Estates & Facilities Services Seminars

Amid considerable resource pressures, and ambitious sustainability targets, sustainable waste management stands out as both a key opportunity as well as a formidable challenge for NHS Trusts.

This presentation outlines practical steps for NHS Trusts to effectively meet sustainability targets while realising cost savings, drawing on a strategy of efficiency through rationalisation, innovative practice, and technology.

The presentation will explore strategies focused on:

1. Holistic Efficiency Overhaul: Encouraging a shift from conventional waste management methods. Identify practical, innovative practices that streamline operations, increase waste segregation, and reduce costs, focusing on sustainable approaches.
2. Sustainability at its Core: Integrate environmental best practices into daily operations through auditing and behavioural change programs. Encourage Trusts to set realistic recycling targets aligned with national sustainability goals. Adopt waste management technologies that enhance efficiency and reduce environmental impact.
3. Strategic Positioning in Healthcare Innovation: Embrace innovation not just for operational efficiency but as a driver for sustainability. Trusts can adopt state-of-the-art waste management solutions, positioning themselves as adopters of progressive healthcare practices, utilising generated waste as a valuable resource and asset.

The presentation looks at how Lean Thinking principles are applied to Construction projects in Japan, enabling faster and cheaper project deliveries; examines how collaborations simplifies the construction process and leading to higher quality; and how to identify wasted efforts and processes that generates little value but clogging up the Project Management System.

The presentation also explore the Lean management thinking and philosophy in the Quality Function Deployment of project management

Panellists in this session are:

Emma Clyne, Principal Category Manager- NHS Shared Business Services

Henry Loo, Capital Project Manager- Lewisham & Greenwich NHS Trust

Delivered as a collaboration between Airedale General Hospital, Curtins and Hive Projects, during this session participants will learn about RAAC; its behaviours, risks and mitigation using Airedale Hospital as a key case study.

RAAC was typically used in hospitals from the late 1950s to 1990s. Unlike standard and dense concrete, the aeration in RAAC makes it relatively weak with an estimated design life of around 30 years. Analysis has since reported that it is prone to excessive deflections, and instant failure. In 2019 SCOSS issued an alert for buildings containing RAAC, after the collapse of roof planks in a school.

In recent years Curtins have acted as one of the UK’s leading engineers appointed to inspect and recommend appropriate mitigation. They have advised a number Trusts across the country, including those on the NHP programme, to provide practical solutions to allow the continued safe running of the estate. Their experience has enabled them to contribute to the IStructE’s guidance on RAAC roof planks, and they have been working with BRE and Loughborough University to analyse planks removed from Aintree Hospital and Airedale Hospital.

Participants will learn about the process of identification and assessment, structural design considerations, practicality of solutions and examples of remediation. As not all RAAC used in construction is obvious or recorded, engineers will continue to be essential to identifying and providing advice over the coming decade.

Potential solutions will be shared, based on real-life projects delivered by Curtins’ engineers identified on the IStructE’s RAAC Approved List, and representatives from those involved in the Securing the Future Programme of Work at Airedale NHS Foundation Trust.

The presentation will also consider the legal requirements of building owners / occupiers and how climate change and increased extreme weather can contribute to the failure of RAAC.

Implementing an energy dashboard across hospitals can save energy in several ways:

Real-time Monitoring: Energy dashboards provide real-time monitoring of energy consumption across various hospital facilities. This allows facility managers to identify areas of high energy usage and take immediate corrective actions, such as turning off equipment that is not in use or adjusting HVAC settings.

Identifying Energy Inefficiencies: By analyzing data collected by the energy dashboard, hospitals can identify energy inefficiencies and areas where energy is being wasted. This could include inefficient equipment, poorly insulated buildings, or outdated lighting systems.

Setting Energy Goals: Energy dashboards allow hospitals to set energy-saving goals and track their progress over time. By setting targets for energy reduction, hospitals can motivate staff to adopt energy-saving behaviors and implement energy-efficient technologies.

Behavioral Changes: Energy dashboards can raise awareness among hospital staff about energy consumption and encourage behavioral changes to reduce energy usage. For example, staff can be reminded to turn off lights and equipment when not in use or to use energy-efficient practices in their daily routines.

Equipment Optimization: Energy dashboards can help hospitals optimize the performance of their equipment. By monitoring equipment in real-time, facility managers can identify maintenance issues or inefficiencies that may be causing excessive energy consumption and take corrective actions to improve performance.

Predictive Maintenance: Some advanced energy dashboards use predictive analytics to anticipate equipment failures before they occur. By identifying potential maintenance issues early, hospitals can avoid costly breakdowns and ensure that their equipment operates at peak efficiency.

Benchmarking and Comparison: Energy dashboards often allow hospitals to benchmark their energy usage against similar facilities or industry standards. This comparison can highlight areas where the hospital is underperforming and provide insights into best practices for energy efficiency.

KPI management: Key Performance Indicators (KPIs) for assessing the effectiveness of energy management initiatives in hospitals. These include tracking total energy consumption, energy intensity normalized by hospital activity or size, managing peak demand to avoid costly charges, monitoring energy costs against benchmarks, etc

Financial Savings: Ultimately, saving energy translates to cost savings for hospitals. By reducing energy consumption, hospitals can lower their utility bills and allocate those savings to other areas of patient care or facility improvement.

Overall, implementing an energy dashboard across hospitals provides a comprehensive solution for monitoring, analyzing, and optimizing energy usage, leading to significant energy and cost savings while also contributing to sustainability efforts.

