Operational Delivery of the Healthcare Estate Seminars

Over the last few years, the Diversity and Inclusion Working Group has been looking at different aspects of this subject.  This year we have been looking at the "Inclusion Ceiling" - what that means to ensure that we have a diverse and inclusive workforce at the highest levels of our industry.  The session will explore different aspects from what we have heard.

Panellists in this session are:

Lucy Rowe, Young Persons & Diversity Lead, National Estates & Facilities Team- NHS England

Caroline Lowe, Workforce HR System Manager, National Estates & Facilities Team- NHS England

Duane Passman, Joint Chair, Diversity & Inclusion Group- IHEEM

Gareth Longley-Gammon, Member, Diversity & Inclusion Group- IHEEM

Kim Shelley, Joint Chair, Diversity & Inclusion Group- IHEEM

Midlands Partnership NHS Foundation Trust (MPFT) formed following the merger of two Trusts in 2018 which bought together numerous different estate data sets. As part of a review of those data sets in 2022, Medical Architecture were asked to assist the new organization in the development of an Estates Strategy for the North Staffordshire region.

Early investigations revealed that the existing estate was typical; with as many construction types, building sizes and levels of suitability and condition as there were buildings.

The Trust's database of estates information was shared for analysis with the architects who observed that a large quantity of very detailed estates information (such as six facet surveys) existed for each property. But missing was any useful context to consider how these properties related to one another, to the wider Trust estate and the population they served. Medical Architecture has worked with MPFT to develop a custom tool which provides that strategic overview.

The Estates Register tool consolidates all the Trust's available data sets and recasts the data, assessing each site against a defined list of criteria. This covers a range of aspects from clinical and functional quality to physical condition, environmental performance, and scope for development. Scores are assigned from A-D and presented in a legible single-page dashboard for each property, allowing a high-level strategic overview of its comparative value.

Adopting a systematic approach and considering each building as part of the wider estate has allowed MPFT to evaluate the characteristics of that estate in a more strategic manner. A team of appointed consultants, including healthcare planners as well as architects and engineers, have worked alongside the Trust to develop an assessment tool which can quickly define the effectiveness, the efficiency of service delivery, improved environmental performance, and value for investment.

The tool, and the process for its use, are systematic and scalable, allowing measured criteria to be reviewed and presented comparatively, so that headline principles are communicated graphically, and more effectively to Trust boards. This presentation will therefore look at the lessons to be learnt, and how these can be taken forward by other Trusts looking to develop a regional estate strategy.

Delivering Hard FM services through a single 'generalist' supplier is a common supply chain strategy, but that is not to say it is always fit for purpose. Partially completed planned maintenance programmes, a mounting backlog of reactive maintenance tickets and an alarming increase in the overall risk profile of the estate were persistent issues that plagued Central & North West London NHS Foundation Trust (CNWL)'s decision to outsource all Hard FM maintenance to a sole service provider.

Having experienced a repeated pattern of contractual underperformance, Quality Trusted Solutions (QTS) - a wholly-owned subsidiary responsible for the CNWL estates portfolio, saw that it was time to devise a lasting solution.

QTS engaged Hatching Ideas, a specialist provider of people and organisational development services, to support the design of a new kind of delivery model, one that would enable direct access to the best specialist engineering capabilities on the market - and bring about a greater degree of operational control.

QTS have established effective working relationships with a suite of service partners - each dedicated to the type of systems maintenance that formed their core business, whether it be Fire Safety, Water Hygiene, Electrical Compliance etc. Moving away from the traditional client/supplier hierarchy and towards a more collaborative partnership was essential.

This transformation project did not just involve supply chain and procurement - it also required a fundamental overhaul of people, processes and the technologies the Hard FM team would need to succeed in a more complex operational environment to improve delivery outcomes.

This presentation will be co-presented by Gill Stafford, CEO of QTS, and Rebecca Bridger, CEO of Hatching Ideas. They will cover their experiences of the programme which transformed the Trust's ability to deliver Hard FM services whilst ensuring that staff felt engaged with, and empowered by, the change.

Panellists in this session are:

Michelle Evans, Associate Direcotr - Capital, Midlands Partnership NHS Foundation Trust

Mark Nugent, Associate Director, Medical Architecture

Rebecca Bridger, CEO Hatching Ideas

Gill Stafford, CEO, Quality Trusted Solutions (Central and North West London NHS Foundation Trust)

This presentation summarises the results of a three-year study at the University of Cambridge in collaboration with the Cambridge University Hospitals NHS Foundation Trust. Hospital EFM departments play a critical role in ensuring the safe delivery of care. However, these departments are suffering from numerous challenges, such as limited financial resources, recruitment problems, a widening skills gap, the need for climate change mitigation and adaptation interventions, and an ever-increasing maintenance backlog. Effective flows of knowledge among EFM departments can enhance their capability to manage change and challenges effectively and efficiently. However, evidence from academic literature, governmental reports, and practitioner interviews highlights the absence of effective knowledge sharing among NHS Estates and Facilities Management (EFM) departments.

