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FM TAG Review:

THE NEW AGENDA FOR HEALTH AND THE IMPLICATIONS FOR FACILITIES MANAGEMENT

Friday 9th June 2000

Marriott Hotel, Preston

The theme for the day revolved around the Government proposed National Plan, detailing concepts to challenge existing practice and future development of Facilities Management.

KINGSLEY MANNING (Managing Director, Newchurch & Company Ltd)

"Meeting the Challenge of Delivering the New Agenda for Health"

Kingsley commanded the attention of the audience when he referred to the proposed new model of Health Care, and suggested that, the increasing expectations of the patient (customer demand) would drive change in the future. Kingsley presented his view of the factors, which would affect Health Care in the future. He explained that the general population would have the right to the same standard of Health Care in all EU countries and this would have an impact of future Health Care in Europe. The shifting purchasing power of the elderly, will also have some impact on future health care provision. The role of medical consultants, future contracts of employment could eliminate the private practice element. He compared the NHS to the Education Sector, could we be seeing the introduction of "Beacon Hospitals" and a similar organisation to "Offstead" could be responsible for identify failing Trusts. The introduction of a Hit Squad could be on the political agenda. He went on to say that Best Value as in local Authorities may be introduced, where Benchmarking will play a vital role in comparing standards and costs. The use of the National Audit Office and other Organisations Database could also be used to test value.

I was particularly interested in Kingsley's reference to the future Facilities Management Arrangements, where shared services could be organised between Acute Trusts and P.C.T's. The enormous impact of new technology (I.T), for Facilities and particularly General Practitioners were discussed. He demonstrated how computing services and the greater use of the world wide web could revolutionise the work carried out by Health Care Practitioners in the NHS overall.

He referred to 32 P.F.I schemes which were being developed, however schemes under £25 million he considered to be not cost effective due to administrative and legal costs. He emphasised that some of the following important service trends would be developed in PCT's, for example segregation of certain services (elective surgery), Computer systems for GP's and the concept of walk in centres for Health Care.

Kingsley set the scene for the day and gave delegates much food for thought.

DR DAVID COLIN-THOME, OBE, General Practitioner - Runcorn, was the second speaker for the day.

"The Importance of Primary Care"

The main theme of David's paper referred to the changing role of the General Practitioners and their relationship with Primary Care Trusts. He indicated that one of the main functions in the future would be to act as "Gate Keeper" in terms of admissions/referrals. He said that the introduction of "Walk-in Centres" would be a prime objective and the impact of NHS Direct would be further developed, where patients contacting the service would be offered specialist expert advice at the time of enquiry.

PCT's could in the future have a Lead Health Minister and that expression of interest from PCG's must be supported by the majority of General Practitioners from within that area.
He considered that General Practitioners will be required to provide a National minimum standard and this should relate to future demands in Primary Care. He said that the future of Out Patient Departments may need further review and that the introduction of "higher skilled nurses" (Nurse Practitioners), into Primary Care establishments would be the way forward, taking pressure off Acute hospitals.

David painted a picture of how Primary Care Trusts would generally change the present Community Health Services. He stressed that the credibility of General Practitioners would be a key issue of a future Government Directive.

PEARSE BUTLER, Chief Executive, Royal Liverpool and Broadgreen University Hospitals NHS Trust

"Delivering Acute Health Care In the Future"

Pearse supplemented David's presentation with views of his own. He stated that the retention of centralised services in Acute hospitals will continue, however the new Health Care Model will create rapid change especially in such areas covering specialised clinical services i.e. Cancer and key hole surgery. He hoped that the present shortage of doctors could be resolved by the year 2005. The role of the Medical Consultant could change to offer a 24-hour Specialist cover, and in the long term improve out of hours quality of care. He said that high technological based services would remain in large Acute Hospitals

There was a case, however, for some de-centralisation of services for example in areas such as tele-medicine, dermatology and primary care and that future referrals could perhaps be made direct to a team of doctors rather than to individual GP's. He went on to describe the impact of Modernising the NHS and specifically referred to the "Patient Experience". He suggested that in addition to dealing with patient waiting lists, as a priority and concentrating on the performance monitoring of medical staff; the Government would be concentrating on the Supporting Services such as Catering, and the cleanliness of hospitals. These services would be compared through Benchmarking activities and performance management would become the norm.

