Dangers of not following a ‘systems approach’

Independent consultant, Dr Melvyn Langford C.Eng, FIHEEM, MIMechE, MCIBSE, discusses the premise that what he dubs the ‘poor managerial standards’ practiced by many NHS Trusts in relation to their estates departments are a result of them failing to adopt the NHS-recommended ‘systems approach’ to governance. The risk and hazard management specialist – who has worked in the NHS for over 40 years – says the key personnel involved ‘need the specific knowledge of the known fundamental failures within NHS national guidance to allow them to exercise their corporate governance roles’.

It is common for NHS local policies and procedures not to state the healthcare organisation’s risk attitude (tolerance, appetite) and risk criteria for the control and monitoring of the activities of its Estates Department. In parallel with these failings, it is normal for Trusts’ various working groups/committees not to actively and periodically compare the working practices of their maintenance department against the national standards required for the safe operation of their estate, and, equally, not to be aware of the fundamental flaws inherent within these guidelines, nor to understand that they are legally accountable on a joint and several liability basis for identifying, assessing, and controlling, risks. These shortfalls are considered to be so severe that when an untoward incident occurs, the Trust and/or its staff would probably be at direct risk of prosecution.

The reader must be made aware that although the scope of this article and the arguments presented are bounded by the subject of maintenance within healthcare premises, the fundamental flaws highlighted are purely managerial issues, and are thus applicable irrespective of the profession/topic being discussed.