Two-thirds of estate leaders have warned that ageing infrastructure is the biggest barrier to tackling backlog maintenance in latest NHS Property Services (NHSPS) survey.
NHSPS is a company owned by the government’s Department of Health and Social Care that took over ownership of around 3,600 National Health Service facilities in April 2013.
Simon Taylor, Director of Policy, Strategy and Capital Projects at NHSPS, told Building Better Healthcare: "The future of healthcare depends not only on clinical excellence, but on the quality, resilience, and efficiency of the places where care is delivered."
He explained that the guide is written by estate practitioners for estate leaders, and offers practical steps to help maintain, improve and future-proof the existing NHS estate.
Taylor added that by bringing asset management and facilities management strategies together, the aim is to make "smarter estate decisions that improve patient environments, strengthen efficiency, and help the NHS work within available budgets."
What did the survey find estates are dealing with?
The organisation carried out its recent survey to find out how to improve building maintenance across its estate.
The survey results reveal how management of NHS sites is changing due to advances in how data is collected and how technology is used to tackle maintenance backlogs.
The maintenance backlog is about to hit $16bn in cost, increasing by over 15% in a year. Tackling this issue is one of the major challenges in UK healthcare today.
Beyond the ageing infrastructure, other high-ranking barriers to reducing the maintenance backlog included funding and the sheer scale of the problem
Taylor said that estates leaders’ message is “loud and clear”.
“They want the tools to help them improve compliance and take advantage of the latest technologies to harness useful data and increase utilisation.”
Therefore, through the organisation’s latest survey and years of management experience, it has now published a guide to help estate leaders create the best structure to begin modernising the existing estate and ensure it is efficiently used.
What is the NHS maintenance backlog?
Nearing £16bn, the NHS backlog maintenance consists of bringing estate assets that have fallen below minimum acceptable standard (Condition B) back to a safe, compliant and operational condition.
This does not include planned maintenance that should already be accounted for.
Realistic tips in the new guide
The new guide, “Maintaining the NHS Estate”, condensed the survey findings into simple, actionable, and, importantly, realistic advice.
Beyond the ageing infrastructure, other high-ranking barriers to reducing the maintenance backlog included funding and the sheer scale of the problem.
In terms of prioritisation for estate leaders, a quarter prioritised reducing the backlog itself, whilst a different quarter prioritised improving compliance, through the legal requirements and best practice.
NHSPS’s guide is clear on its findings. While short-term decisions are often required to keep buildings operational, these are not able to provide long-term improvements.
With no control over funding, the guide provides estate leaders with practical considerations as to how to reduce their backlog maintenance through process.
One of the core themes of the guide is understanding your estate as a whole.
The guide advises that this should include building a complete backlog view and categorising the entire estate into “core”, “flex” and “tail”:
- Core - Essential buildings that are critical for delivering services long term.
- Flex - Buildings that are currently providing unique access to services but may not be needed long term.
- Tail - Sub-optimal buildings that should be phased out when alternative estate is available.
Having this categorisation will help with decision making.
The guide also recommends that the condition of the estate should be reviewed regularly; planned investment is cheaper than reacting on an ad-hoc basis. By releasing capacity and improving utilisation, as well as modernising space, estate leaders can also reduce the long-term cost of maintaining their buildings.
Finally, maintaining a rolling five-year forecast of assets and bringing clinical leaders into the discussions avoids the costs associated with inaction.
In addition to direct maintenance, the guide also considers how the NHS's commitment to achieving Net Zero by 2040 (and direct emissions by 2045) is reshaping how buildings are operated and upgraded.
Taylor added: “The NHS already possesses much of the expertise, framework and data required to improve estate performance.
He believes the task is achievable and success depends on how decisions are made, how evidence is used and how effectively leaders are aligned from board level through to operational teams.
“When these are in place, strategy becomes action, leading to better patient care,” Taylor said.