The future of Out Patient Departments with the impact of walk-in centres would change future demands for Out Patient Services. The provision of Care of the Elderly could be extended into the Private Sector and provided by Nursing Homes. Round the clock provision of emergency services should be provided with full Consultant input in the future. Pearse went on to emphasise the importance of the greater use of new technology, the introduction of digital TV access by patients and touch screen computer services at ward level

CERI DAVIES - Professor of Building Resource Management, Cardiff University.

"Remodelling the Infrastructure to Meeting the New Challenge"

Ceri commenced his presentation by referring to his professional experiences in connection with NHS Estates and his principal current academic research projects. He referred to the many changes that have occurred during the past three decades; he even made reference to the commencement of the NHS in 1948 and to the basics of health care started by Florence Nightingale. Many of the fundamental practices of the past and experiences of management he suggested should be revisited and included in future initiatives.

Professor Davies went on to suggest that some Managers had lost sight of basic Estates Planning and Design Principles. He emphasised that there was a need to identify specific problems through the process of an Estates Strategy. He also emphasised the need to improve the quality of decision making. The present system is slow and cumbersome and perhaps there is a need to develop a management technique that would speed up the process, creating quicker response in resolving problems. A team approach should be developed, within the organisation and should take into account the following:

* Pace of change
* Productivity
* Social Demands
* Resources i.e. cash
* Sustainability

The main message for the day from Ceri was that Managers should judge the importance of their main function in relation to the overall purpose of the business and that was the provision of Health Care to the nation. His final comments were that there was no one solution to any problem and that Managers should investigate all options.

ROB THOMPSON - Senior Head of Estates Development, NHS Estates, Leeds

"The Implications of Future HealthCare Trends for Facilities Management"

Rob gave an excellent presentation and expanded upon the need for change in Facilities Management. He made reference to the following topical issues, which in his opinion would shape the future of Health Care and the requirements of Facilities Services:

* Consumer Direction - Patient experience
* Procure 21- the principal theme was Project Partnership
* Primary Care Trust - He expanded on the important role that Primary Care Trusts would play in the future of Health Care.
* Egan Report

In discussing in some detail the future role of NHS Estates/Facilities he stressed the importance of breaking down existing barriers; ensuring the uniformity of high standards in maximising cost value and quality in the services provided. He continued to talk about Patients Expectations; their first impressions of the facilities and that there should be an improved ambience on hospital sites. Catering and Hotel Services would have a "high profile" in the future. National standards will be set and agreed with Trusts. Quality assessment will be achieved through Benchmarking, Best Value and assessing Performance Standards against National League Tables.
The proposed National Plan - Rob indicated that some of the following issues would be addressed:

* Strategic Planning
* Health and Safety
* Fire Safety
* Environmental Management
* Estate Code
* Facilities Management

In conclusion he referred to the need to develop a National Training Strategy, the establishment of recognised qualifications within Facilities should be introduced. Staff development would form an important part of the Estates Training Strategy in which coaching and mentoring would be an important feature. He referred to the excellent work presently carried out within the North West Training Advisory Groups and suggested that these could be extended and used within the national framework. He went on to refer the need to value the expertise of existing Managers within Facilities and that the development of future Managers should be on a "fast track" arrangement. In summing up Rob emphasised the need to capitalise on past experience and to progress Estates and Facilities Services to the twenty first century, taking into account the impact of new technology and the revised National Strategy.

Mike Gallagher - Director of Facilities, Blackpool Victoria Trust chaired the day with his usual professional charisma. He emphasised the importance of Professional Networking and the need to gain professional knowledge from participating in national and local training events. Mike encouraged audience participation during the day, which in turn generated a positive response to the subject areas of all the speakers.

