April 22, 2013
Consultants E C Harris have just published the latest edition of their report into the NHS Estate which claims that the service has an opportunity to save around £2.3 billion a year in the way it manages and procures space. Every report needs headlines to go with and in this case E C Harris have plumped for the idea that the NHS is underutilising space equivalent to an area the size of Hyde Park and that an eighth of the estate is unsuitable for its intended use, equivalent to ‘three Hyde Parks’. Last year’s edition of the report claimed the potential saving of disposable space was the equivalent of ‘264 Premier League football pitches’, which at least has the advantage of being comprehensible for those who can’t envisage how big Hyde Park is.
The contrast of the two annual reports shows that the amount of unused or underutilised space has actually changed fairly significantly over the past 12 months. The 2012 edition, when using proper numbers, claims that there was around 1.9 million sq. ft. of such space in the previous year whereas this year, the figure is under 1.6 million sq. ft. of estate.
As you would expect in an estate with annual running costs of £7.7 billion that deals with a range of services, organisations, regions and a building stock that varies enormously in age and type, there is a deal of variation in the apparent efficiency of buildings. But the report concludes that not all of this variation can be ascribed to the nature of buildings and organisations.
The report concludes:
“The variety in the NHS performance suggests that there is considerable improvement in behaviours needed of those in the 3rd and 4th quartile when compared with high performers that simply isn’t related to physical aspects but hints at lack of experienced personnel, poor technical understanding and ability to deliver major projects. Whilst the best Trusts are active in pursuing improvements, senior staff in other Trusts often don’t know their own metrics for area, condition and costs by estate type. This is a marked contrast to those in the private health sector or major non health business sectors who view the estate as a comprehensive business enabler .”
You could expect some people to question this final conclusion given that all organisations have a degree of inefficiency, especially larger organisations with large and diverse estates. You could also question the idea that private sector firms see their property as a ‘business enabler’. Some do, some don’t. If that weren’t the case there wouldn’t be an ongoing debate in the building design and facilities management sectors about the matter.
It’s also remarkable that a report of this nature running to ten pages can do so without mentioning PFI once. The report does welcome the fact that the proportion of the NHS estate that was built before 1948 has reduced from 50 per cent in 1995 to under 16 per cent in 2012, a period coinciding with the advent and widespread use of PFI but does not mention the ongoing controversies over the value for money offered by such schemes.