how trusts responded · louise english –nth solutions llp emma bolton –community ventures...
TRANSCRIPT
How Trusts Responded
Claire Hennessy – Birmingham Community Healthcare NHS FT
Louise English – NTH Solutions LLP
Emma Bolton – Community Ventures (Management) Limited
The effect of the pandemic on space utilisation and estate strategies
How did we respond to the pandemic?
Our Capital Team
• 2 weeks into a 12 week refurbishment program of ward 8 at Moseley Hall Hospital when the works were stopped due to the urgent need of the ward for additional bed capacity
• All works up to that point were quickly reversed making good to finishes and re-instating where required and reviewing the safety and compliance of the ward
Our Capital Team
Arranging a centralised PPE Store
Utilising meeting rooms for PPE stock
Redeployed staff helping to deliver PPE across Birmingham to our many community sites
Working with a local charity to manufacture much need gowns
Supported by volunteers
Our Facilities Team
On Call deep cleaning of community sites following contact with a COVID positive or suspected visitor or patient
Supporting the Trusts swabbing teams
Training bank. Agency and redeployed staff to support in housekeeping, portering and catering roles
Working with key contractors to ensure contingency of service provision
Supporting the charity to provide a food bank for staff to use
Providing staff with lots of bottled water, fresh fruit, sandwiches and hot beverages
Our Estates Team
Setting up swabbing test centres
Arrange car hire for clinical services
Reinstate a mothballed ward within 2 weeks to increase bed capacity
Support the Trust in delivering much need stock across the community sites
Our Land and Property Team
Supported the Estates team by flushing the little used outlets across all sites
Undertook all other requests as they flooded in!!!
And now?
For the last few months the whole team has been supporting the Trust whilst services are restored, ensuring all Trust occupied space is COVID secure
How?
By working closely with our clinical service teams and IPC
Challenging the use of space
Surveying the space and producing drawings that detail how lay out the room to social distance effectively
Ensure that cleaning stations are provided with masks, hand sanitiser and wipes
Install lots of signage to remind everyone of the precautions that must be taken
The Future
A questionnaire was circulated to 356 members of staff, with a positive response rate of 74%
85% of staff do not think it is essential for them to be in the office to do their job effectively. Only 1% of staff (3 people) state that it is impossible for them to work from home effectively
Whilst lockdown has presented staff with numerous and varying challenges, overall, 57% of staff report that they are happier working from home than in the office, and 44% would be happy to always work from home. Staff have cited benefits such as increased productivity, less time travelling to and from work, and financial savings
When asked in an open question if any working practices or processes that have been adopted due to lockdown should be implemented on a permanent basis, 40% of staff provided comments indicating their desire for continued or more use of technology that enables them to work remotely, such as MS Teams
The Future?
The pandemic has caused us to review how our estate is being used
Working from home
Office space – what will it look like going forward?
Digital Technology – Clinical space need?
Period of reflection
Currently taking stock / period of reflection
Will impact be permanent or is this a ‘blip’?
Behavioural changes may outlive the pandemic
NHS historically a face-to-face service delivery model
‘Choose Well’
Increased digitalisation
Technological advances
Increase in NHS digital technology Technology Enabled Care Services (TECS)
NHS App
NHS Pathways
NHS 111 / 999
Video conference capabilities
Emergence of a remote working culture in the NHS – not the case for all areas though
The patient needs to remain at the heart – balancing act
Not an isolated conversation of increasing utilisation of remote working practices v. continuing as before
Care in the community
Impact on hospital and community care
Outpatient care closer to home
Integrated Community Services
Remote patient monitoring and digital health services
Case studies
Role of the estate
What does this mean for the estate?
Changing role of hospitals and health centres – somewhere people go to get better
Highlighted profile of estate in providing safe and appropriate care to patients when they need it most
Role of facilities management - no longer ‘the silent service’?
Design and use are key components
Connecting of the physical and digital space
Maximise productivity
Workforce productivity
Service productivity
Diversify approach rather than focusing on one or the other, or eliminating approaches altogether
Key components = flexible environments and an equity of provision that meet the needs of all the people who use them –both patients and staff
Planning for the Future
Are the Carter Metrics still relevant?
