Repositioning IHEEM takes priority

Q What are your three top priorities as IHEEM president?

A My three top priorities are related to repositioning the Institute – introducing and developing a business structure capable of taking iniatives forward quickly; increasing Institute membership; and increasing the influence of the Institute.

Q At this year’s IHEEM annual general meeting, you indicated that you were going to adopt a sleeves-rolled-up style approach to the presidency and encourage members of the Institute’s Council, and others, to direct to you to dealing with key tasks. How is this approach working?

A I certainly want to be active. The strength of this Institute is in the membership, and it is through the regional committees and branches that the Institute maintains high standards and transfers best practice. These are two essential requirements of the healthcare environment. I want to support their efforts in whatever way I can and that starts with listening. There is a high level of commitment from the branch committees which connect with the membership at large. I, together with other Council members intend to meet them formally within the next couple of months and get closer to their issues. By considering strengths, areas for improvement, opportunities and threats we will be able to move forward to develop a strategy for the future.

I have visited the Welsh Conference and the Northern Ireland Conference, and I will be attending the Scottish Conference and, of course, this year’s Healthcare Estates Conference and Exhibition being held in Harrogate in November. I will be attending a couple of Council’s sub-committee meetings.

Q With the disappearance of NHS Estates, is there a significant opportunity for IHEEM to increase its standing, at the highest levels, as a lobbying and influencing organisation?

A Increasing our influence must be one of our aims. The restructuring of the NHS Estates as the Estates and Facilities Division within the Department of Health will give us opportunities as the division will have a greater policy-making role. For example, the division will now be commissioning services once carried out NHS Estates. It is important that we as an Institute take advantage of this situation and I suggest that we need to offer our services to the DoH Estates and Facilities Division as a provider of specialist healthcare specific services.

This will be particularly important when considering the consultation, re-writing, and distribution that is involved with design guidance documents and specifications. I think we are well placed to carry out this work for and on behalf of the new DoH Estates and Facilities Division.

I believe that there remains a cultural connection between the Institute and the new NHS estates organisation due to the number of our members who work within the NHS. Of course, we also have a significant number of members drawn from the private sector. Our membership profile will allow us to offer experience and best practice advice gained in both public and private sectors and hence, with a huge knowledge of specialist areas, we can be a provider of healthcare intelligence. I am sure this intelligence will be seen as a valuable commodity and therefore useful to the DoH. Subject to the seeking views of the Institute membership, we will also be looking to reorganise our structure at national level to enable us to take advantage of more commercial activities. I think our intentions to restructure, and our intelligence base, will form a sound platform from which we can increase our influence.

Q Are IHEEM activities adequately reflecting the increasingly mixed economy seen in healthcare provision?

A The UK is probably at the forefront of healthcare procurement models with PFI, ISTC, P21 and LIFT. I think that the changing face of healthcare is the major reason why the Institute has to change.

The introduction of the private sector I see as an opportunity to gain new members as well as creating career opportunities for all healthcare facilities professionals. I think the important issue is to make sure that engineering standards do not fall. It is a shame, of course, that the NHS Estates guidance in the form of HTMs and HBNs has not had the necessary funding to keep it up-to-date. I think that had the guidance documents been regularly updated through an on-going re-write programme there could have been less prescription embedded in the documentation which would have allowed innovation.

The worst situation is where we have no up-to-date guidance, untested innovation and no design or operational validation. The reason for the prescriptive standards in the first place was to ensure consistency of quality which gave confidence that issues such as resilience, system effectiveness and safety were well thought through.

We are, after all, looking to ensure the well-being of the general public in our facilities. I think that IHEEM will have a role to play in helping the Department of Health Estates and Facilities Division to maintain standards.

Work that has been done on the Institute’s organisational structure will help to provide a platform to allow us to become more commercially involved with guides and standards.

Q How can the experience of senior healthcare estates and FM personnel be better used as plans for the hospitals of tomorrow are progressed?

A I have always shied away from trying to make visionary statements on the “hospital of the future” solution.

This is because I believe it is linked to changing public health attitudes to health, new drug development, the digital revolution, innovation in clinical and surgical procedures, the management of chronic illness and the extension of the hospital to the home.

