Simon Taylor, director of estates policy, strategy & capital projects at NHS Property Services, introduces the NHS Estate Optimisation Guide
The Government’s new ten-year health plan has refocussed the healthcare debate onto prevention and delivery of services in the neighbourhood. The NHS will be focussed on delivering more preventative services, including around 300 neighbourhood hubs – 40 to 50 within the lifetime of this Parliament.
To rapidly progress the objectives in the ten-year health plan, the existing NHS estate must work more efficiently and provide more without fundamental change. Empty and underutilised spaces will need to be transformed to support additional capacity, cutting-edge diagnostics, and health services in communities to prevent ill health.
Property
Property is often one of an organisation’s biggest expenses: the NHS has more than 10,000 buildings covering 25 million square metres. The need to improve ICBs’ and Trusts’ ability to manage their existing estate is the very reason we have created this NHS Estate Optimisation Guide.
NHS Property Services (NHSPS) owns about 10 per cent of the NHS estate, we also advise how buildings can be used more efficiently and deliver better value for money whilst maintaining patient care at a high level. We have the property, people, and professional expertise to support the delivery of the ten-year health plan’s neighbourhood hubs as well as the experience to maximise value for money by repurposing the existing estate.
Our long-term goal is to establish more efficient, more collaborative, and sustainable ways of working so that estate leaders can get more out of the space they have and better manage their costs.
Underutilised
Many assume that NHS spaces are fully used but our own recent research has revealed they are often only 40 per cent utilised or less. NHS England chair, Dr Penny Dash, recently commented on how much the NHS wastes money and that empty buildings are one major cause of this waste. She argued that it is management and process systems that hinders good utilisation.
There are many reasons for space not being used effectively, estate leaders have told us they have low (32 per cent) or medium (55 per cent) understanding of how the space across their estate is being used.
And 41 per cent of estate leaders have told us they do not have the budget to look at vacant space and its use, while more than a half (55 per cent) said they do not have the ‘in-house capacity to manage change to spaces and deliver’ to optimise the space they have.
However, there are solutions and the best start to making better use of space is developing a detailed understanding of buildings and spaces, overlaying the estate strategy, and reviewing occupancy and utilisation on a regular basis.
Digital tools
One valuable tool NHSPS has created is NHS Open Space, first launched in 2016. Over half of NHS leaders surveyed stated they lacked the right data to make informed decisions, and a third said they lack the expertise to make the right changes to their estate.
Open Space is a digital platform which provides the NHS with booking and analytical tools as well as expert support and guidance to healthcare specialists so they can efficiently use their existing rooms and oversee who they are being used by. NHS organisations can then better manage the space they have in their buildings and make use of and better analyse underutilised space.
One case study is Greater Manchester Mental Health NHS Foundation Trust (GMMH). They successfully used NHS Open Space and drove 21 per cent cost efficiency through increased space utilisation and 32 per cent cost savings. Previously, the Trust had been reliant on a manual room booking process which meant spaces were not being booked efficiently. For example, clinical spaces were being booked for full-day sessions, even when only an hour was needed.
A further case study at Belmont Health Centre shows how important managing space is. Three GP practices and a community services provider needed more space for their 20,000 (and growing) patients. NHSPS held the headlease, which had 30 per cent vacant space at a cost of £110,000 per year to North West London ICB. We helped the ICB unlock £1.6m of capital to reconfigure and refurbish the building, increasing consulting room capacity, providing a new reception and colleague facilities, and improving accessibility. Now there is no vacant space, overall costs for the NHS have been saved, and more patients can be seen.
To gather the data needed to assess how space is being used, relatively affordable digital equipment can be used such as desk sensors to monitor desk occupancy, area sensors to monitor occupancy of a space and movement sensors which detect occupancy based on motion, these are infrared or ultrasonic based.
We have been using ongoing monitoring since 2019, collecting, and analysing room motion sensor data. The dashboards we use track property and financial data on a room which increases the use of the space. This space optimisation has unlocked £38.5million for the NHS since it was first launched.
In conclusion, the NHS needs to be ready to adapt and fully utilise the core, long-term estate to deliver the new ten-year plan’s goals, provide first-class patient care, and provide better value for money.
This NHS Estate Optimisation Guide provides a simple framework to help advise on what to look out for. We can help estate leaders better understand the value of monitoring space and how by doing so they can unlock greater value from their existing spaces.
