NHSE/NHSI ESTATES FORUM
Nightingale hospitals in nine days to make sure that there was lots of surge capacity should the NHS need it, and the increase in ITU capacity. He said: “You managed and masterminded all this, alongside your ceaseless work to adapt the estate to meet the demands and clinical needs of this pandemic – from testing and re-working patient flows, to supporting social distancing, and even more intensive cleaning and infection control.”
Maintaining capacity despite the challenges
With the seven Nightingale hospitals, and the national oxygen infrastructure programme alone, the Minister said the EFM profession had ‘supported essential critical care emphatically’, meaning that however challenging the numbers needing care for COVID infection got – for example, there were up to 38,000 hospitalised patients at the second wave’s peak – there was always the care in hand ‘to ensure that our NHS was not overwhelmed’. The Minister also thanked all the ‘partners’ who make up the NHS supply chain, without whose efforts he said the Nightingale and national oxygen programmes could not have delivered the significant increase in additional oxygenated beds. He told the webinar: “You have all risen to the occasion in a way you should all be incredibly proud of.” The context within which EFM personnel had achieved ‘the various milestones’ had equally never – Edward Argar stressed – been more challenging, while the human costs had, sadly, been significant, and he had been saddened to learn of the members of the estates profession, and the ‘NHS family’, who had lost their lives to COVID.
A ‘close-knit’ community
Aware of ‘how closely-knit’ the healthcare estates and facilities community was, the Minister believed that this ‘sense of community and collaboration’ would be ‘more vital than ever as we move forward from this pandemic’. He said: “Indeed, moving forward will require us, even more so than usual, to work as one team, recognising that every person – every link in that team – is vital to it functioning.” He continued: “You will all know that the challenges we will face – many of them historical – are significant.” Government investment (in healthcare) by governments of all parties over the past few decades had, he acknowledged, been ‘unpredictable’ at times, with a constant pressure on EFM professionals to balance competing demands – from the urgent demand to address critical infrastructure risk and day-to-day maintenance needs, to ‘raising our eyes to look to the longer term’, and ‘developing an estate that is the right size and shape to meet future service needs’. The Minister said: “The
38 Health Estate Journal May 2021
Edward Argar recalled Health Secretary, Matt Hancock, citing John F Kennedy meeting a janitor carrying a broom down a hallway on his first visit to NASA. When the then US President asked the janitor what he did for the Agency, he reportedly replied: ‘I’m helping put a man on the moon.’
needs of monitoring and maintaining an ageing estate have meant that it has often been hard for many of you, and indeed for us, to always focus on the long term perhaps as much as we should have.” All too often, ‘completely reasonably’, the urgency of short-term pressures had won out. However, looking ahead, the Minister said the approach being adopted by this Government, ‘championed by Boris Johnson’, would be ‘to tackle both’ – in investing in meeting immediate needs, but in parallel, also in the long-term, with a sustained and predictable pipeline of investment.
Turning to some of the ‘specific challenges’ for the healthcare estates and facilities community, Edward Argar pointed out that current backlog maintenance alone was ‘a £9 bn challenge’ that all estates professionals grappled with daily. He added: “The day- to-day costs of keeping the healthcare estate in working order are huge, which is why we have allocated £4.2 bn for NHS operational capital investment supporting NHS Trusts to refurbish and maintain the estate. You grapple with these challenges every day, and yet every day you ensure that our estates, surgeries, and hospitals, are there and functioning to deliver world-class healthcare.”
The climate change agenda Here, the Minister said he wished to turn to look at ‘some long-term challenges’. He said: “Climate change is a global challenge for all of us, and the NHS must play its part in achieving Net Zero carbon emissions. Indeed, it is a legal requirement for the whole of the UK by 2050. We must also create an estate fit for 21st century clinical and patient needs –
reflecting advances in science and clinical treatment, and the ways in which we are able to treat different illnesses and help keep people alive and fit, and enjoying a high quality of life, for longer.” Against this backdrop, building an estate capable of incorporating technological advances ‘as they emerged’ over coming years, ‘as standard’, would be key. The vision set around the current Government’s Long Term Plan for the NHS – ‘a vision built around patient and place and the integration of care’ – was unachievable unless enabled by strategic, sustained investment in infrastructure and estate. The Minister said: “That is why we must deliver that long-term strategic approach – one that enables Trusts to look beyond day-today demands, and to embrace that vision, and that intent, encapsulated by that quote from the janitor at NASA. It is my job to work with my Secretary of State to ensure that this approach is driven by clear leadership, and delivered at pace.” ‘In that spirit’, the Minister said he would like to talk about the NHS Strategic Infrastructure Board, which he chairs. In the role, he had seen, ‘first hand’, the collaboration between NHS staff at all levels. He added: “We have seen how well traditional silos and ways of working can be transformed in a pandemic situation. I hope this will continue long beyond the pandemic, and that the positive structural shifts in healthcare accelerated as a result of the pandemic continue to develop at pace.”
Collaboration Hub
All NHS estates teams were now – he explained – registered in the NHS Estates Team Collaboration Hub, a tool Edward Argar said enabled the EFM community to ‘communicate across the system’, and share knowledge, experience, and best practice. It would, he believed, also enable
The Minister said Prime Minster, Boris Johnson, was ‘firmly behind a long-term, sustained, and predictable, pipeline of investment’ in NHS healthcare infrastructure.
Richard Townshend
commons.wikimedia CC BY 3.0
Ben Shread
commons.wikimedia OGL v.3
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