. One approach could be to pool resources across Trusts and Integrated Care Boards (ICBs) in an area. This could help drive maximum benefit from estate optimisation teams, leverage shared expertise, and generate lessons learned across areas. Pooling of resources or knowledge-sharing across projects isn’t a new idea, but can help minimise costs.
n Benefits of estate optimisation and utilisation Among the many benefits of estate optimisation are: 1. Enhanced efficiency: A better understanding of assets enables NHS teams to optimise estate usage, reducing void spaces, and increasing service capacity. 2. Improved patient outcomes: strategic investments, such as converting underutilised rooms, can directly contribute to shorter wait times and improved patient care. 3. Adaptability and flexibility: Transition teams can plan for the evolving nature of healthcare delivery, ensuring that assets remain adaptable to future technological advancements and changing service demands. 4. Net Zero compliance: redirecting funds toward sustainability initiatives, such as energy efficiency improvements, aligns with NHS goals and national priorities.
For the NHS, building and maintaining strong relationships with private sector parties is essential.
64 Health Estate Journal March 2025
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