Innovation and productive partnerships in asset management

This year’s Healthcare Estates event takes place in Manchester in October. The conference theme aims to tackle key topics in three streams: strategy and leadership; engineering and facilities management; and planning, design and construction. Health Business examines the three in more detail

Healthcare Estates, taking place on 10-11 October 2017, is attended by over 3,500 highly engaged, curious visitors with a passion for new solutions, technology and answers at the industry’s foremost event for the healthcare sector. It is the ideal event for meeting face-to face with industry colleagues, discussing the key issues within their sectors while finding out about latest technologies at this festival of ideas and discovery in the healthcare sector.

The show features six enlightening and challenging seminar theatres which focus on key areas in the healthcare sector – each zone offers free to attend theatres delivering specialist content and case studies, while exhibitors showcase a range of specialist products and services.

Steve Webb, Healthcare Estates show director, said: “Following recent events in the UK – a terrorist attack, the devastating fire at Grenfell Tower, and the NHS cyber attack – NHS estates and facilities directors are understandably concerned about their requirement to ensure corporate governance and assurance to their board. Healthcare Estates has gathered key figures from the NHS, including Simon Corben, past president of IHEEM, Paul Kingsmore, director of services at Manchester Metropolitan University, and Kevin Oxley, director of Estates, Facilities and Capital Planning at South Tees Hospitals NHS Foundation Trust, to discuss and consider the highly topical subject of corporate governance assurance and give their individual standpoints.”

The conference opens with keynote speaker Simon Corben, director of NHS Estates and Facilities at NHS Improvement, who will reflect on his first six months in office, and discuss the need for stronger and more robust corporate governance assurance, a subject that will be picked up in the panel discussion session that follows.

Strategy and leadership
There has been little real attention given to how the NHS estate could help to improve efficiency, move more care out of hospitals and exploit new technologies. The discussions in the ‘strategy and leadership’ stream look at how models of care are still designed around buildings, and asks whether re-thinking the way that the NHS uses its estate could catalyse change’.

The NHS workforce will require significant transformation across all disciplines to keep pace with the changing service and financial environment. The new national Apprenticeship Levy creates opportunities, but has significant cost and organisational implications alongside. Brighton & Sussex University Hospitals NHS Trust is pursuing a multi-dimensional approach to workforce transformation – creating coherent career development pathways for NHS staff, delivering sustainable pay cost reductions overall, and ensuring improvements in the quality and safety of patient care.

The need for workforce transformation is made more urgent by the £486 million redevelopment of the Royal Sussex County Hospital in Brighton, the first major stage of which opens in 2020. This will deliver a step-increase in capacity in clinical services known to have national and local supply-side/recruitment challenges, and significant changes in physical design (proportion of single rooms, size, layout of facilities), for which innovative approaches to staffing models and role design will be critical.

The ‘Efficiency in Workforce Development’ presentation, hosted by Duane Passman, director of 3Ts at the trust, will highlight the approach being taken and how it is being developed and implemented in practice. It will identify key learning points and the experiences of developing this programme in a dynamic and operationally-pressured environment whilst ensuring clinical leadership and engagement.

The Royal Liverpool University Hospital
The construction project for the new Royal Liverpool University Hospital includes an innovative sustainable communities programme. The programme consists of three key areas: reducing worklessness, local economic regeneration and community. Reducing worklessness includes targets for apprenticeships and work experience opportunities. One of the successes of the programme has been the upskill programme, which has supported long-term unemployed people through training to get the ‘construction site ready’.

Local economic regeneration has been supported through working with Liverpool in Work (the city council’s employment arm) to ensure that local businesses are aware of upcoming opportunities. Community regeneration has been supported through a programme of community volunteering, which has provided construction support for local charities. Carillion also provided £100,000 for a Liverpool Community Fund. Ian Stenton, the trust’s head of Sustainability will host this session alongside Carillion’s community regeneration manager.

