TRAINING AND DEVELOPMENT Working Groups
Pete Sellars Workstream 4 Lead Chief Executive Officer, and Past President, IHEEM
T
his workstream forum brings together practitioners, academics,
and innovative industry professionals, to address headline poignant topics in estates management today. Following the highly successful and widely accredited earlier work exploring a common language for acuity, the group is setting out to develop practitioners’ guidance for two key areas of relevance to EM developments.
PFI hand-back
Across the NHS, many PFI projects are reaching the end of their contract period, and the processes relating to the hand-back from external PFI companies to host NHS bodies presents many complex challenges. Just as the initial implementation of PFI
was an uncharted process, so the hand-back of those schemes is something of an enigma at present. The work of the group will seek to explore
all aspects of PFI hand-back, with the goal of supporting estates colleagues across the NHS. IHEEM is developing a “paper to digital” governance toolkit which will dovetail into the Premises Assurance Model (PAM), and will deliver the practitioners’ guidance needed in all aspects of the process.
The key to success is managed transition
and a willingness by all parties to collaboratively develop solutions which work for all involved. On the day the PFI contract ends, there should be no ‘cliff edge’: preparation and modelling of every aspect of the estate affected by hand-back is essential, with a recommendation by IPA and others that preparation begins up to 7 years before the expiry date, supported by IPA health
Research and review topics currently in the spotlight
checks. The NHS is not alone. Many other public
services have extant PFI contracts, and there is some initial guidance published by the Infrastructure and Projects Authority in several linked documents under the heading ‘Preparing for PFI contract expiry’. Some of these documents are nearly a year old, and it is the intention of this SEM working group to produce guidance for current circumstances. As all 42 ICBs develop their Estates
Infrastructure Strategies there is an urgent need to produce robust commercial handover plans from both the ICB and LIFT perspectives. The scope of this work extends into all of
IHEEM’s professional groupings, and involves colleagues from all the Institute’s Technical and Advisory Platforms.
Capital and revenue or
capital v revenue The watertight separation of capital and revenue allocations and budgets for public sector bodies, including the NHS, has patently not served well over the years. The workstream will take a fresh and
whole-system view of financing healthcare facilities from cradle to grave and – most importantly – challenge economic appraisals of business cases so that capital and revenue are evaluated as complementary and interrelated. Crucially, the assessment of projects
should include, at its core, the aspiration to improve health outcomes and patient care. Colleagues will recognise the relentless downward pressure on capital project costs
October 2023 Health Estate Journal 15
to achieve the ‘allocated capital budget’, often set far too early and without full project information, let alone a brief. (See also the work of Workstream 1 noted above). As a scheme gets some tangible form, then follows the development of its ‘revenue consequences’, as if revenue is very much a secondary aspect of the project. The workstream hopes to develop some
new thinking around project costing and the application of this to current ‘whole system’ redesign being evaluated by Integrated Care Boards to support the required move to primary and social care defined by the AfH as the “shift closer to home”. It is hoped that this work might be rolled
out to assist ICBs as they prepare their development proposals.
The group is setting out to develop practitioners’ guidance for two key areas of relevance to EM developments.
ESTATES
MANAGEMENT MACRO FORUM
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