Dr Melvyn Langford C.Eng, MIMechE, MCIBSE, who worked in the NHS for nearly 40 years, including as an estates and facilities manager at several NHS Trusts, has written several previous HEJ articles on ‘systematic failures’ in the way maintenance of NHS healthcare buildings has been managed, and on what he claims is a ‘fundamental flaw’ within the national guidance for backlog maintenance (see HEJ – November 2009, September 2010, and September 2011).
Here he outlines the conclusions of a recent three-year research project, which he says strongly suggest that that the service’s continuing use of fixed yearly budgets, and a lack of sufficient monitoring, may be resulting in what he dubs ‘a catalogue of systematic failures within most organisations that are generating risk profiles that expose patients, visitors, and staff, to unacceptable levels of risk’.
The problems associated with the managerial systems employed by estates departments throughout the National Health Service (NHS) have been the subject of a number of related articles1–3 that I have written for, and had published in, Health Estate Journal over the past three and a half years, and relate to my research in association with Loughborough University. The common theme binding all of these articles is what I believe is a systematic failure over a number of years of those responsible for the delivery and monitoring of the maintenance activity within healthcare buildings and estate; a responsibility which goes far beyond a single hospital estate department’s managerial role. I have also made clear my belief that the current debate surrounding the ‘fundamental flaw’ within the national guidance for backlog maintenance (on which this Journal was the first to publish), should be expanded, to address these demonstrable managerial failures within the healthcare maintenance system as a whole. I feel that this review can only be (and must be) successfully led by Department of Health estates professional advisors. Failure to act will, in my view, be to condone intolerable risks being generated that are exposing NHS healthcare organisations, patients, visitors, and staff, to unacceptable levels of risk, such that, should an incident occur, then it is probable that the organisation and/or staff concerned would be at direct risk of prosecution.
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