There are so many variables there that it would be a brave person who could see the ideal model for future healthcare and wrap it up into a facility.

I think the only thing that is assured is that things are going to change on a short and regular cycle and therefore the facilities we currently have, and have yet to build, will need to be extremely flexible in order to accommodate the inevitable changing face of healthcare.

The whole issue of designing and managing facilities for change is where our senior members have a role because, of course, they will have been involved in ongoing development of sites.

They will have encountered the requirements for changing facilities, the stumbling blocks associated with poor planning, the risks involved in failure, stretching infrastructure to its limits, managing estates on diminishing budgets, the development of infrastructure enabling works strategies, the logistical problems of decant strategies and, importantly, the associated costs.

This is why we must value our experienced members to ensure these characteristics of change are thought through and evaluated. Perhaps we should formulate a steering group of senior members to consider publishing a document titled Accommodating flexibility in healthcare facilities.

Any volunteers?

Q Should IHEEM be increasing its ability to advise on topics ranging from specialised engineering issues to asset management and estate rationalisation?

A I think that the Institute should be advising on all the aspects that are specific to healthcare design and estate management.

This includes some of the crossovers between engineering and architecture. Having been involved in the design of many different building types I must say that I think an acute hospital is the most difficult facility to design as it requires a wide breadth of multi-disciplinary knowledge.

Engineers and architects need to work extremely unselfishly to ensure integrated and co-ordinated solutions are achieved. Both sets of professionals need to understand and respect the constraints that each are faced with and this is particularly the case when innovation is required.

When we bring infection control into the equation we find another vocabulary that engineers need to become familiar with and I do think that in the future we will be looking to develop a specialist discipline of engineering microbiologists.

Last year my predecessor Richard Nugent chaired a gathering of Architects for Health in London. The topic was infection control and involved a number of presentations by engineers, architects and microbiologists. There was standing room only in the lecture hall and the multi-disciplinary nature of the event was extremely enlightening.

I see this holistic approach as a future direction for the Institute.

Q How can IHEEM move further towards expanding its membership base and yet retain influence in its representation of the interests of healthcare engineering?

A There is no doubt that the environment within which we are operating is changing. The Institute will have to change at a faster pace than the business environment to ensure we are ahead of any game that confronts us.

As in any business there are two fundamental ways of achieving growth, organically and acquisition. We will continue to grow organically through all our members promoting the Institute to their colleagues in the workplace; through the hard work of our membership management team developing links with private companies; through our main conference which is a marvellous vehicle to promote ourselves; through initiatives with universities to capture the interests of graduates early in their careers and finally through our public sector members promoting the virtues of membership within healthcare procurement processes to ensure that tendering private sector contractors appreciate the value of the Institute as the vehicle for transfer of best practice and innovation as exemplified by articles in our magazine, Health Estate Journal, and regional conferences.

The second opportunity for growth is through acquisition and although this represents a faster process it also brings into play the merging of cultures. The targeting of medical specialists, quantity surveyors, architects, healthcare planners, equipment specialists and scientists are all on the agenda as far as I am concerned, Everyone we target must be working within the healthcare field.

All options are worthy of consideration if it means that the Institute positions itself for a sustainable future by embracing the holistic nature of healthcare design, procurement and estate management.

Q What practical steps can IHEEM take to recruit more young members?

A Recruiting young members is a difficult problem because of the diminishing number of students entering engineering and seeking engineering as a profession when they qualify.

However, I think we need to be proactive and become involved in the universities to increase awareness among undergraduates and lecturers of healthcare facility design and estate management as a career path.

We should also welcome nonengineering based graduates, working in facility design and estate management, to become members once they have selected the health sector as their chosen career path. One very practical step to take is to have a young engineer on Council, and consideration is being given to this.

Q How can difficulties encountered in attracting graduates into the healthcare engineering arena be overcome?

A The diminishing numbers of engineering graduates coming through the system is causing considerable difficulties.

I believe we have had a few good years recently in which engineering graduates were in plentiful supply and in which they entered engineering after they qualified. Unfortunately, we now seem to be moving back to the early part of the decade when engineering graduates were being picked off by management consultants, financial services companies and investment banks because of the relevant competencies. Engineering graduates are logical, numerate and communicate well.