How are we going to deal with future business continuity issues?
Clinical vs non clinical space
Estate: an enabler or a driver?
Is the estate an enabler, should it be a driver or are there times when it is both?
The role of estates to challenge ‘presenteeism’ decisions
The property sector and the NHS in particular doesn’t have the capacity to deliver such significant plans at speed in its current form
Requires significant investment and a relaxation of the ‘red tape’
Transformation
Breaking down the barriers to change
Well, we’ve removed a whole load of the rules and thebureaucracy that has held back individual changes andindividual intuition being used on the frontline, and we’regoing to keep it that way. And that working culturewhere people are more collaborative instead of thisatomised system that we’ve had in the law in the past,that has got to change.
Matt Hancock, The Andrew Marr Show, BBC One 5th July 2020
What are ‘The Rules’?
Business Cases
Procurement
ICT
Collaboration
Improved partnerships between partners, commissioners and regulators allowed change to happen at pace – eliminated unnecessary red tape and oversight that hindered collaborative working in the past
Movement from ‘silo’ working to working across an ICS/ICP footprint
Is estate “ownership” a blocker to collaboration?
Intra NHS L&T arrangements
Spatial Planning for the Future
Will the pandemic impact the way we live our lives, and will provision of healthcare have to adapt in future?
Location remains an overriding consideration - hub and spoke model? Areas of population density rather than employment density?
Could health environments become a core driver for new development activity in the future – more joined up working between local authority and NHS?
Fujitsu Model
Smart Working: realising optimal working styles Flexible working hours
Offering additional support to remote workers
Borderless Office: a reassessment of the ideal office environment Creating hub offices, with overall footprint reduced to 50%
Satellite offices with multisite video conferencing systems
Culture Change: transforming corporate culture Training on one-to-one communication skills
Wellness checks focusing on physical and mental wellbeing
Just over half of German companies want to foster remote working
Considering making the right to work a statutory entitlement
Siemens – “move away from a presence culture towards a results orientation”
Move from 12% to 25% home working
40% said they would like to continue to work from home at least some of the time
Funding the Future
References
HSE - Regulating occupational health and safety during the coronavirus outbreak - https://www.hse.gov.uk/news/hse-regulatory-activity-during-coronavirus.htm
Working Safely During Covid-19 in Offices and Contact Centres -https://assets.publishing.service.gov.uk/media/5eb97e7686650c278d4496ea/working-safely-during-covid-19-offices-contact-centres-110520.pdf
NHS ERIC https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/england-2018-19
Kings Fund – the Deteriorating State of the NHS Estate
https://www.kingsfund.org.uk/blog/2019/10/ERIC-data-nhs-estate
Carter Report https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/499229/Operational_productivity_A.pdf
Changes to NHS financial regime https://www.hfma.org.uk/news/news-list/Article/debt-write-off-and-capital-regime-outlined
Code of Practice for Commercial Property Relationships During Covid-19
https://www.gov.uk/government/publications/code-of-practice-for-the-commercial-property-sector/code-of-practice-for-commercial-property-relationships-during-the-covid-19-pandemic
Fujitsu Case Study - https://techrseries.com/news/fujitsu-embarks-towards-new-normal-redefining-working-styles-for-its-japan-offices/
Inhealthcare - https://www.inhealthcare.co.uk/
AttendAnywhere - https://www.attendanywhere.com/
Shared Lives UK - https://sharedlivesplus.org.uk/
Home Share UK - https://homeshareuk.org/
Louise EnglishCapital Planning & Property Manager NTH SolutionsMobile: 07949 244 038Email: [email protected]:https://www.linkedin.com/in/louise-english-5b714154/
Emma BoltonArea Director (Leeds and North East)Community VenturesMobile: 07935 755 062Email: [email protected]: https://www.linkedin.com/in/emma-bolton-frics-84043316/
Thank you for listening!
Claire HennessyDirector of Estates and FacilitiesBirmingham Community Healthcare NHS FTMobile: 07718 250928Email: [email protected]