Facilities management that meets evolving healthcare needs

Keeping a safe and well-run environment in healthcare settings has a direct bearing on patient safety and care, the wellbeing of the NHS workforce and that of the wider public. With products continuing to evolve, a focus on carbon reduction, and lessons learned during the peak of the pandemic, NHS Shared Business Services has renewed its Hard FM Framework to reflect the modern needs of healthcare settings

The second iteration of the Hard FM Framework from NHS Shared Business Services is designed to respond to the need within the NHS for high-quality, innovative and cost-effective solutions, which help NHS trusts manage their estates successfully. The new framework’s scope has broadened to encompass Covid-19 safety provisions and includes a specific emphasis on sustainability and innovation.
From infection control through to the maintenance and upkeep of medical facilities and equipment, keeping a safe environment in healthcare settings has a direct bearing on patient safety and care, the wellbeing of the NHS workforce and that of the wider public.

A costly business
Data from NHS Digital’s 2020/21 Estates Return Information Collection shows that the annual cost of running the NHS Estate stands at £10.2 billion - a four per cent increase on 2019/2020, with the cost of clearing the required maintenance backlog having risen 2.2 per cent to £9.2 billion.  
With this in mind, NHS Shared Business Services (NHS SBS) launched its second-generation Hard Facilities Management (Hard FM) Framework Agreement, with a broadened scope to encompass Covid-19 safety provisions and with a specific emphasis on sustainability and innovation.
The framework agreement has been specifically designed for the NHS and healthcare sector, with inputs from NHS trusts (procurement, estate management and capital development personnel), the wider healthcare community and other public sector bodies.
It can provide up to 10 per cent savings for estate, facilities and capital development teams that buy services through it. With £800m expected spend via the framework over the next four years, it could potentially equate to public sector savings of up to £80m.

The new framework caters for the significant developments in the digitisation and automation of systems and access control which have come to the fore since its previous iteration.  An example of this is contactless preliminary temperature screenings at entry points in hospitals and healthcare settings during Covid, which detect individuals attempting to access the building who may have elevated body temperature.

Low carbon provision
As the UK’s largest employer, the NHS is responsible for around four per cent of the nation’s carbon emissions. It is, therefore, committed to tackling climate change by reducing its direct emissions to ‘net zero’ by 2040 and 2045 for those emissions it can influence.
With 60 per cent of the NHS carbon footprint occurring within the NHS supply chain, public procurement will be leveraged to effect change. Therefore, commencing in April 2022, NHS England extended the reach of the Government’s model to deliver social value through its commercial activities to the commissioning and purchase of goods and services by NHS organisations.
The Hard FM Framework makes provision for this, via the 154 suppliers awarded a place across its 46 specialist lots. This mix of expertise spans the provision of low carbon energy infrastructure, incorporating smart microgrids with on-site generation of renewable energy.
It also covers air cleaning, decontamination and infection control systems, as well as Covid-secure queue management systems and access control, partitioning, isolation and social distancing systems, and integrated workplace management systems.

Support for estate managers
Brendan Griffin-Ryan, NHS SBS senior category manager for estates & facilities, said: “The management of NHS estates and facilities demands specialist expertise in areas such as strategic planning alongside comprehensive knowledge of the estate’s condition. Compliance, with an ever-increasing list of regulations, places further pressure on teams managing these vital services. This framework is designed to support estate managers meet these targets and provide a compliant route for reactive, planned and new installations of equipment and infrastructure.
“With an approach heavily focused on sustainability, NHS SBS’s new framework agreement ensures broader ethical environmental objectives are considered and met, tying into the strategies and ambitions detailed in NHS England’s ‘Delivering a ‘Net Zero’ National Health Service’ plan.    “The Covid-19 pandemic has presented new safety and infection control challenges and led to healthcare providers having to significantly adapt to ensure they can maintain Covid-safe environments. Hence the framework’s inclusion of a range of supplier services and innovative solutions, such as touch-free entrance technology, to support the new Covid-safety requirements.”

Effective facilities management
Effective facilities management in healthcare buildings is important for a number of reasons. Not only does it ensure smooth operations, it sets a good impression on patients, staff and visitors – and can indeed contribute to effective recovery and wellbeing of patients. Clean, safe and well-run buildings enable healthcare workers to focus on their job - that of treating and caring for patients - without distraction. 

Hospitals are emotive places, and having properly managed facilities can have a significant impact on employee morale and increase employee productivity.
And significantly, having properly managed facilities enables the NHS to save much-needed cash. Effectively managing premises, systems and equipment will reduce maintenance issues and help the focus shift to prevention rather than treatment.

