Written evidence submitted NHS Property Services
NHS Property Services (NHSPS) welcomes the opportunity to provide written evidence to this consultation on NHS backlog and waiting times.
NHSPS is a property owner, manager and service provider looking after 12% of the total NHS estate with more than 3,000 properties and 7,000 tenants. Our portfolio comprises mainly primary care facilities, from GP practices to community hospitals. We are a government-owned company which exists to help the NHS get the most from its estate, and ensure that it is consistently fit for purpose, so that healthcare professionals can focus on delivering excellent patient care.
This submission will look at our work to expand the physical capacity of the NHS estate to meet rising demand during and after the pandemic, and how the investment that we have made in supporting preventative services and providing better spaces for NHS colleagues could prevent lengthening waiting lists.
Key Points
Over the pandemic we have successfully used our expertise as a property and facilities manager to increase spatial capacity within the existing NHS estate to support increased demand for inpatient services. In total, we delivered 1,503 additional beds across existing facilities in our portfolio. Our business-as-usual activities have also delivered the space and enhanced facilities to enable primary care facilities to expand their patient lists. We believe the delivery of this additional spatial capacity is a key component in supporting the reduction of the NHS backlog and waiting times for treatment.
Our support of the NHS Long-Term Plan has led us to invest in programmes geared towards the prevention of poor health. We have opened vacant space in our sites both to bring outpatient services out of acute sites and into communities and to provide premises to health and wellbeing initiatives and charities seeking to promote improved population health. This action in providing the infrastructure to fight poor health outcomes seeks to safeguard NHS waiting lists in the long term and give the NHS the space it needs to combat the treatment backlog caused by the pandemic.
At NHSPS we know that the NHS’ greatest asset is its people, and through our investment in better colleague environments we seek to promote their wellbeing. We hope that our activities in this regard serve to support colleague resilience, and ultimately clinical capacity to reduce waiting lists and help patients to access the care they need.
Expanding the estate’s capacity
Work to support demand over the pandemic
In response to the threat to NHS capacity posed by the escalating pandemic, in March 2020 we identified vacant space in our portfolio that could be reconditioned for patient use. Through this work we recommissioned 1,503 beds or 46,220 sqm of additional space across 52 sites in England. The cost of recommissioning this space was £1.5 million – representing an efficient return on investment. The programme was an example of our ability to quickly respond to rapidly rising demand for bed capacity in a cost-effective way utilising the existing estate.
Subsequently a number of our customers have retained the bed space we recommissioned during our pandemic response, with Brentwood and Basildon Clinical Commissioning Group (CCG) and Northeast London Foundation Trust retaining 120 of the 176 beds created at Brentwood Community Hospital to accommodate COVID patients.
In addition to bed recommissioning to expand inpatient capacity, our teams of frontline cleaners have worked tirelessly to ensure that inpatient wards have been ready to safely accommodate patients. Over the pandemic, NHSPS domestic colleagues have delivered over 9,000 incremental discharge cleans, enabling inpatient beds to be turned over quickly and efficiently.
Optimising space within the NHS estate
Our business-as-usual activities in reconditioning the estate have also served to expand capacity across the NHS to enable them to better cope with the NHS backlog.
We are working hard to keep the NHS estate fully operational, and by the end of this financial year, will have spent around £65 million on backlog maintenance. This figure represents a substantial proportion of our overall maintenance backlog (around 9%), keeping the estate in a good condition and maintaining its spatial capacity.
We have gone above and beyond in maintaining our estate and our Healthy Places programme, a pipeline of our 300 most significant projects, will see approximately 150,000 sqm of improved space over the next 3 years.
One example of this work is at Lance Burn Health Centre in Greater Manchester. In this project we reconfigured poorly-utilised space in the Health Centre to create a store for patients’ medical records across the local Primary Care Network (PCN). This work has freed up 6 rooms in buildings across the PCN and the local CCG estimate that this additional capacity will enable the participating practices to take on a combined total of 6,000-8,000 patients.
We believe that the quickest, most efficient and cost-effective method of expanding clinical space and capacity within the NHS estate is in the repurposing and improved utilisation of existing buildings.
Whilst the NHS property companies are unable to address staffing issues within the NHS, in our work during the pandemic we have demonstrated our ability to deliver the spatial capacity the NHS requires to service the increased demand created by rising treatment backlogs and supporting a reduction in waiting times for patients.
Support for the delivery of preventative services
As part of our commitment to delivering on the NHS Long Term Plan’s emphasis on the prevention of ill health, we have sought to support preventative services to alleviate pressure on the acute care sector in the short, long, and medium term.
Our Open Space scheme, which enables clinicians to rent both clinical and non-clinical space on an hourly, daily or sessional basis has increased access to healthcare in communities, with the sites predominantly being used to deliver clinical services, such as outpatient clinics. Created in 2019, Open Space has taken 151,000 bookings and 80% of these were for clinical use. This transfer of outpatient services out of acute hospital settings and into communities not only increases spatial capacity in those acute sites, but also enables patients to seek preventative treatment, alleviating waiting list pressure on the acute sector.
In addition to clinical use, Open Space is actively supporting health and wellbeing programmes by providing affordable and bookable space within our sites, with 6% of bookings being used for mental health services and 4% for community-based schemes. The preventative benefits of accessing these health and wellbeing services could support a reduction in demand for acute services for both physical and mental health.
The Listening Place, a suicide prevention service based in Camden, is one such organisation that has taken space in our property under our social prescribing programme. In addition to providing free space to the charity, we reconditioned the space they occupy to create a modern and pleasant environment for The Listening Place’s service users to come and meet with their counsellors. The charity does excellent work in providing support and counselling to adults contemplating self-harm and suicide, preventing both acute psychiatric and hospital admissions.
Whitton Clinic in Suffolk is another NHSPS social prescribing site providing wellbeing services to the local community aimed at preventing ill health. The site plays host to a range of tenants, one of which is Active Suffolk. A part of the England-wide Active Partnership, Active Suffolk works to encourage more people in the community to take part in physical activity and, in doing so, increase its overall health.
Through NHS Open space and our social prescribing programme NHSPS seeks to provide an estate that supports the prevention of ill health and the growth in patient waiting lists.
Support for the wellbeing of frontline colleagues
NHS colleagues are one of the most important tools in combatting the treatment backlog. We are keen to support their wellbeing by providing high quality rest and working environments. Through our Building Refresh Programme we have invested £1 million in improving colleague spaces within our properties.
An example of one such project was the improvement of colleague spaces at Cramlington Health Centre, delivered in late 2020, as part of a wider £850,000 refurbishment of the facility. Works included toilet refurbishment, the delivery of a new staff kitchen and dining area, and the full redecoration of the site. We have had positive feedback on the changes from colleagues on the site who say that these newly renovated colleague areas provide them with the pleasant and comfortable environment they need to unwind on their lunch breaks.
On developing the colleague spaces of the new Goodman’s Fields Health Centre in East London, we worked with our design consultant AECOM and the site’s tenants to provide a facility that supports colleague wellbeing. In hearing tenants’ feedback that high quality rest environments were important to them, we worked hard to develop a design for the site with a therapeutic focus that offers green space. The site centres around a courtyard that provides natural light and views out to a landscaped garden, providing staff with a peaceful and pleasant environment in which to work. Colleague spaces include a large, open plan kitchen for those working on site to take breaks and relax in on busy days.
NHSPS hopes that through our focus on providing quality environments where clinical and other frontline colleagues can rest and unwind whilst on duty, we are helping to maintain NHS staffing capacity and driving a healthy and happy workforce to meet rising demands for care across the health system.
December 2021
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