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News archive - November 2018
The time for change is now
The healthcare estate is to change dramatically over the next decade, driven by new clinical pathways and innovation in medical devices and technology.
Delegates at the 2018 IHEEM Annual Conference in Manchester last month were given a snapshot of what the future will look like from a number of speakers.
Running alongside the Healthcare Estates exhibition; the two-day conference heard from a number of industry experts that flexibility will be crucial to the running of NHS facilities moving forward.
Simon Waters, head of technical advisory at Government-led Community Health Partnerships, said: “Good use of NHS infrastructure is critical for the delivery of high-quality patient care.”
But the current estate, and the direction of travel of some more-recent new-build and refurbishment projects, does not always enable services to operate in the most-effective way possible.
Sweating the estate
Jeremy Sneddon, director of project management consultancy, Provelio, revealed: “We need more-flexible working practices and if we can sweat that estate more, we will get more value out of the system.”
And he argued that many recent developments were out of keeping with the needs of the NHS.
He said: “Hospitals we are building are the wrong size.
“I’m not criticising PFI, but to have a large, fixed, inflexible estate in a massively-fast-moving system creates a massive challenge. We need to move towards smaller systems.”
Simon Boundy of Stride Treglown, added: “26 million square metres of NHS estate is not going to go away any time soon, but if we are going to deliver the efficiencies needed it’s going to be a key enabler.
“Capital investment is insufficient to fund transformation, so how we use the estate is going to be key moving forwards.”
And designing in flexibility will be crucial.
Boundy said: “The life of a building is typically around 60 years, but clinical services evolve more dramatically.
“The key is understanding the potential of the estate. The devil is in the detail.”
The publication of the Health and Social Care Act in 2012, and the recommendations in the Carter Review, have led to the realisation that the current healthcare system, which is mostly reactive, should switch to become more pro-active.
This approach means the creation of a new generation of primary care and GP facilities.
Under one roof
Known as health and wellbeing centres, integrated care centres, or locality hubs; these are characterised by the co-location of a large number of services under one roof, with GP surgeries often the cornerstone. These services include libraries, job centres, outpatient clinics, mental health teams, fire crews, the police, education services, housing, community nursing and children’s services, as well as charitable organisations.
Tim Kilpatrick of IBI Group said: “A few years ago we analysed 40 projects and found that 90% of healthcare buildings were taken up by health and care services. More recently, and looking at the pipeline of projects in development, we found it was just over 40%. This shows a major shift to linking health and wellbeing services.”
But delegates at the conference were warned that, while bring services together, these buildings were not necessarily integrating them fully.
And this will have to change moving forward if the NHS estate is to deliver operational and financial efficiencies.
Architect, Jonathan Wilson, of Stantec, said: “The key issue to solve moving forward is sharing space between the different providers as currently there are low levels of utilisation.
“We offer space on a square metre basis, but if the provider isn’t utilising that there’s often no way it can be shared.
“It’s not hard to do and these buildings won’t work without it.”
Waters added: “Utilisation of healthcare facilities is often around 30-40%.
“These are high-quality buildings, which are fully maintained, but for 60% of the time they are sitting idle.”
Another major influence on the healthcare estate over the coming years will be the emergence of new technologies.
Sneddon told the conference: “If you take any bit of equipment, it is getting smaller, and that means estates will get smaller as well.
“Hospitals of the future should be built flexibly as we could be repurposing space every five years as things advance and change.”
Another key discussion point at the conference was the pressing need for a new generation of qualified estates and facilities personnel, and IHEEM committed to a recruitment drive focusing on attracting new apprentices, as well as increasing the number of women and ethnic minorities in the trade.
During the two-day event, more than 2,000 people visited the conference and the exhibition.
And dozens of companies used the show to publicise their latest innovations. New product launches included IDEXX’s Legiolert for testing water for Legionnaires’ disease; Vanguard Healthcare Solutions’ latest mobile healthcare unit; and Static Systems’ latest improvements to the Aspire SmartSync wireless nurse call solution.