Our research aimed to examine the crucial elements affecting knowledge sharing among NHS EFM departments and comprised two studies: (i) a multiple comparative case study of seven NHS Trusts across England and (ii) a three-stage Delphi study involving EFM participants from various hospital types (acute, mental health, and community) and at different organisational levels.

The audience will gain insights into the distinct characteristics of EFM staff at different organisational levels, including their varying career backgrounds, essential knowledge requirements, and common challenges in the role. Additionally, we will highlight the critical collaboration enablers that should be taken into account when designing knowledge sharing channels across different hospital types and regions. Overall, the results highlight the need for customising knowledge sharing channels for different organisational levels and Trust types.

These findings provide NHS policymakers with an understanding of the fundamental principles of knowledge sharing for designing of cross-organisational and regional collaboration initiatives. Furthermore, the insights can support EFM practitioners in implementing and maintaining collaborative partnerships with other NHS Trusts.

2022 saw the publication of NHS England's first ever Estates & Facilities Management (EFM) Workforce Action Plan. The importance of developing a diverse, resilient workforce, building the next generation of EFM staff was highlighted but how prepared are NHS departments to deliver against this ambitious plan and to meet their strategic objectives?

Following an 'inadequate' rating of some services by the CQC in 2020, Sheffield Health & Social Care NHS Foundation Trust (SHSC) launched a new Strategic Plan which included a programme to review and develop the estate and facilities team. It was critical for the Estates & Facilities (E&F) Directorate to ensure staff had the right capabilities and support in place for the new plan to have a chance of success; however, it was unclear if some the challenges they faced were due to issues with competency or a lack of capacity in staff.

The E&F leadership worked closely with organisation development specialist Hatching Ideas to engage staff, producing a detailed capability review of the department which informed the Trust leadership of actions and additional support required. The report was subsequently endorsed by NHS England as an example of how Trusts should be looking to grow, develop and retain their workforces.

Capability Reviews are likely to form a key starting point of any department's response to the NHSE EFM Workforce Action Plan - understanding the starting point for change, whether staff feel engaged and equipped for the change ahead and if the leadership has the capability to deliver the strategic objectives of the Trust.

This talk will be co-presented by Pat Keeling, Director of Strategy at SHSC, and Rebecca Bridger, CEO of Hatching Ideas, and will cover their experiences of an engagement programme that resonated with staff and helped to safeguard the Trust's ability to deliver exceptional EFM services.

Panellists in this session are:

Carl-Magnus con Behr, Doctoral Research, University of Cambridge

Pat Keeling, Director of Strategy, Sheffield Health and Social Care NHS Foundation Trust

Rebecca Bridger, CEO, Hatching Ideas

Being an Authorising Engineer for Lifts is a vital role responsible for providing advice and assistance to NHS Trusts to ensure the safe operation and good management practice of elevator systems.

This role demands expertise in lift engineering, encompassing design, installation, maintenance, and regulatory compliance.

The role will incorporate the annual management auditing of the Trusts Lift Management systems. This audit will cover:

• Management of Lift Maintenance.
• Meeting records.
• Method statements.
• Risk assessment
• Communication.
• LOLER Compliance.
• SAFed inspections.
• Identify Training requirements

The Authorising Engineer will also assess the competence of the Authorised Person for lifts, providing a recommendation to the Designated Person.

Annual equipment audits are also carried out by the Authorising Engineer,  with reports being produced on their condition, compliance and life expectancy.  This will allow budget planning for projects to be realised.

Technical advice and design team assistance can also be provided by your Authorising Engineer in relation to lift projects.

PFI contracts and their success have been contentious and at times divisive, so managing their expiry over coming years represents both a challenge and opportunity in order to achieve positive outcomes.  Having a plan in place, benefitting from other's experiences, managing stakeholders successfully, de-risking the process, whilst decarbonising and maintaining the built environment and ensuring continuity of service provision are all key elements of the flight path to expiry and beyond.

Panellists in this session are:

David Smith, Director, ILECS Lift & Escalator Consultants

Matthew Vickerstaff, Deputy CEO & Head of Project Finance, Infrastructure & Projects Authority