The Board at Worcestershire Health & Care NHS Trust now receives a comprehensive overview of the cost, quality and productivity metrics relating to the running of Estates and Facilities (E&F) thanks to a suite of internal Key Performance Indicators (KPIs) developed in-house by Head of Estates, Richard Best. The initiative was shortlisted for HEFMA’s 2020 Awards in the Efficiency & Improvement category.
The KPIs amalgamate information drawn from ERIC, the Model Hospital and PLACE scores to provide detailed information about the performance of E&F, benchmarked against peer group Trusts. It is the first time information of this breadth has been available for the Trust Board and provides significant assurance around the E&F performance, covering maintenance, cleaning, catering and sustainability.
The information has also enabled the development of a performance reporting discipline within Richard’s team as well as highlighting where the team is performing strongly or needs improvement.
The data sets generated help to provide evidence to both the Trust Board and team colleagues of the value of measuring the estate performance and being able to correlate data with strategy. For example, the Trust’s high quartile cleaning costs per square metre for the clinical space correlates with very low infection incidents, which justified a previous Board decision to move away from outsourced cleaning contracts. This incentivises colleagues to take a much greater interest in the value the estate plays than was hitherto the case.
In another example, outlier high patient food costs at some in-patient sites were found to relate to additional catering services that were not evident at other sites but are relevant to the patient group. This has led to increased patient compliments through the PALs system and FFT tests, again vindicating a Board decision. The data pulled from ERIC also highlights the benefits to those sites where the Board has supported investment in projects such as boiler replacement and LED lighting.
Perhaps the biggest fundamental change brought about through this initiative is the interest and awareness at Board level of the total cost of the estate. This brings confidence and assurance that the estate is being efficiently monitored and managed so that future investment can be expertly prioritised. An example of this is the evidence around energy consumption anomalies which justified a roll-out of sub-metering and other energy monitoring devices as a result of which both consumption and cost have fallen significantly on some sites.
The presentation and quality of the data analysis informs investment decisions across the whole estate. For example, it is now possible to include compliance elements, upgrades and other cost saving measures into capital projects with information on how these developments need to be maintained and life-cycled. This in turn leads to more efficient projects, fewer snags and also fewer variations, as end users are closely consulted.
Despite the variation and definition anomalies in ERIC, Richard has produced site-by-site relevant comparators identifying the benefits of sub-metering, new plant investment, energy management systems and other investments, which coupled with monitoring and management systems demonstrates real savings that can be replicated across other parts of the estate. This has led to some marginal improvements in the Carter indices, which are already in the "green" zone. The estate is now better utilised, with some redundant space also being brought back into use.
This approach could be adapted to any diverse or complex estate portfolio within the public or private sector. The principles of good estate management backed up by well-evidenced data to inform estate decisions are universal.
