Lessons learned shared at joint study day

At the recent Joint Study Day held by HEFMA, the HCA and the ahcp in Bristol (February 15), Tricia Down, Head of Sustainable Health & Capital Planning at North Bristol NHS Trust explained how a new way of working was central to the planning of the new Southmead Hospital, Brunel Building. This was particularly relevant for the facilities staff, who formed one of several user groups involved in the planning process.

Down was very clear about the successes of the project, elements that didn't work and lessons learned. She also pinpointed succinctly the consequences in terms of the provision of FM services through some of the design decisions implemented.

Some of the learning from this process:

* The new Southmead Hospital famously installed robots/Automatic Guided Vehicles for some of the portering services, but they weren't embedded in the design from the outset so they operate in standard corridors. If building from scratch, embedding robots into the design means they can be specifically accommodated, with their own corridors.

* The 32-bed wards offer 75% single room en-suite accommodation with a single four-bed bay. A 60-40 split might be more optimal as it is easier for staff to care for seriously ill patients if they are grouped more closely together.

* The single room en-suite accommodation decision also impacted on cleaning by significantly increasing the number of wash hand basins and toilets.

* Dementia has become a much bigger issue even in the relatively small amount of time since this hospital was designed and built. They didn't have a strong vision for dementia care and although they have some good elements in place, such as clear wayfinding, they also have lots of doors, so dementia patients cannot wander around a continuous loop without encountering an obstacle.

* The demands of health and safety can conflict with the needs of cleaning teams - particularly over elements such as slip resistant flooring. The hospital is now introducing cleaning robots.

* One of the design principles was to bring the outdoors into the building as much as possible because daylight has a positive impact on the wellbeing of patients and staff. The hospital was designed with particularly wide windows, but this meant special curtains had to be sourced.

* The procurement solution selected for patient entertainment at the bedside failed at the last minute and left the hospital with no TVs for nearly two years after opening. Access to a charitable fund eventually provided TVs on stands, but the wards now have exposed cables and covers on the walls, which complicates the environment for cleaning teams.

Flexibility to respond to changes in the way services are delivered so the building is still in good shape and good for purpose in 30 years' time; introducing trailblazing ideas that work as opposed to pioneering innovation; sustainable development throughout with open spaces, transport provision, energy-efficiency, water-efficient appliances and minimum carbon footprint; and the importance of achieving an excellent finish are all important elements that the team at Bristol stuck to throughout.

"We could have done things differently, but overall I think it's been a success," said Down. "Set a clear vision and try to keep hold of that. Listen to people's ideas - I don't think we did enough of this. And ensure FM staff are embedded in all the discussions."

This was the first joint event held by the three associations since they pledged to work more closely together with the signing of a Memorandum of Understanding just over a year ago. The National Chairs from each association - Stewart McKenzie, HCA, Lee Peddle-Blair, ahcp, and Jonathan Stewart, HEFMA - each provided an update of their activities. Jonathan Stewart stressed that strengthening connections with partner organisations, associations and different Trusts working together are practices that will lead to a stronger NHS Estates & Facilities profession.

The programme also included a presentation from HEFMA National Secretary, Alison McCree on the topical subject of establishing a wholly owned subsidiary - County Durham & Darlington (CDD) Services, of which she is now Managing Director; Andy Turner and Martin Withers from Spearmark Healthcare, who outlined the extremely positive results from trials of its innovative new patient hydration system, Droplet®; and Elliot Perry from Menumark who provided an update on the technology available through electronic patient meal ordering systems and the benefits to the hospital caterer. The Forum was mediated by Mark Hayman, Vice President of the HCA.