John Simpson, ex-estates and facilities director at the Royal Stoke University Hospital, will also present in this theatre on ‘Mergers & Acquisitions - Lessons learnt’, providing a reflection on the 2014 acquisition and merger of Mid-Staffordshire NHS Foundation Trust and University Hospital North Staffordshire.

Engineering and Facilities Management
The NHS is not unique in finding estates and property difficult to manage, and this task is increasingly being outsourced. While all of this means that there are unexploited opportunities for improving value for money, perhaps the most important concern is that opportunities for new models of care are not being maximised and that the existing estate is an obstacle to innovation. There needs to be more ambition in the way the NHS estate is used. The current model of ownership and operation needs to be challenged and new methods of financing need to be developed that avoid the very significant downsides of PFI, in particular, the associated intergenerational transfer of debt.

As part of the ‘engineering and facilities management’ sessions, Malcolm Thomas will present a seminar on ‘Operating Theatres – The surgeon’s panel’. All operating theatres should have an information display colloquially known as the ‘Surgeon’s panel’, whose primary function is to bring together information on the operational state of the facility so that the surgical team can decide whether it is safe to commence a surgical case.

Traditionally these panels used coloured lights, meters and clocks that were hard wired on a stainless steel plate. Today most panels are touch screen with menu driven displays. While they have many advantages they can suffer from presenting too much information in a confusing way. Lack of clarity has resulted in surgery being undertaken when the ventilation was not operating or was in “Set back” resulting in increased infection rates. The Specialised Ventilation for Healthcare Society (SVHSoc.) have produced a paper that itemises the information that should be present on a surgeon’s panel and clarifies the method of display. Malcolm’s presentation will launch that paper and explain the thinking behind it.

There are a number of physical and biological tests described in HTM 03-01 for both validation and verification of critical ventilation systems. In conventional theatres microbiological sampling is required at validation only. However carrying out sampling at verifications can indicate where there are problems which can go unnoticed by normal visual inspections. Surely it is better to do simple active air microbiological sampling annually rather than wait until problems manifest in infection rates.

This second presentation, delivered by Jerry Slann, of the Institute of Occupational Medicine, will highlight the advantages of carrying out some additional tests during verification which the author believes to be invaluable to estates, infection control and users.

Overcoming financial barriers
The NHS is a highly energy intensive organisation with all trusts and foundation trusts spending over £560 million on energy each year. The installation of energy efficiency technologies is at the centre of the action to not only decarbonise the UK but also reduce energy spend for the NHS.

In this session, Mark Hogan, energy and environmental manager from Wrightington, Wigan and Leigh NHS Foundation Trust will be joining Salix to discuss the trust’s previous and current energy efficiency projects and how they have utilised over £2.6 million of Salix funding across their hospitals. Their projects include boiler retrofit economisers, replacing steam plate heat exchangers and heat recovery systems and are estimated to save the trust over £590,000 each year.

Salix Finance provides interest-free government funding to trusts and foundation trusts to improve their energy efficiency, reduce carbon emissions and lower their energy bills. Salix will draw on its extensive experience of funding over £48 million of energy efficiency projects in over 55 NHS trusts and foundation trusts across England to showcase best-practice examples of projects that provide quick paybacks on investment, creating both significant carbon and financial savings for NHS trusts.

Planning, Design and Construction
The third theme of the show offers a packed programme, focusing on Hopewood Park - Northumberland, Tyne and Wear NHS Foundation Trust’s exemplary new 122-bed inpatient facility for adults and older people. The redevelopment forms part of a wider scheme known as PrIDE (Providing Improved Mental Health and Learning Disability Environments) in Sunderland and South Tyneside.

The trust’s long-term strategic approach to managing and upgrading the estate infrastructure sets them apart. From the outset, each individual project was always undertaken with full knowledge of the wider context and future-proofed to be sustainable for the changing needs of the trust for years to come. The rest of the world has sat up and noticed, too; these award-winning developments attract international interest from those eager to learn.

