FACILITIES MANAGEMENT
dispersed community estate, they can quickly become safety risks.
Turning fragmented information into decision- grade data.
record keeping, and assurance. An outsourced model can introduce a common operating framework across dispersed sites. That consistency matters not just for compliance, but for confidence. Clinicians need to trust that the environment they are working in meets the same safety standards, regardless of postcode.
Where outsourcing works well In practice, the most successful examples of outsourced hard FM supporting community expansion share a common feature: they treat mobilisation as a clinical risk issue, not a facilities transaction. Another recurring theme is data. Community
transformation is frequently constrained by a lack of reliable estate intelligence. Decisions about whether to refurbish, repurpose, or replace buildings depend on understanding condition, utilisation, and lifecycle cost. Outsourced operators can bring established systems and processes that turn fragmented information into decision grade data, supporting both operational assurance and longer term investment planning.
Owen Ransford Rowe
Owen Ransford Rowe AMIHEEM, AWMSoc is director of business development at CBRE, specialising in solutions for NHS and complex healthcare estates. He started his career nearly 20 years ago working directly for the NHS and has supported dozens of Trusts over the years with compliance and outsourced Hard FM models. He is a member of IHEEM and the Water Management Society.
Where outsourcing requires work However, it would be misleading to suggest that outsourcing automatically solves the challenges of community delivery. Some of the most significant risks arise when outsourced hard FM is introduced without sufficient attention to integration and local context. One of the most common concerns is fragmentation.
Community care depends on collaboration across organisations, yet FM arrangements can easily mirror the very silos the NHS is trying to dismantle. Multiple providers, complex landlord arrangements, and unclear accountability can leave staff unsure who to call, who is responsible, and how issues are escalated. In a hospital, those ambiguities are often resolved informally; in a
During mobilisation of a recent community and mental health Hard FM contract with East London NHS Foundation Trust, we encountered a set of challenges that are typical of large, dispersed healthcare estates, particularly around inconsistent asset data, an early spike in reactive demand, and the need to maintain uninterrupted clinical services while transitioning people, systems, and supply chains. Rather than attempting to ‘fix everything at once’, we focused first on establishing clear mobilisation governance and a single source of truth, putting strong compliance oversight in place and prioritising life safety and statutory risk while asset records were validated and normalised. Where gaps were identified, interim controls and specialist support were deployed quickly to maintain assurance, supported by a structured helpdesk and CAFM front door to stabilise demand and manage expectations. TUPE and capability risks were addressed through early engagement and targeted use of pre-qualified supply chain partners, ensuring continuity while the permanent operating model embedded. While the mobilisation was not without pressure in the early weeks, this disciplined, risk based approach created transparency, control, and confidence for the Trust, allowing the service to move into steady state with improved compliance visibility, stabilised performance, and a more resilient platform for long term delivery. There is also the risk of losing local knowledge.
Community buildings frequently function based on relationships and unwritten rules, such as knowing which rooms stay busy late, which clinics require minimal disturbance, and how people actually access spaces compared to official guidelines. If an outsourced model is overly remote, focused on KPIs rather than presence, response times may look good while user experience deteriorates. Another challenge is contractual rigidity. The ten year
strategy explicitly anticipates ongoing service redesign, yet many FM contracts can be built around static assumptions. If adding a site, extending opening hours, or repurposing space requires renegotiation or lengthy change control, the FM model becomes a brake on transformation rather than an enabler. Finally, there is the ever present danger of reducing outsourcing to a cost saving exercise. In the short term, that approach may deliver financial relief. In the longer term, deferred maintenance, reduced planned work, and rising failure rates undermine exactly the stability that community services need to build trust and confidence.
What ‘good’ looks like from an operator’s perspective From experience, the outsourced hard FM models that best support the shift to community care share a number of characteristics, even if they are not always described in the same way. First, they are designed around outcomes rather than
The challenge is no longer whether the system wants to move care into the community, but whether the estates and infrastructure that underpin it are ready to do so safely, consistently, and at pace.
42 Health Estate Journal September 2026
AdobeStock / Seventyfour
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