FUTURE ESTATE PLANNING
to acquire the equipment.” Paul Maulbach said: “Better equipment
of course delivers better outcomes. If I take my service, we have people choosing to wait longer for the urology service at Royal Wolverhampton NHS Trust, because they use a robot, which delivers better outcomes. We would do better with greater transparency, and relating the use of investment to outcomes and associated variation. That would create an impetus for getting the investment to the right places. It’s not only about the equipment upkeep, but also about ongoing training and staff development. To keep up with the pace of technological opportunities, we need to invest more in this.”
King’s Fund report Another audience member asked: ‘Of the key issues facing the NHS, are we recognising sufficiently the role of the NHS estate in addressing them?’ She referred to a recent King’s Fund report, Integrating additional roles into primary care networks, on the implementation of additional health professional roles, such as social prescribing and clinical pharmacists in primary care. Prof. Sir Chris Ham said: “Paul said earlier that this is another aspect of planning – thinking ahead to where we want care delivered in the future, given the technological developments, the population’s needs, and – particularly in the current climate – our ageing population and concerns about multimorbidity. This ought to be addressed first and foremost in a primary care setting, but by GP practices working together, and with a wide range of health services staff in the community, Allied
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Prof. Jane Perry said she had been ‘fascinated to hear discussions about the estate’, as her University was now developing a new hospital and primary care training hub.
Health Professions, nurses, and social care staff, included.” To address the staffing challenges the audience member had alluded to, Professor Sir Chris’s view was that ‘we need to make the investments in buildings, equipment, and other infrastructure appropriate to future, not just looking through the rearview mirror’. He said: “Having attractive buildings that are good places both to work in, and be treated in, is a big part of that.”
Navigating patients to ‘the right practitioner’ Professor Perry said: “I think it’s about navigating patients to the right practitioner; sometimes the journey is quite long – you see a GP and they may
Prof. Sir Chris Ham: “We need to make the investments in buildings, equipment, and other infrastructure appropriate to future, not just looking through the rearview mirror. Having attractive buildings that are good places both to work in, and be treated in, is a big part of that”
refer you to somebody else. It would be great to use some of the learnings from places like Bromley-by-Bow, where they do a lot of work around social prescribing, and reduce the number of people that need to see a GP.” Paul Maulbach said there was
considerable investment going into new roles – particularly out of hospital, ‘in health coaching, physios and more pharmacy etc.’. “However,” he said, “there’s a mismatch between available capacity and people, because – due to the lack of long-term planning, and not necessarily being able to target capital development in the most deprived places – we very often have a shortage in physical infrastructure to house those staff. We may have enough space, but in the wrong places. This emphasises Richard’s point about the need for a proper strategic planning approach to capital development.” Another attendee asked whether
there needed to be more discussion on infrastructure such as key worker accommodation, and making the sector attractive to work in.
Good accommodation “When I started my career, back in 1990,”
May 2022 Health Estate Journal 55
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