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NHS estates teams need to “put an end to pushing repairs down the road”, a senior NHS estates official told the Healthcare Estates conference in Manchester last month. 
© Alamy
© Alamy

04 November 2019 |  Herpreet Kaur Grewal

NHS estates teams need to 

“put an end to pushing repairs down the road”, a senior NHS estates official told the Healthcare Estates conference in Manchester last month. 

Simon Corben, director and head of profession, NHS Estates and Facilities, NHS England & NHS Improvement, told delegates that The NHS Long Term Plan, published earlier this year, acknowledged that much of the NHS estate is beyond its shelf life and this was “a positive realisation”.

He said: “We are now tracking the disruption to clinical services caused through infrastructure failure, [such as] the potential failure of a 45-year-old cable [that] could and will mean millions saved in the event of failure. These costs become secondary when you then consider the impact that this has on patients, friends and family to the disruption to their care.” 

The new approach and language is clearly getting “significant traction” as the government had announced an extra £1 billion of capital funding this year and there was potential for more to come. 

Corben added that “tracking failures in infrastructure is difficult” partly because they are fixed so quickly but he said that the “accumulated effect that these disruptions are having on staff and the service is significant” and he stressed the need to continue to track them so the case for more funding could keep being made. 

NHS estates staff were working towards “the government’s net zero-carbon targets” and that it was “important that we focus our efforts throughout our operations on achieving a positive impact”. 

He added that as a profession the Estates Facilities Management community has been “exceptional in the space, with year-on-year savings being realised and the unwarranted variation reducing by almost 30 per cent”. The challenges now, however, are “reducing the non-clinical space down from 35 per cent to 30 per cent”.

Technology would also make “a major contribution” to reaching the Carter report target. [Lord Carter’s review of hospital efficiency set out how the NHS could make savings.]

“We have seen through the model hospital that quality data and national oversight allows us to make improvements in the way that we work. It also allows us to explain, by way of a simple table, to others not close to the estates, what we do and how well we are doing it. The next natural step is to go a level further and link on-the-ground operating systems together, so that we can understand the impact of failure and also by drawing that up to a national level, gain improved oversight and feedback to some of our major suppliers on common faults,” he said.

Fire alert

Graham Ware, fire safety consultant at property consultancy Pennington Choice, told delegates that NHS estates teams must learn and enact vital lessons about fire safety from the Grenfell Tower fire.

The “big” lesson that NHS estates teams could learn from Grenfell was compartmentation problems.

He said: “NHS trusts have big issues with compartmentation. It’s usually [an issue that is] hidden away and not seen on a daily basis.”

Compartmentation means having specific areas called ‘fire boxes’ that make an area resistant to fire and smoke. At Grenfell it was the basis for the widely criticised ‘stay put’ policy, which meant people did not escape by leaving their flats but stayed in their homes expecting the spread of the fire to be contained.

Ware said: “Hospitals and healthcare establishments are unique in that we have lots of people occupying the building that are not able to get out on their own. So they need protecting and if they need to evacuate, they need assistance from staff. We need to try our best to make sure they don’t have to evacuate; that is the key to compartmentation – containing a fire in a small area so it does not spread elsewhere.”

He added: “Compartmentation is key to the ‘stay put’ policy in a high-rise tower block; it is also key to fire safety in a hospital because we need to protect people who can’t self-evacuate.”

Ware said the other significant lessons that NHS estates teams can learn from the tragedy was to make “fire safety a priority”. He said: “That is starting to happen. Perhaps in high-rise buildings that was not as prevalent as it could have been and in healthcare that was not as prevalent as it should have been for a number of years. Now that is starting to come to the top and that is a result of Grenfell. It is important that there is buy-in all the way up to board level; it must be taken seriously and appropriate resources must be put in to make sure they deal with fire safety issues in a hospital.” 

Emma Potter