Delivering the framework
NHS Shared Business Services was established in 2005 by the Department of Health and Social Care, in partnership with Sopra Steria. It reinvests a high percentage of revenue back into its services, allowing it to make significant capital investments at scale and at its own risk.
NHS Shared Business Services developed the second-generation Hard Facilities Management (Hard FM) Framework Agreement to help deliver improved sustainability, compliance and patient and staff safety for the NHS. It has been carefully designed to meet the specific challenges faced by estates, facilities, and capital teams. NHS Shared Business Services worked with NHS Trusts and organisations, the wider health community, and the public sector to develop a framework agreement that addresses three key challenges facing the healthcare industry; sustainability, innovation and safety solutions. The framework is supported by a carefully selected network of specialists, and offers a comprehensive range of products and services to meet these challenges with confidence.

The renewal of the Hard Facilities Management framework gives healthcare settings access to safe, reliable and high-quality products to ensure their estate is managed compliantly, sustainably and with added social value. It also supports the reduction of their carbon footprint and improves patient and staff safety.

All suppliers are fully compliant, and there’s a growing network of regional suppliers for more reactive, bespoke services. The framework helps buyers save time and money on formal tendering, and also helps hospitals make the most of their budget thanks to its competitive capped pricing.

The details
The Hard Facilities Management Framework from NHS Shared Business Services started in April 2022 and runs to April 2024, with the option to extend to 2026.
The Framework Agreement is free to access for all UK public sector bodies. It provides estates, facilities and capital teams a compliant route to market for the provision of hard facilities management products and services from a wide range of estates and maintenance specialisms, utilising both SMEs and national providers, to deliver either a single service, bundled service or provide a fully managed service.
Key services covered include computerised estate and facilities management services; building works & maintenance services; power supply, fuel and steam plant; and electrical installation and maintenance. It also includes ventilation, air conditioning, air cleaning and decontamination, as well as infection control systems. Automatic and fire doors and entry management systems are also included on the framework.
Using the framework allows buyers to use an efficient FTS-compliant process. A detailed procurement exercise has taken place to ensure that suppliers who are selected meet all legislative requirements; therefore no formal tendering is required, which saves valuable time and money in the procurement process.
The framework has been specifically developed for the NHS & Healthcare sector’s FM requirements, utilising input and expertise from NHS stakeholders.
There are different ways to access the hard FM framework; the direct award provides the flexibility to choose suppliers within the agreement remit, while the fully managed service allows you to engage one supplier for all your requirements. The measured terms contract is available for reactive and planned maintenance of building, electrical, mechanical and painting and decorating.
The framework allows users to benefit from competitive pricing, and capped pricing during the framework period can support budgeting. A mini-competition may be undertaken to meet the bespoke requirement of each customer.
The framework uses a diverse supplier mix. It contains large national providers, but also a good number of regional SMEs to be more reactive to local needs.  E

A pathway to net zero
The renewed Hard FM framework includes a specific emphasis on sustainability, given that the NHS has ambitious net zero targets in place, and hospitals are required to develop ‘green plans’.
Identifying the route to net zero emissions for a complex, highly specialised organisation as large as the NHS is particularly challenging. Two targets for have therefore been set; for the emissions the NHS controls directly, the target is to reach net zero by 2040, with an ambition to reach an 80 per cent reduction by 2028 to 2032.
However, for the emissions NHS can influence, it aims to reach net zero by 2045, with an ambition to reach an 80 per cent reduction by 2036 to 2039.
Delivering these trajectories will require action across every part of the NHS. However, the main areas of action will be within estates and facilities, travel and transport, supply chain and medicines.
Becoming more energy efficient is one of the most significant ways that healthcare estates can lower carbon emissions.
The UK government is investing over £280 million in decarbonising the NHS estate in England through the Public Sector Decarbonisation Scheme.
One hospital that has received funding under the scheme is Leeds Teaching Hospital NHS Trust, which was awarded over £20m to install low carbon heating and energy efficiency measures across the Trust estate.
The initial programme of works has seen the installation of air source heat pumps, which will reduce the consumption of natural gas, installing photovoltaics for electrical generation, switching to energy efficient LED lighting and replacing single glazed windows with low U value double glazing to reduce building fabric heat loss.
The next phase of work will focus on reducing energy demand by installing draft proofing and roof insulation and expanding the number of buildings connected to the local district heating network. In April, Beckett Wing at St James’s University Hospital became the first Trust building to connect to Leeds PIPES. The heating network provides affordable, reliable and sustainable heat to connected buildings. It uses recovered heat to serve the households and businesses across the city, including the Trust, to provide a low-carbon alternative to the traditional burning of fossil fuels for hot water heating.
Craige Richardson, director of estates and facilities at Leeds Teaching Hospitals NHS Trust said: “Reducing carbon emissionsand achieving net zero is a top priority for
the Trust. The funding will enable us to deliver schemes and initiatives that will reduce our carbon footprint and decarbonise our estate.
“As an anchor institution, it’s important that we make a positive contribution to our local community, converting our waste into energy, not only benefits the Trust, it helps provide affordable low-carbon heating for households across Leeds”.
It is estimated that the projects will reduce carbon emissions by 5,500 tonnes per annum, which is equivalent to flying one way from Leeds Bradford Airport to New York 6,875 times, and the amount absorbed by 275,000 trees.
Chris Kelly, associate director for estate risk and compliance at LTHT said: “By fully integrating our road map for decarbonising the Trust estate, we aim to achieve a targeted reduction in the Trust’s greenhouse gas emissions and meet the NHS 2040 net zero ambitions. This includes planned and strategic investments in energy and building infrastructure, focusing on reducing operational energy use, increasing renewable technology and low-carbon energy supply integration whilst maintaining resilience.”

