An holistic approach to the health of the NHS estate

The pressures on the NHS have never been greater as the programme for this week’s NHS Property 2015 demonstrates.

On their own, the projected rates of dementia and obesity present a future funding challenge. Add to that, a welcome change in attitudes to mental health. But as understanding about mental well-being increases, so too does the expectation that the NHS should provide the same level of care and support for mental health as it does for physical health. And all of this against a backdrop of a population that is living longer and that will need increasing levels of support and care into old age.

The long term social, economic and environmental sustainability of the NHS is therefore a massive issue for public interest and concern.

The entire NHS built estate is thought to comprise about 25 million sq metres of occupied space, and its monetary value is estimated at £30 billion. Almost too large to comprehend.

Being able to manage and maintain that built estate more effectively could yield huge benefits for the NHS’s version of the triple bottom line: supporting wellness (people), achieving better outcomes with fewer resources (profit), and reducing the environmental impact of its operations (planet).

A whole lifecycle approach to developing, design, operating and managing the NHS built estate has an important contribution to make to these challenges.

Now with proper use of building information management and data, key issues can be factored in to the initial phases of planning and designing a building. It involves a range of questions such as:

What kind of materials will we use to make this building? Are they materials that are energy efficient? Will we be able to re-use or recycle them at the end of the building’s useful life?
How flexible will this building need to be? Will we need to reconfigure it many times over its lifetime to keep up with changing patterns of demand and treatment?
How will we manage and maintain this building? Can we design in efficient services? Can we ensure they will be easy to operate and maintain, and in a way that will not disrupt the delivery of treatment and care?
Can we capture the data of the physical assets that will be used in the building? Can we create an accurate, digital, operations and maintenance manual that can be accessed and interrogated electronically – and on mobile devices - by those who will be responsible for maintaining and managing the building?

There are answers to all of these issues if access all of the technologies now available for the built environment. And we can apply much of this thinking and capability to existing buildings, too.

For example, BAM has assisted Wharfedale Hospital, which has been operating for eight years , to create a digital asset management model that is yielding considerable efficiencies in the way the building is maintained and managed.

It is great to see these issues on the agenda for NHS Property 2015. We are looking forward to the debate.

BAM is exhibiting at stand 14 at NHS Property 2015.

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