05 November 2018 | Herpreet Kaur Grewal
The running of NHS estates are disjointed and require a lot of work, reports Herpreet Kaur Grewal.
The amount of innovation, research and development put into running National Health Service estates in a more joined-up and efficient manner is "woefully light", delegates at the Healthcare Estates conference heard last month.
Simon Corben, director and head of profession, NHS estates and facilities efficiency and productivity division, told attendees: "From an infrastructure point of view, the way a patient travels through the estate is broken."
He said thought had to be given to this area "on a system-wide basis".
Corben, speaking as a part of a panel discussion at the Manchester Central Convention Complex, said: "We all relate back to personal circumstances and you can see inappropriateness. You can see people wanting to give the very best of care to patients in inappropriate environments.
"We talk a lot about patients but I think it's important that we understand staff as well. If one-and-a-half million staff are working in pretty low-rate facilities that has a huge impact on motivation and retention We really need to innovate [to address these matters]."
He said that often, clinical strategies are given too much thought (clinical strategies are generally designed to improve clinical outcomes and patient experience) when they move forward and develop so quickly.
"We need to be more innovative in our facilities. We get hung up on clinical strategies... I think what we have to do is look at the system and bring the system together and understand what is right for the demographic."
Corben added that more funds had to be specifically earmarked for innovation.
Nick Hulme, CEO of East Suffolk and North Essex NHS Foundation Trust, who sat alongside Corben, said: "You cannot manage a healthcare system with your hands tied behind your back in terms of your estate. And we have so much more estate not within our control, either in terms of maintenance and flexibility - crucially the flexibility of use.
"The relationship between us and NHS property needs to change so that we have much more direct influence and accountability and have levers we can pull in terms of change The status quo of that relationship is that there is a hand or one-and-a-half hands tied behind our back."
Rose Gallagher, professional lead for infection prevention & control and RCN lead for sustainability for the Royal College of Nursing, also on the panel, said: "The relationship between engineers, estates staff and clinical staff is really important I have spent many hours clamouring around with estates staff in various ventilation units to understand how systems work."
She added: "I would suggest that if you work in an NHS acute facility that there is an option to make sure this work is built into the system's timetable. It's absolutely essential; you cannot run operating theatres without making sure the ventilation is working properly."
People should be encouraged and helped to have relationships with estates staff, she said. "It works in my world of infections and prevention control because we need to understand water, heating, ventilation, but that doesn't mean it's a part of the world of board managers or even operating theatre managers because they are very focused on what they have to deliver."
In the government's response to Robert Naylor's review NHS Property and Estates: Why the Estate Matters for Patients, published in March 2017, it said it would improve the professionalisation of the NHS estates and facilities workforce. It concurred with the review's "primary conclusion that the NHS must manage and use its estate more efficiently and strategically".
A strategic estates planning service would be created, it said, to support Sustainability and Transformation Partnerships and build capability to invest in training and developing the estates and facilities workforce.