My Views

The seminar provided a platform for the future development of Facilities within the NHS and that many of the initiatives identified by the speakers should be used for future seminars.

Review by:
Graham Hague,
(FM and Hotel Services TAG Member)
Facilities Operations Manager, Blackpool, Wyre and Fylde Community Health Services NHS Trust

Itinerary

A NEW AGENDA FOR HEALTH AND THE IMPLICATIONS FOR
FACILITIES MANAGEMENT

held on
FRIDAY, 9TH JUNE 2000

in the
BROUGHTON SUITE,
PRESTON MARRIOTT HOTEL,
GARSTANG ROAD, BROUGHTON, PRESTON, LANCASHIRE

The purposes of this conference is to identify trends in the future provision of Healthcare and their impact upon facilities management. This involves an overview of the provision of Healthcare, the implications of primary care groups / trusts and how the new models of Healthcare will impact upon the provision of acute Healthcare services.

One of the speakers is Professor Ceri Davies whose presentation will focus upon the implications of health trends for the NHS infrastructure and changes needed to meet the new agenda.

Finally, the conference will consider how facilities management should respond to the changes in the provision of Healthcare.

The cost of attending the Conference is £125.00 per person or £95.00 each for two or more attending from the same Trust. This includes attendance at the Conference, coffee/tea on arrival, mid morning coffee/tea and biscuits, 3 course lunch served in the Four Seasons Restaurant of the Marriott Hotel, and afternoon tea/coffee and biscuits.

Itinerary

PROGRAMME

9.00 am Registration, Coffee/Tea on Arrival

9.30 am WELCOME AND INTRODUCTION

Michael Gallagher,
Director of Facilities & Chairman of the Facilities Management TAG, Blackpool Victoria Hospital NHS Trust.

9.45 am MEETING THE CHALLENGE OF DELIVERING THE NEW AGENDA FOR HEALTH

Presenter - Kingsley Manning
Newchurch & Company Limited,London

10.45 am Coffee / Tea and Biscuits

11.00 am THE IMPORTANCE OF PRIMARY CARE

Presenter -
Dr David Colin-Thome, OBE General Practitioner, Runcorn

11.45 am DELIVERING ACUTE HEALTHCARE IN THE FUTURE

Presenter - Pearse Butler
Chief Executive, Royal Liverpool and Broadgreen University Hospitals NHS Trust

12.30 pm QUESTION & ANSWER SESSION

12.45 pm 3 Course Lunch Served In Four Seasons Restaurant

1.45 pm REMODELLING THE INFRASTRUCTURE TO MEET THE NEW CHALLENGE

Presenter - Professor Ceri Davies
Building Resource Management, Cardiff University

2.45 pm Tea / Coffee and Biscuits

3.00 pm THE IMPLICATIONS OF FUTURE HEALTHCARE TRENDS FOR FACILITIES
MANAGEMENT

Presenter - Rob Thompson,
Senior Head of Estates Development NHS Estates, Leeds

3.45 pm OPEN FORUM

4.15 pm CHAIRMAN'S CONCLUDING REMARKS

Presenter - Michael Gallagher

4.30 pm CLOSE OF CONFERENCE

ABOUT THE SPEAKERS

MICHAEL GALLAGHER,

Director of Facilities and Chairman of the Facilities Management TAG, Blackpool Victoria Hospital NHS Trust
Mike Gallagher is a Building Surveyor by profession and is Chairman of the North West NHS Facilities Management Training Advisory Group. He is employed as Director of Facilities by Blackpool Victoria Hospital NHS Trust and is responsible for the delivery of non clinical support services. The annual revenue budget for the Facilities Directorate is in excess of £11 million and the directorate employs approximately 340 staff (excluding contracted out services) and has a capital budget in excess of £6 million. Mike is an associate Director of the Trust Board and has an extensive involvement in planning the Trust's strategic direction. He is also Project Director for a major re-development of the site, costing in excess of £30 million.

