NEW HOSPITAL PROGRAMME
they are fundamentally questions about patient outcomes, resilience, and long- term value. Every period of unplanned downtime, every maintenance intervention that is more complex than it needs to be and every avoidable operational challenge has a consequence that extends beyond the estate itself and into the delivery of healthcare. This is why a whole-life perspective is so important. A completed building should not be viewed as the final output of a project, but as the platform through which healthcare will be delivered for decades to come. For Industrialisation, this represents an important shift in emphasis. The opportunity is not simply to improve delivery performance, but to create Products, systems, and standards that perform consistently in operation and can evolve through learning. In this context, EFM is not a consideration that follows
Digitalisation is key to enable enhanced and predictive operational performance.
Dr Abbie Romano
Dr Abbie Romano is head of industrialisation for the NHP at NHS England, where she leads the development of Hospital 2.0 Products and the wider industrialisation strategy. Her career has spanned product, project, and programme environments across academia, research and development, consultancy, and client- side leadership, giving her a unique perspective on how industrialisation can move from concept to implementation. She is passionate about creating the relationships, capabilities, and delivery models needed to enable interoperable products and systems, supporting a more repeatable, adaptable, and continuously improving approach to infrastructure delivery.
The same principle extends beyond doors, whether considering any of the other Industrialisation Product such as partitions, facades, en suites, or other repeatable Products, the underlying opportunity is the same: creating a more stable foundation from which operational teams can work. When Products, interfaces, and maintenance requirements become more predictable, organisations spend less time dealing with unnecessary variation. Digitalisation will be a significant enabler of operational performance within Hospital 2.0. By combining standardised products, interfaces, and information structures with robust digital data, EFM teams will be better equipped to plan maintenance proactively, understand asset performance and make informed operational decisions. Over time, this has the potential to reduce unplanned disruption, improve the availability of clinical space, and strengthen the ability of Trusts to learn from operational experience. Industrialisation provides the consistency; digitalisation enables that consistency to be captured
Rethinking value through a whole-life lens
If industrialisation and digitalisation can improve operational performance long after a hospital opens, then value must be considered through a lens that extends beyond construction and capital delivery. Capital cost will always matter, and programme certainty will always matter. However, how we define value in healthcare infrastructure cannot stop at capital delivery. A hospital that is difficult to maintain, expensive to operate, poorly understood by its operational teams, or unable to adapt over time will continue to generate cost and risk long after construction has finished. For EFM professionals, the true value of healthcare
infrastructure is realised through how successfully it performs through its operational life. That performance can be considered through questions such as: n Can clinical spaces remain operational when they are needed?
n Can maintenance be planned and undertaken without unnecessary disruption to healthcare delivery?
n Can potential failures be identified before they affect patients, staff, or services?
n Can operational teams’ access and maintain critical assets safely and efficiently?
These questions may appear operational in nature, but 36 Health Estate Journal October 2026
construction; it plays a critical role in defining what value looks like in the first place.
Designing for the next 60 years This requires Products to be defined by more than their physical characteristics alone, with equal consideration given to performance and operational requirements. Within Hospital 2.0, throughout the journey of Product development, significant emphasis has been placed on clearly defining product performance, interfaces, and geometry to create the consistency required for deployment across multiple schemes while still allowing the supply chain flexibility to innovate and optimise solutions. The importance of this approach became particularly
evident through the development of the In-Room MEP Product. A significant effort has focused on the technical requirements surrounding interfaces between the Product and the wider hospital environment. The interfaces (particularly from in-room to ensuite, bedhead, or horizontal MEP distribution) are critical because they establish the point at which repeatability, buildability, and long-term operation intersect. From an industrialisation perspective, standardised interfaces provide the foundation for repeatable deployment. They give suppliers confidence about the requirements that must remain consistent across schemes while creating space for innovation within those boundaries. The benefits extend far beyond delivery. For EFM teams, those same interfaces create long-term operational advantages. Products may change throughout the life of a hospital as technologies evolve, systems are upgraded, and equipment is replaced, but stable interfaces provide continuity within an otherwise changing environment. This can support more consistent maintenance approaches, more predictable replacement strategies, and easier adaptation as operational requirements evolve. Perhaps most importantly, standardised interfaces
help create the conditions through which learning can accumulate. When Products are developed against a common framework of performance, interfaces, and geometry, improvements made through one deployment can be transferred more easily into the next. Operational experience can inform future iterations, product development becomes progressively more informed, and the benefits of learning are no longer confined to individual projects. For an asset expected to support healthcare delivery for 60 years or more, this becomes particularly important.
AdobeStock / Toowongsa
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