A BBC news story last month painted an alarming picture of the condition of the English NHS estate, with health reporter Nick Triggle citing Department of Health 2009/10 statistics suggesting that 17% of this occupied estate was “not functionally suitable for use”.
However IHEEM President Paul Kingsmore said the story largely ignored the past 10-15 years’ “pretty well unprecedented” investment in the NHS. He said: “Coupled to this, estates personnel are working hard to devise innovative initiatives to enhance the existing estate at a time of shrinking capital budgets. The entire sector is striving to maintain a safe, comfortable, and fit-for-purpose treatment environment, and such stories are unhelpful in reassuring patients that they can expect a positive hospital stay. The categories used in estates assessments are designed to be highlevel, broad-brush assessments to give boards a strategic view, and not meant to describe the estate in detail. The reality in many healthcare facilities is very different from the BBC’s grim picture.” According to Nick Triggle’s story, some patients are being treated “in cramped, unsuitable, and badly laid out hospitals, as ageing NHS buildings struggle to cope with modern health service demands”. “A host of major hospitals” were “among the worst affected”. To be deemed “not functionally suitable”, NHS buildings must have significant space, layout, and design deficiencies, alongside, for example, poor toilet and storage space availability. The BBC said some estates managers believed problems had been compounded by money earmarked for building improvements “too often being diverted elsewhere”. Among the “more serious problems” reported were “wards that are too small”, “poorly designed” A&E units”, “services spread across too wide an area”, insufficient single-sex accommodation, and “key wards too far away from essential services”. The BBC’s research uncovered 33 hospitals with 50% or more of their estate classed as “not good enough”, with another 109 NHS sites – mainly mental health units and community hospitals – having problems “on a similar scale”. The Department of Health responded: “The situation in the NHS regarding functional suitability has improved, but making further improvements through better use of existing assets will be fundamental to the NHS efficiency drive. It’s important to note that functional suitability does not relate to the safety of NHS buildings, and is under constant review. Trusts must seize the opportunity to make the best decisions for their patients, and decide locally on how to become more efficient. This includes cutting out wasteful spending, and focusing on patient outcomes.”
