ESTATE MAINTENANCE
Right: The environment in which the patient is treated is as important to the health of the NHS as any other factor.
Far right: “For the sake of the future of the NHS,” David Jones says, “we need to start investing and caring for it a bit more.”
David Jones
David Jones, the director of Estates, Facilities and Capital Development at the University Hospital of Southampton, has worked in senior positions across the NHS for 16 years, and – prior to this – in the commercial and public sectors. A Fellow of IHEEM, he has an MBA from the University of Surrey, and is currently in the fourth year of working towards a Ph.D. at the University of Southampton. His research is focused on understanding the causal relationship between backlog maintenance and patient safety incidents within the acute sector of NHS England – ‘to set a foundation for greater study and understanding of the impact of the built environment on the patient journey’. For more information, visit
www.dpjones.uk
The next thing that needs to occur is significantly more research into the impacts of the estate, failing or otherwise, on patients and staff alike. Only by truly understanding how the built environment interacts with the users of the facility can we make meaningful changes. The author is currently undertaking two studies which will support this understanding. The first is to retrospectively review four million patient records to understand how failures within the estate infrastructure are impacting patients, and to what extent of harm. The study has been training the large language model, ‘BERT’, to recognise estates-related factors within the clinical reports. It is anticipated that the results of the study will be available by the end of 2024. The other study seeks to understand the importance of
backlog maintenance among key executives and senior managers in NHS acute Trusts. The study is looking at why backlog maintenance is not getting the level of funding it requires over other projects, and whether the potential risk inherent within the backlog maintenance is being articulated sufficiently. This study should conclude early in 2025. (For direct access to the study, scan the QR code on the right).
Summary There is a lot of pressure on NHS Trusts to reduce waiting lists, to tackle queuing ambulances, and to continue to provide an elevated level of care and professionalism. However, the environment in which the patient is treated is as important to the health of the NHS as any other factor. While not investing in the infrastructure supports the immediate budget pressures, the long-term effects and cost to rectify the issues will spiral. More research into all aspects of the healthcare environment will support both the understanding of its interaction with patients and staff, and the importance of the infrastructure. The infrastructure is the second biggest asset the NHS has. For the sake of the future of the NHS, we need to start investing and caring for it a bit more.
References 1 Jones D. Badly maintained buildings can be a risk for all. HEJ 2022; 76 (8): 52-54.
2 NHS Digital 2023 Estates Returns Information Collection, Summary page and dataset for ERIC 2022/23. https://tinyurl. com/5n8sah5p
3 NHS England » NRLS Reports [Internet]. 2020 [cited 2021 Dec 6].
https://tinyurl.com/5cvuyzu8
36 Health Estate Journal October 2024
4 Slips, trips and falls in hospital. The third report from the Patient Safety Observatory. National Patient Safety Agency, 2007.
https://tinyurl.com/3jdeahsx
5 Dickerman K, Barach P, Pentecost R. We shape our buildings, then they kill us: Why health-care buildings contribute to the error pandemic. World Hosp Health Serv 2008;44(2):15–23.
6 Edwards M. An Organizational Learning Framework for Patient Safety. Am J Med Qual Off J Am Coll Med Qual 2016 Feb 26;32.
7 Leape MLL. Error in medicine. Jama 1994;272–1851. 8 Eames I, Tang J, Li Y, Wilson P. Airborne transmission of disease in hospitals. J R Soc Interface R Soc 2009 Dec 1;6 Suppl 6: S697-702.
9 Braithwaite J. Changing how we think about healthcare improvement. BMJ 2018; May 17; k2014.
10 Alexander M. Exposed – the shocking extent of fire risk in our hospitals and mental health trusts. openDemocracy 9 February2018.
https://tinyurl.com/bem7ftjb
11 Triggle N. Many buildings unsuitable, NHS figures show. BBC News [Internet] 8 December 2010.
https://www.bbc.com/ news/health-11769182
12 BMA. Building the Future: healthcare infrastructure reports Estates infrastructure.
https://tinyurl.com/2urnk9hf
13 Dejaco MC, Gramigna M, Moretti N. Plant maintenance in hospitals facilities. IOP Conf Ser Earth Environ Sci 2019; Jul 30: 296:012030.
14 May D, Pinder J. The impact of facilities management on patient outcomes. Facilities 2008 Apr 4; 26(5/6):213–28.
15 Brambilla A, Buffoli M, Capolongo S. Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings. Acta Bio Medica Atenei Parm 2019; Sep 13: 90(9-S):54–63.
16 Sundberg F, Olausson S, Fridh I, Lindahl B. Nursing staff’s experiences of working in an evidence-based designed ICU patient room – An interview study. Intensive Crit Care Nurs 2017; Dec 1: 43:75–80.
17 Williams I, Allen K, Plahe G. Restricted capital spending in the English NHS: a qualitative enquiry and analysis of implications. University of Birmingham Health Services Management Centre 2019.
https://tinyurl.com/3wh4a5ae
18 DELVE. Scoping Report on Hospital and Health Care Acquisition of COVID-19 and its Control. 6 July 2020. https://
tinyurl.com/bdcu2bjt
19 Gillespie TA, Johnson PRE, Notman AW, Coia JE, Hanson MF. Eradication of a resistant Pseudomonas aeruginosa strain after a cluster of infections in a haematology/oncology unit. Elsevier Enhanced Reader. Clin Microbiol Infect 1999;6(3):125–30.
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