IHEEM PAST-PRESIDENTS’ ROUNDTABLE – PART TWO


Tackling skills gaps and encouraging diversity


May’s HEJ included a report on the first ‘half’ of a roundtable event held in March at which two IHEEM Past-Presidents – Greg Markham and Lawrence Turner, and the Institute’s current President, Pete Sellars, got together at De Morgan House, the home of the London Mathematical Society, to discuss six key topics – from how the role of the healthcare estates manager/healthcare engineer has changed, to whether the benefits of PFI-built healthcare facilities outweigh the bad. HEJ editor, Jonathan Baillie, chaired the discussions, and here reports on the second ‘half’ of an interesting debate.


In the first 45 minutes of a wide-ranging discussion during which the three participants debated some key 21st- century issues for healthcare estates and healthcare engineering professionals, and reflected on their time as President, the focus was on the first three of six questions which it had been decided would form the event’s focus. These were: n What have been the key changes in the role of the healthcare engineer over the past 3-4 decades, and has the job become easier or more difficult?


n What impact has the considerable reduction in the size of the central NHS DH ‘Estates’ resource had on the healthcare engineer’s role, and where can such personnel now get good guidance and expertise?


n How can the profession best tackle the lack of incoming skills, against a backdrop where many experienced and knowledgeable personnel are close to retirement?


In the roundtable’s second ‘half’, participants moved to debate the final three questions: n What major challenges and issues do the panel anticipate will confront


healthcare estates teams over the next two decades, given changing technology, the growing use of telecare/remote care, and clear intentions to move a lot of healthcare out of acute hospital settings?


n Has PFI been a ‘good or a bad thing’ for the construction of new facilities and the maintenance of a fit-for-purpose estate?


n Is there now sufficient encouragement for women to enter the healthcare estates management/healthcare engineering profession, and what can members of IHEEM and other professional institutes do to increase the number working in the field?


Looking to the future


The first question discussed by ‘panel’ in the debate’s second ‘half’ (and the fourth overall) related to what major challenges and issues the three participants anticipated would confront healthcare estates teams in the short-to-medium term. The first participant to speak was Pete Sellars. PS: “Firstly, telecare and telemedicine will ultimately have a huge impact on the healthcare estate, but as yet I don’t


The four participants at the start of the event. Lawrence Turner


Pete Sellars Jonathan Baillie Greg Markham


Changing care locations GM: “I think the acute setting will become even more acute, because you will be really poorly before you have to come in to hospital. Telemedicine will be used to help keep people healthy for longer, with minor interventions to maintain their health; and the new diagnostic capabilities and technologies are already proving themselves. Think back 15 years of the elaborate equipment you needed just to take blood pressure readings, while a preoperative assessment nearly always meant a hospital appointment. Now a ‘wearable’ on your wrist can do much of this. Take it a few steps further, and the medics are talking now about endoscopy no longer being required because you can swallow a pill which will do a full 3D scan as it passes through you. The endoscopy unit will still be required, but the cases it deals with will be more acute. As for scanning and imagery, we’ve got MRI scans, CAT scans, and we are now going to lithotripsy and proton beam therapy; that’s a massive, engineering undertaking, a real specialism that simply didn’t exist a decade ago.” JB: “Presumably quite a lot more for estates people and engineers to get their heads around, which in many ways


June 2018 Health Estate Journal 19


believe anybody fully understands what that impact will be. However, with technology changing almost daily, I think we will see more intense, hi-tech diagnostic clinical healthcare systems regionally and nationally, and a shift to non-diagnostic healthcare being delivered in a different way. I think Lord Darzi first introduced the concept, 10-12 years ago, of moving acute care to primary care settings. It’s still being discussed as part of the major transformation plans being considered, but you have to weigh it up in terms of clinical governance. It’s one thing to move all this care out, but you still need that specialist care available locally to deliver a safe model.”


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