KINGSLEY MANNING,

Managing Director, Newchurch & Company Limited, London
Kingsley Manning is the Managing Director of Newchurch & Company. Since founding Newchurch in 1986, he has pioneered the concept of social businesses, bringing innovative and often radical approaches to organisations in healthcare, government, and education, as well as, private sector companies. Kingsley has worked for over 250 healthcare clients, in both the public and private sector, in the last 13 years and has played a leading role in the development of the Private Finance Initiative in the NHS. His particular skills and experience relate to service review, healthcare strategy and business planning for both purchasers and providers of healthcare services. Kingsley has written and published widely on healthcare and other issues relating to social businesses and is an established contributor to national conferences and seminars. He has completed the publication of a series of Briefing Papers looking at the impact and implementation of the White Papers. Kingsley has an Honours Degree in Biochemistry, a Masters Degree in Business Administration and a Diploma in International Management.

DR DAVID COLIN-THOME, OBE, General Practitioner, Runcorn.

Dr David Colin-Thome, OBE, MBBS, FRCGP, MFPHM, MHSM, is a Graduate of Newcastle University. Has been a General Practitioner since 1971 in Runcorn, and a part-time General Practitioner since 1994. He is a Director, Primary Care - London RO., NHSE (part-time); Primary Care Adviser NWRO, NHSE; Primary Care Adviser to Dorset Health Authority and Community Trust; Part-time Fellow of the Health Services management Unit at Manchester University; Fellow of the Royal College of General Practitioners; Member - Steering Group of the National Primary Care Research and Development Centre; Editorial Advisory Board "Journal of Management in Medicine"; Editorial Advisory Board "Employing Medical and Dental Staff". David is married with two grown up children, a proud grandfather and "loves Everton Football Club !"

PEARSE BUTLER,

Chief Executive, Royal Liverpool and Broadgreen University Hospitals NHS Trust
Pearse Butler is currently Chief Executive of the Royal Liverpool & Broadgreen University Hospitals NHS Trust which is a large multi-site integrated Trust with an annual budget of approximately £177m. The Royal Liverpool Hospital is one of the largest Acute Teaching Hospitals in Europe and employs approximately 5000 staff. Previously, Pearse has held the post of Chief Executive at Wigan and Leigh NHS Trust, Wirral Health Authority and the Royal Liverpool Children's NHS Trust. He is an active member of ESAT, the Emergency Services Action Team. He has a BA Honours Degree in Jurisprudence from Keble College, Oxford. Pearse is married with two children and despite living in Liverpool, is a season ticket holder of Everton Football Club.

CERI DAVIES,

Professor of Building Resource Management, Cardiff University
Ceri Davies is currently Professor of Building Resource Management at Cardiff University and a consultant in private practice. He is a chartered architect, chartered builder and is also a past President of the Institute of Health Service Engineering and Estate Management. Among his two principal current academic research projects are an EEC funded study into the productivity of scanning services in health services across Europe and a study on the running cost implications of hospital layouts. Current practice commissions include strategic estate planning for hospitals, Health Action Zones and Universities throughout the UK. Previously Professor Davies was Head of Consultancy at the Department of Health, London, and was responsible for developing a number of health planning, design and related financial concepts which have become widespread in the NHS. He was chairman of a government enquiry into property management in the NHS and his report has become fundamental to strategic estate planning throughout the public sector. He was previously Visiting Professor of Facilities Management and Architecture at the Universities of Strathclyde and York respectively and Research Fellow at the College of Estate Management, Reading University.

ROB THOMPSON,

Senior Head of Estates Development, NHS Estates, Leeds
Rob is currently Senior Head of Development at NHS Estates in Leeds which he joined in 1997. He joined the NHS in 1973 and has held various posts which include Chief Executive and Director of Strategic Development. He has over 25 years experience of the NHS, working mainly in major acute hospitals throughout the North of England. His varied experience includes leading a successful Trust application and developing and delivering several major capital schemes. He is currently involved in several policy areas including Controls Assurance, A & E Modernisation Programme and Facilities Management. He recently co-ordinated the Developing an Estates Strategy publication. Rob is also a Non-Executive Director of a rapidly growing specialist training organisation and has an increasing interest in critical management.