Following the 2017 Naylor Report into NHS estates, it has been estimated that estate upkeep costs have reached approximately £10bn in annual funding for 2019/2020.
More recently, ERIC (Estates Returns Information Collection) data collection has contained some deeply alarming news about the condition of NHS buildings and equipment.
Latest data from the Kings Fund, shows in 2018/19, the total cost of tackling the backlog of maintenance issues in NHS trusts rose by 8.4 per cent to £6.5 billion. And of this over half, £3.4 billion, was for issues that present a high or significant risk to patients and staff.
If these numbers don’t sound alarm bells, a little more context is needed. High-risk issues are identified where repairing or replacing NHS facilities or equipment ‘must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution’ (ERIC data definitions).
We are not just talking cosmetic issues that are looking a little shabby, or letting a building become run down when it is scheduled for closure. We are talking about facilities and equipment that are so outdated they no longer comply with statutory safety standards. This has left the NHS with a mix of world-class, state-of-the-art facilities and Victorian hospitals that are no longer fit for purpose.
The story of how we got to this point is well-rehearsed. Over the most sustained period of austerity in NHS funding, more than £4 billion of planned capital investment has been reprioritised to support the day-to-day running costs of the NHS (eg. paying for staff salaries and medicines). This has left the UK lagging behind other countries in the level of capital investment provided to its health service. No wonder then, that NHS Trusts have been as focused on getting the hospital boilers fixed, as on the long-term strategic integration of health and care services.
At the recent Healthcare Property and Development Conference, Paul Fitzpatrick, Director of Estates and Facilities at Liverpool University Hospital, told audience members that “there’s not much evidence of that being spent.”
Aintree Hospital, Fitzpatrick’s previous employer, have been trying to generate capital by redeveloping disused parts of its estate with help from One Public Estate, Fitzpatrick explained: “We’ve been working quite close with the programme and we’ve had a £200,000 grant to redevelop part of our campus, which covers 6.5ha.”
Aintree Hospital is looking to develop key worker accommodation or extra care facilities as part of the redevelopment.
This year’s Healthcare Estates Conference will focus on the latest promised government spending with a look at current schemes and proposed future funding. Linked with complimentary content on the exhibition floor, this year’s event features a new area, the New Engineering and
Compliance Zone which features FREE-OF-CHARGE content specifically tailored for the NHS built environment:
Current exhibitors in the area include:
Avidity Science Ltd. a supplier of Reverse Osmosis water systems for all decontamination applications. Avidity provide Thermally sanitised RO systems for Endoscopy; Steam or Electrically heated RO systems for Sterile Services; Full pre-treatment and process water solutions for hot and cold softened water in sterile services. Avidity work alongside all suppliers of washer disinfectors, autoclaves and AERs with over 15 years’ experience and expertise in HTM compliant water, to provide the reassurance you need. Visit stand G55.
HTM Authorising Services Ltd on Stand A48 will be providing visitors to their stand with the opportunity of speaking with HTM Authorising Services John Rhodes who they are proud to announce his inclusion on to the IHEEM register. John has over 30 years experience in the NHS estates departments and 10 years commercial Medical Gas specialist experience. John is backed up by a full team of AE’s and AP’s with many years of experience and multiple discipline qualifications.
Medical Gas Services Ltd also on stand A48, is a total solutions medical gas company undertaking medical gas needs from conception to installation and maintenance, management, compliance auditing and staff training. MGS will have a dedicated design team on the stand with experienced AE’s and AP’s to aide visitors in getting a compliant and practical system. MGS have an installation division to install systems compliant and safe, fully tested and commissioned.
Running alongside the prestigious IHEEM conference, Healthcare Estates exhibition gives visitors the perfect opportunity to engage, and network with high level decision makers and specifiers direct from the NHS.
NHS estates have a rapidly increasing maintenance cost, yet if the necessary estate works are funded it provides a strong pipeline for the construction industry and can lead to a high-tech renewal.
The cost of fixing NHS buildings to avoid serious injuries to patients and major disruption to clinical services continues to rise and outstrip the NHS’ investment in estates maintenance, new figures reveal.
As of April 2019, the NHS’ estimated bill to carry out urgently-needed repairs to “high-risk” estate had risen in a year by nearly £60m – from £1.038m to 1.095m, according to data from the Estates Returns Information Collection.
The increase is smaller than in previous years. However, the rapid rise (in 2014-15 the estimated cost was £458m) has prompted strong concerns from trust chief executives.
Tracy Taylor, chief executive of Nottingham University Hospitals Trust, said in a release from NHS Providers “our hospitals will continue to deteriorate and our ambition for better healthcare may never be realised” without both short-term and long-term capital investment.
A spokeswoman for the Department of Health and Social Care (DHSC) said it had “supported the NHS with £3.9bn to upgrade facilities” and “recently injected an extra £1.8bn to tackle the most urgent infrastructure projects”.
High-risk estate is defined as areas where repairs must be addressed with urgent priority in order to prevent “catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution”.
Nearly a third of the NHS’ total high-risk cost is carried by Imperial College Healthcare Trust (£334m). Other trusts with the highest costs in this category include Hillingdon Hospitals Foundation Trust (£48.5m), Medway FT (£37.5m), and University Hospitals of Morecambe Bay FT (£34.5m).
The NHS’ overall backlog maintenance cost now stands at £6.5bn (£5.9bn in 2017-18), of which more than half (£3.4bn) is categorised as “high or significant risk”.
But the figures show trusts only spent £433m on reducing backlog maintenance in 2018-19.
Josh Kraindler, an economics analyst with the Health Foundation, told HSJ magazine recently, the maintenance backlog has grown to such a level that it is larger in trusts than their annual capital budgets. “A fair bit of the overall backlog’s increase is in the high and significant risk categories, and it looks like the increase is split across quite a few trusts,” he added.
Since 2017, the government has allocated more than £3bn to the NHS, but the majority of this cash has not yet been distributed to the recipient trusts.
Last month, the government announced funding for the rebuilding of six hospitals and outlined plans for dozens more schemes between 2025-30.
A DHSC spokesperson commented: “We want patients to receive safe, world-class care in world-class facilities and have launched the largest hospital building programme in a generation, as part of a long term programme of investment to modernise the NHS estate and eradicate critical safety issues.”
Meanwhile, the ERIC data also shows a 25 per cent rise from 2017-18 (3,835) to 2018-19 (4,810) in the number of incidents caused by estates failures resulting in delays or cancellations to clinical services – such as power failures.
The process of building the Conference programme for Healthcare Estates will focus on some of these key areas of concern.
The call for presentations generated a huge response, with submissions coming in from a number of NHS Trusts, including Buckinghamshire Healthcare NHS Trust, Nottingham University Hospitals NHS Trust, Royal Papworth Hospital NHS Foundation Trust, South Warwickshire NHS Foundation Trust, and University Hospitals of Leicester NHS Trust, with submissions being spread evenly between the Engineering and Facilities Management, Planning Design and Construction, Innovation, and Strategy and Leadership themes that will form the structure of the conference at Healthcare Estates this year. The main topics that are featured in the Call include asset management, efficiency, innovation, new technology, patient experience, planning, safety and sustainability.
The Call for papers is one of a number of tools used to curate the most relevant conference content for the healthcare engineering sector. We also work and consult with a number of other groups; Architects for Health, P22, SOPHE, and the engineering and facilities management directors group EFM2.