Engineering-based organisations are finding it impossible to match the starting salaries of the types of sectors mentioned above. Ideally what we need is an engineering graduate school that trains multi-disciplinary engineers for a career in healthcare engineering and a structure that offers them a career. I think that this is an issue which requires widespread consideration. We are among a number of institutes struggling with this question. Some innovation is needed.

Q Should IHEEM improve and expand its academic role?

A Education and training are two key reasons why the Institute exists. The CPD events are managed by the education committee, the regional committees and the branches as they are the guardians of our intellectual standards.

It may be beneficial for the Institute to become involved in the sponsoring of courses at some universities in specific healthcare related subjects. Modules in medical gas system design, sitewide infrastructure design and system resilience, health and safety issues involved in working within a live hospital site, design practice related to the therapeutic environment, and specialist ventilation systems used in healthcare facilities would all be useful modules in any university engineering course.

However, this comes at a cost and the benefit would need to be evaluated. I also like the idea of developing partnerships with existing training organisations. When I worked in an RHA I had the pleasure of visiting Falfield on a number of occasions and I learnt a huge amount from my visits there. I would like to think that we could develop those sorts of links again. One of the areas that we are considering developing is an Authorised Engineers voluntary register for medical gases. The work is being carried out by the education committee and we are looking for members with a special interest in this topic to help. We believe that this is an important step for the Institute and a valuable service for healthcare facilities managers.

Q How would you like to see the IHEEM branch structure evolve?

A The strength of the Institute is our members and branch structure. We have recently had a new structure approved by council that increases the number of branch members attending the council meetings to 12 from nine – therefore there will be no shared representation, and every branch will be able to voice opinions.

Q How important to IHEEM will be closer affiliations with other organisations?

A I think that closer affiliations with other organisations will be extremely important.

Considered could be partnering with academic institutions, training providers and professional groups which are involved in healthcare design and facilities management. In fact we should be open to discuss partnering with anyone who has healthcare as a main focus. I think it would be wrong to spread ourselves too thinly and move into other sectors – healthcare is what we do and what we are very good at. We must, however, ensure that we become an inclusive learned Institute for all disciplines because it is this approach that will ensure a sustainable future through membership growth and the harvesting of intelligence which would lead to a higher level of influence.

Q What administrative changes are planned to ensure the Institute is in the best possible position to deliver a wider range of services to an expanded membership?

A There are some administrative changes planned. One of the enforced changes is the replacement of our chief executive William Pym.

His retirement will create a void that we will find difficult to fill. As well as appointing a new CEO, we are also looking to recruit a business development manager who will enable us to focus on the market to increase our income. We have already employed a membership assistant to support the Portsmouth team.

Finally, we will be looking to create a private company to enable us to take advantage of commercial opportunities that perhaps we would have been reluctant to pursue as a learned institution. We will be seeking support from the members in the coming months to progress this initiative.

We are developing a competency framework as the basis for performance appraisals for all the headquarters’ staff and also introducing a salary structure linked to performance. We will be supporting structured training for staff based on career development and as highlighted in performance reviews.

Phil Nedin

Phil Nedin B.Eng C.Eng FIHEEM, MIMechE, MCIBSE, DipMgmt, was installed as IHEEM’s president at the Institute’s annual general meeting in May.

He has a varied engineering background and, for seven years, was employed by a Regional Health Authority where he gained valuable experience working with specialist air conditioning systems and other healthcare-specific technology. In 1988 he joined Ove Arup and Partners in its Cardiff office as a senior engineer. In his 18 years with the firm Phil Nedin has attained the position of its director leading the mechanical, electrical and public health group. He is also responsible for the Arup healthcare business which is a key area for the firm and which has a global portfolio of projects.

He has been lecturing at Cardiff University for the past 12 years and for the past four years has been involved in a final year multidisciplinary project which currently involves the design of a 50-bed healthcare facility.

In 2002, Phil Nedin completed a management diploma with the Open University. He is married with two children and in his spare time enjoys music, golf and rugby.