NEW HOSPITAL PROGRAMME This involvement is reinforced
through the programme’s structured governance processes, with EFM representation incorporated into the review and assurance of H2.0 information as Products, standard designs, and technical requirements evolve. Rather than engaging at isolated points in the process, EFM perspectives are considered throughout Product development, providing a mechanism to challenge assumptions, validate operational requirements, and ensure that decisions reflect whole-life performance as well as delivery objectives. Importantly, co-creation does not mean removing challenge from the process. In reality, some of the most valuable discussions have arisen when different perspectives collide. Designers may prioritise spatial efficiency or technical compliance, manufacturers may focus on production and assembly, contractors on delivery certainty and programme, and EFM teams on how an asset will be used, maintained, and adapted over the decades that follow. Each perspective is valid, but none on its own is sufficient. Through the PDP, the value of industrialisation is that it creates a framework within which these perspectives can be brought together earlier and more systematically than has traditionally been possible. Rather than asking whether a completed solution is acceptable, stakeholders have an opportunity to explore whether it can be improved before it is deployed at scale. That may involve difficult conversations around buildability, maintainability, cost, programme, or operational preference, but those conversations are considerably more valuable when they take place before a Product becomes embedded across multiple schemes. In this sense, co-creation is not simply a collaborative
exercise. It is a mechanism for improving quality and reducing risk. By bringing together the people who design, manufacture, deliver, and ultimately operate healthcare infrastructure, industrialisation creates an opportunity to identify challenges earlier, test assumptions more rigorously and develop solutions that reflect the realities of the entire asset lifecycle rather than a single project phase.
Standardisation as an operational strategy
In doing so, industrialisation helps distinguish between variation that adds value and variation that simply introduces complexity, creating a foundation for a more informed discussion on standardisation. But few words generate as much debate in healthcare infrastructure as standardisation. For some, it raises concerns around uniformity, reduced choice, or the risk of overlooking local needs. Yet much of this debate stems from a misunderstanding of what industrialisation is trying to achieve. The objective is not to make every hospital the same. Rather, it is to bring greater consistency to those elements where variation adds little value, while preserving flexibility where it genuinely improves outcomes. Viewed through an EFM lens, the value of standardisation becomes much clearer. Operational teams are responsible for navigating the complexity that accumulates over the life of an estate. Small differences
in Products, layouts, maintenance approaches, and information requirements can seem insignificant at the point of design, but multiplied across a portfolio they create additional workload, introduce inefficiencies and increase operational risk. Standardisation provides an opportunity to reduce that complexity by creating more predictable environments in which hospitals can be operated and maintained. In practice, this can influence everything from asset management and maintenance planning to workforce capability and operational resilience. Consistent approaches to Products and systems allow maintenance teams to build familiarity, transfer knowledge more easily between sites, and apply lessons learned with greater confidence. The benefit is not simply efficiency; it is the creation of an operational environment that is easier to understand, manage, and improve. Doors provide a useful illustration of how industrialisation can create operational value. While an individual door may seem insignificant, the cumulative impact of variation across a hospital estate can be substantial. Different door types, ironmongery specifications, maintenance regimes, and replacement parts all introduce complexity for both operational and maintenance teams. Industrialisation seeks to remove unnecessary variation where it adds little value. In the case of doors, this can improve reliability, simplify maintenance, and reduce the range of components that teams need to manage. It also creates greater consistency across the estate, making it easier to transfer knowledge and apply learnings.
Unnecessary variation in door types create additional complexity for maintenance and operational teams.
The opportunity for NHP is much broader than delivering hospitals faster. It is about creating a more repeatable healthcare infrastructure model, standardising where consistency adds value while retaining flexibility where it is needed.
October 2026 Health Estate Journal 35
AdobeStock / ANDREW NORRIS
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