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HEALTH ESTATE STRATEGY


consultations across the healthcare sector. GP patients are now telephone triaged before being streamlined into ‘hot’ or ‘cold’ consultation facilities; community healthcare practitioners undertake remote consultations to patients using video or telephone conferencing, and outpatient appointments have been conducted in a similar way. It is increasingly likely that this model will continue in the future, and may ease access for people to primary and community care. The recent focus on extended opening hours for practices and ‘seven-day services’ to meet increased demand for out-of-hours access may become less important given that it is now possible for patients to access some clinical appointments remotely. In addition, back-office NHS functions have continued remotely, as staff have adopted home working, with virtual Board meetings, team meetings, and staff ‘one-to-ones’ becoming the norm. This could see an emergence of a remote working culture across the healthcare sector, with the improvement of work-life balance as previously highlighted.


l Lasting changes in how new NHS buildings are configured, as an increase in remote and virtual appointments could reduce the requirement for consultation space. While there needs to be equity of provision, and such facilities will need to cater for those who cannot, or do not ,have the ability to access the required technology, it is expected that the overall requirement for space where a patient will need to be seen face-to-face will be substantially reduced. There also needs to be consideration to how space can be developed that can flexibly adapt to any alternative future need.


l Much of the community health estate is tired, and requires refurbishment or replacement: in the 2018-19 ERIC Return, the community hospital estate reported a Critical Infrastructure Risk of £40.9 m.4


This figure excludes the NHS


Property Services estate portfolio, the majority of which is also community healthcare estate; nor does it include GP or social care estate – only half of GP practices report their premises as fit for present needs, and 85 per cent of the UK care home stock is more than 40 years old.5


The COVID-19


pandemic has required increased flexibility in the use of space, with community services space being utilised for primary care purposes, and vice versa.


Repeated efforts to move outpatient care closer to home in recent years could be an unintended beneficiary of new working


24


Screens being installed to health centre reception areas to ensure the safety of NHS staff.


practices, with increased focus on delivering care closer to the patient, and a much closer interface between primary and community care. This may foster improved collaboration between neighbouring healthcare providers, and see healthcare professionals rotating between buildings, with patients able to access multiple services online or within one local health centre. The estate will need to adapt to accommodate this, and it is therefore essential that backlog maintenance is addressed, and consideration given to the refurbishment and redevelopment of space to increase its adaptability and flexibility for a range of services. Space ‘ownership’ as a model, whereby one provider leases space and prevents another from using it, should be discouraged going forward, with the ability to share space an intrinsic part of this new model. l The lessons learned from COVID-19 pandemic management and emerging ICS structures are generating more willingness for different parts of the NHS to work as ‘one team’. This is likely to continue, and it is hoped that the close partnership working which has been fostered during the pandemic response will continue, with reduced ‘silo’ working, and more cross- system working to the benefit of the patient.


l The pace of acceleration of the pandemic has demanded the sharing of ideas, best practice, and discussion, both between counterparts and with industry consultants/specialists. The NHS needs to equip itself with specialists in their field, and Estates teams are no different. There has been increased availability of free CPD opportunities for estates professionals during the lockdown period, which needs to continue in order to sufficiently and effectively develop,


educate, and upskill NHS estates professionals. Supportive networking across NHS estates and facilities teams has never been so important.


Transformation The pace of transformation within the healthcare sector since the onset of the COVID-19 pandemic has been remarkable. Many of the barriers which have historically delayed the progress of developments, projects, and changing modes of service delivery, have been relaxed or adapted in the interest of preserving and enhancing the effectiveness of the NHS. This could lead to lasting change, whereby there is a quicker response from the NHS ‘centre’ to approving business cases, and a stronger justification for necessary changes that the NHS needs to make in order to create the ‘new normal’. It is perceived that the focus of attention will be as follows: l Increased attention on ‘fast-track’ procurement models given the high profile of the Nightingale hospitals


Use of signage to remind people to stay two metres apart.


IFHE DIGEST 2021


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