Carbon reporting for suppliers
As part of the greener NHS plan, the NHS has committed to net zero by 2045 for the emissions it influences, through the goods and services it buys from its partners and suppliers.
The Hard FM framework makes provision for this, via the 154 suppliers awarded a place across its 46 specialist lots.
The NHS England Public Board has approved a roadmap to help suppliers align with its net zero ambition between now and 2030.

It requires that from April 2022, all NHS procurements will include a minimum 10 per cent net zero and social value weighting. The net zero and social value guidance for NHS procurement teams will help unlock health-specific outcomes.
From April 2023, the NHS requires suppliers for contracts above £5 million to publish a carbon reduction plan for their UK Scope 1 and 2 emissions as a minimum (building on PPN 06/21).
From April 2024, the NHS will extend the requirement for a carbon reduction plan to cover all procurements. Suppliers will be required to publish a carbon reduction plan for their UK Scope 1 and 2 as a minimum.
From April 2027, all suppliers will be required to publicly report targets, emissions and publish a carbon reduction plan for global emissions aligned to the NHS net zero target, for all of their Scope 1, 2 and 3 emissions.
From April 2028, new requirements will be introduced overseeing the provision of carbon foot printing for individual products supplied to the NHS. The NHS will work with suppliers and regulators to determine the scope and methodology.
From 2030, suppliers will only be able to qualify for NHS contracts if they can demonstrate their progress through published progress reports and continued carbon emissions reporting through the Evergreen sustainable supplier assessment.

Covid-safety innovation
The new Hard FM framework caters for the significant developments in the digitisation and automation of systems and access control which have come to the fore since its previous iteration, often as a result of Covid-safety measures. This includes contactless preliminary temperature screenings at entry points in hospitals and healthcare settings, which detect individuals attempting to access the building who may have elevated body temperature.
Fever is one possible symptom displayed when a person is infected with the virus which causes COVID-19. Some medical devices allow temperature to be checked without close physical contact with another person. Using these devices, a large number of people can typically be checked in a short space of time and in a non-disruptive way.
Access control plays a crucial role in the management of infection. Doctors are often treating patients infected with Covid-19 and other viruses, and so to prevent spreading viruses, hospitals need to reduce the touchpoints and promote contactless access control security systems.
Access control systems help hospitals to manage who enters a hospital and where they are permitted to go. For example, a doctor may have access to certain rooms, whereas a cleaning staff or a nursing staff may not. A well-developed access control system is therefore crucial in healthcare.
Contactless access control systems prevent the need to touch the access control devices or the doorknobs to unlock a door. Doctors, hospital staff, and the management can unlock the door by just waving their smartphones or scanning the QR code and avoiding coming in contact with any touchpoints.
Airborne transmission of Covid-19 and other viruses is a major issue for hospitals. Indeed many struggle to meet the NHS’s own ventilation guidelines of six air changes per hour in wards due to inadequate existing ventilation systems in older NHS hospitals and expensive retrofit costs.
Clean air solutions can be a powerful weapon in the battle against COVID-19, if the technology is specified correctly, and the renewed Hard FM framework can help in this area.

Evolving needs of healthcare
The renewed Hard FM framework from NHS Business Services was developed to meet the modern needs of the NHS, allowing for the continued innovation in products, and also incorporating lessons learned during the peak of the Covid-19 pandemic.

What’s more, with a major focus on carbon reduction – from its estates as well as its supply chain, the new framework allows for the procurement of products that can help with the ‘Greener NHS’ agenda, and focuses on the environmental credentials of its suppliers.