This presentation will look back on the achievements of this partnership, including: the background to the Trust and the starting point of their estates redevelopment; the history of the partnership; the estate’s geography; the projects leading up to Hopewood Park; and the lessons learned.

Health service estate requires improvement and change on an on-going basis to meet the challenges of changing patient demand and financial constraints. Modular buildings have a number of advantages over traditional build, including speed of delivery, quality, control of costs and timescale.

The ‘Lessons Learned: Modular Installation of Laminar Theatres at Daisy Hill Hospital’ presentation will detail the modular installation at Daisy Hill Hospital of two laminar-flow theatres, an endoscopy suite and a 28-bed recovery facility, including the following key issues, and explain how the building was connected to an existing theatre block on the third floor, on a severely sloping hillside.

Evelina London Children’s Hospital
Informed by ethnographic and design research into reducing violence and aggression in A&E, the art scheme for Evelina London’s Children’s Emergency department aims to bring reassurance and stimulation to families and children, ensuring they feel well-cared for throughout their journey, as well as promoting role model behaviours and acceptance of information.

John Criddle, paediatric emergency medicine consultant at the Evelina London Children’s Hospital, will be joined by Martin Jones, director of Art In Site, to discuss the project that ensures that children and families feel well looked-after throughout their hospital journey.

Reducing carbon footprints
The Energy & Sustainability Theatre will showcase the latest techniques and innovation in reducing the carbon footprint across the NHS, allowing the NHS to meet its legal targets set out in the Climate Change Act. In-depth content will also be delivered by the Carbon and Energy Fund (CEF), specifically created to fund, facilitate and project manage complex energy infrastructure upgrades for the NHS.

Sessions confirmed for this theatre include ‘The future of energy use in the NHS – How modern steam plants can save energy, lower carbon emissions and reduce utility costs’, and ‘Increasing efficiency of steam and hot water systems’, which will be delivered by Mark Hogan, Energy and Environment Manager at the Wrightington, Wigan and Leigh NHS Foundation Trust.

The Facilities Management Theatre will run a two day programme focusing on hard and soft facilities management in healthcare. Topics to be explored in this theatre include: ‘The cost of slips, trips and falls within healthcare’; ‘The Internet of Things – digital disruption in FM’; ‘The importance of food standards in the NHS’; and ‘The importance of cleaning within healthcare environments’.

Healthcare design
Each year, the Healthcare Design Management theatre is a ‘must attend’ destination for architects, contractors and clients as it features the latest case studies, findings from post occupancy evaluation as well as the sharing of best practice in healthcare design. This year the theatre will feature presentations from Architects for Health, BIM4Health, ProCure22, specifiers and many more.

Philip Ross and Jeff Bartle, board members at the Design In Mental Health Network, will address quality control for mental health environments in their session on ‘Independent Product Performance Testing’. Jenny Gill, chairman of the Design in Mental Health Network, will also present ‘Best Practice Guidance’ on the second day of the conference.

The Hospital Engineering Theatre will feature presentations by leading NHS trusts on recently completed innovative engineering projects. The theatre is supported by IHEEM and NAHFO and will feature examples of engineering excellence, case-studies and best practice.

Elsewhere, NHS estates and facilities professionals can listen to and meet companies that provide solutions for water safety across the NHS in the Water & Infection Control Theatre. This covers specialist subjects such as rapid microbiology, existing and emerging water pathogens and the challenges of infection control and engineering.

New for 2017
There are significant changes on the horizon within the health sector, including the introduction of new roles and changes to how training will be funded. Many trusts are looking at NHS apprenticeships as a way of meeting the challenges that lie ahead. Apprenticeship and traineeship programmes can be a cost-effective way to create a skilled, flexible and motivated workforce and can help employees keep pace with developments in technology and working practices within healthcare. In light of this, the 2017 edition of Health Care Estates will host an Apprentice Today Leaders Tomorrow Theatre.