‘Never waste a good crisis’, delegates told

Addressing a sizeable audience in Harrogate’s magnificent Royal Hall on the opening day of the 2009 IHEEM national conference, the Institute’s president Rob Smith, who is director of Gateway Review, Estates and Facilities Division, at the Department of Health (DH), told delegates he believed public confidence in the NHS was currently “at an all-time high”. Having joined the service in 1986, when he recalled waiting times for hip and cataract surgery could be up to two and half years, he said today’s NHS deserved “huge credit” for, for instance, bringing down the time from initial GP referral to subsequent treatment to 18 weeks. While such trends were “extremely encouraging”, the growing public confidence resulting from today’s shorter waiting times, improved cleanliness, and more modern wards, was increasing pressure on estates and facilities management (EFM) personnel to “continue to deliver environments that reflect that confidence”. Although anecdotal evidence and his own recent experience suggested that the overall care environment was indeed improving, “and that patients were noticing the improvements”, Rob Smith pointed to the latest Care Quality Commission survey, which suggested that, in some areas, healthcare estates and facilities standards had recently “slipped back a bit”. One particular challenge, he believed, would be satisfying public expectations for single-sex accommodation in more and more healthcare facilities. Inevitably, with forecasts suggesting that the current economic climate will put further pressure on many public services over the next 3-5 years, Rob Smith warned that EFM personnel would need to be “increasingly innovative” in delivering high quality care environments, and in “demonstrating how it is possible to reduce the amount of money spent on the physical environment while continuing to maintain hospital buildings to the 21st Century standards patients and regulators now expect”. He cautioned: “This conference is taking place shortly after the release of the latest ERIC data, which shows, at just over £4 billion, a marginal increase in backlog in estates maintenance in English NHS hospitals at a time when we are seeing a downturn in available capital resources.”

PFI initiative ‘slowing down’

While the healthcare PFI initiative and the major hospital replacement programme in England now appeared to be slowing down, and the financial climate made securing funding for improvements harder, Rob Smith said Government, patient, and regulator expectations for the highest quality new healthcare environments showed no sign of diminishing. Coupled with the need to maintain buildings and facilities to a high standard and, wherever possible, to replace or renovate existing facilities, would be increasing pressure to improve effective utilisation and reduce the NHS estate’s carbon footprint. Ironically, at a time when most healthcare providers were striving to reduce their electricity consumption, many hospitals were installing ever more sophisticated diagnostic and treatment equipment which relied on electricity to operate. Reducing estates and facilities costs would inevitably, he believed, mean further reductions in the NHS estate’s footprint, necessitating an even greater focus on efficient utilisation of existing building stock. Despite the extent of the current challenges facing the sector, however – Rob Smith described a past project on which he headed a team as “far easier that my current role” – the IHEEM president told delegates now was “a fantastic time to be in estates and facilities management”. He said: “The current challenges require not only people with the best skills, expertise and knowledge, but equally a portfolio of sound, up-to-date estates information on which to base our decisions. We also need within our teams individuals with the tenacity and expertise to be able to articulate arguments and present data in a way that makes decision-makers sit up and listen.” Rob Smith moved toward the close of his presidential address with a reference to the recent Cabinet Office “capability review” of the Department of Health, which examined, among other matters, the existing workforce’s skills. The result of the review was, he explained, “a focus on developing leadership skills for the future”. He said: “We must recognise that it is incumbent on us all to review our teams’ competences and skills so that we can deliver the highest quality estates and engineering services.” One way to ensure skills were kept upto- date, he told the conference, was to harness the help and expertise, as well as the training and education initiatives, offered by IHEEM and its membership, adding: “Never has there been a better time both to be an IHEEM member, and to access the broad range of people the Institute’s membership encompasses, each with specialist knowledge and experience to pass on to colleagues as we enter a very challenging period.”