Panellists in this session are:

Richard Burgin, Estates Projects Manager - RAAC- Airedale General Hospital

Andy Buckley, Design Director- Curtins

Oliver Organ, Team Leader

Chris Waine, Project Director- Hive Projects

Arun Sebastian, Project Manager-Capital Delivery- The Royal Wolverhampton NHS

Eastbourne District General Hospital is the first hospital in the United Kingdom to be exclusively heated by renewable energy. In a landmark project the Trust, in collaboration with the Carbon and Energy Fund (CEF), bid for and won £28million from the third phase of the Salix Public Sector Decarbonisation Scheme to deliver an ambitious energy overhaul of this 1970s acute hospital. The project had two key aspects; significant overhaul of the entire building fabric and conversion from steam to a multistage air source heat pump system, supported by solar photovoltaics. Ahead of project commencement, the Trust on recommendation from the CEF installed heat meters on every heating circuit in the hospital, which for the first time ever has enabled the impact of a holistic approach to thermal improvement to be quantitively appraised. This presentation will present the data analysis to date, which is anticipated to show a much improved case for holistic fabric improvements compared to a piecemeal approach that may influence future capital spend on energy projects.

This presentation will provide the latest summary and learnings from this landmark project and an opportunity for questions and discussions with the presenters.

The presentation will report on the outcome of a large multi-disciplinary study which was carried to support the Estates teams at two NHS Trusts (UCLH and Barts Health) in looking at the efficiency and energy reduction of hospital theatres. Using support from UCLP through the Greener NHS initiative, the team worked on two activities

1. Rethinking the Operating Theatre Suite: led by Dr Anne Symons UCL (Healthcare Architect)
2. Operating Room Ventilation: Turn it down, Switch it off: led by Professor Ian Eames UCL (Mechanical Engineer).

The aim of Project 1 was to be able to select suitable operating theatres in the trusts where trials could take place. It involved visits and studies to various hospitals within the trusts and in Germany and the Netherlands to study not only the ventilation systems but to see what effect the layout of the theatre suite had on net zero and saving energy. Project 2 supported by Professor Duncan Wilson, CASA, UCL and student teams working with Professor Ian Eames, collected and analysed data in relation to the ventilation systems through sensing the systems and taking information from BMS Systems. The academic team were supported by a medical team led by Consultant Paediatric Anaesthetic Consultation Dr Jonathan Groome, Barts Healthcare and GASP (Green Anaesthesia) whose aim was to reduce energy costs within Barts Health. Lindsay Muirhead from UCLH Estates Department led the sustainability team.

All estates teams in the participating hospitals provided expert technical information that permitted the team to examine the efficiency of the theatres from the perspective of (a) how the space is used, (b) how the space is configured, and (c) the type of ventilation. Three types of ventilation: Traditional – Turbulent Flow, Ultra Clean (Laminar Flow) and Temperature Controlled (Avidicare :Opragon). Currently temperature-controlled ventilation is not included in HTM 03 Specialised Ventilation. The presentation will report on energy estimates and savings, how to use BMS data for energy costs, and share the best practice and experiences that already exists across the NHS estates teams.

Panellists in this session are:

Steven Heape, Programme Manager- Carbon and Energy Fund

Anne Symons, Healthcare Planner and- Bartlett School of Sustainable Construction

Healthcare estates face an impending perfect storm with regard to ventilation. On the one side a Greener NHS looks towards a rapidly approaching roadmap with regards sustainability. On the other ERIC data is showing a £11.6Bn maintenance backlog and indications centrally there is unlikely to be an increase in budget allocations. Natural ventilation using outside air is the preferred method under HTM 03.01. Today, in many city areas, this natural air can be heavily polluted with PM2.5 and VOC’s. These pollutants can increase mental health symptoms, such as aggression and violence, whilst also directly affecting patient outcomes, particularly in relation to cardiac and respiratory areas.

HTM 03.01 is carefully thought out innovation and good practice. This talk is aimed at exploring innovative approaches enabled within HTM 03.01, with a view to helping mitigate risk without significant capital spend or energy overheads.

Dorset County Hospital (DCH)NHS Foundation Trust has opened its newly refurbished Outpatient Assessment Centre at South Walks House in Dorchester. This clinically led model of care provides health on the high street for outpatient appointments and diagnostics testing resulting in:

• Reduced waiting times
• Patients receiving the right care and treatment more quickly
• Clinicians across different specialties can work together to find the best treatment options for patients
• People are signposted to the services they need on the day, so they can see the healthcare professionals they need at the same appointment
• Patients can access a wealth of health and wellbeing information and advice on-site to support their treatment
• Alleviates pressures on the main DCH clinical site

DCH (along with University Hospitals Dorset NHS Foundation Trust and Dorset HealthCare University NHS Foundation Trust) is a healthcare partner of the Dorset Integrated Care System (ICS) working with two local councils, other NHS services and the community and voluntary sector to address local health, wellbeing, quality, and financial challenges across the county.

In November 2021 a pop-up Outpatient Assessment Centre was created operating out of the ground floor of the former council offices in South Walks House which had been unoccupied since the start of the COVID pandemic due to the consolidation of the council’s office requirements. This consolidation provided the NHS with a unique opportunity to re-purpose the space as it was in a prime location, close to both the high street and the hospital with excellent transport links and facilities, was convenient for patients and staff, and ensured a positive experience by avoiding the need to visit an acute hospital setting unless necessary. This temporary measure to tackle NHS waiting lists was created as part of a partnership between NHS Dorset, Dorset HealthCare, Active Dorset and LiveWell Dorset.

The Trust received more than £14million from the NHS England Elective Recovery and Community Diagnostics Programme to transform two floors of South Walks House into permanent clinical space after signing a 20-year lease with Dorset Council. This funding has been used to expand and enhance the centre. There are now two floors of dedicated clinical space that will allow the Trust to run more outpatient clinics and offer diagnostics appointments (such as x-rays and scans), as well as day case local anaesthetic procedures and general health and wellbeing services.