A longer-term solution to meet the needs of Estates departments is an Enterprise Asset Management system that can be used to track and manage assets throughout their lifecycle.
The landscape of hospital estates has changed dramatically over the last decade. Where key drivers for those managing hospitals and healthcare settings used to be predominantly user experience, cost, and efficiency, there are now many other essential elements to the mix, including the Net Zero carbon (NZC) agenda, and how the estate and its surroundings integrate into the communities which they serve. Many healthcare Estates and Facilities Departments are now dealing with the triptych of an ageing estate, little, if any budget, and increasing pressure from stakeholders to maintain and improve. Understanding the condition of your estate is the key to unlock how best to strategically plan both refurbishment and new-build projects, and data is the gold dust that helps this understanding
Facilitating strategic masterplanning
I have written in detail before about how six-facet surveys are now more than just a tick box, but rather can provide the data to facilitate strategic masterplanning, support Outline Business Cases (OBCs) and Full Business Cases (FBCs), and, ultimately, the funding for estate management. However, six-facet surveys also have a role to play in helping Estates and Facilities management personnel meet their sustainability targets, and work towards their Green Plans, with the physical condition of buildings and estate, compliance, and Net Zero carbon goals, all intrinsically linked to ensure that effective capital planning and potential funding streams are available.
There are two key NHS Net Zero targets:
Direct emissions (the NHS Carbon Footprint): Net Zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032, and
Indirect emissions (our NHS Carbon Footprint Plus): Net Zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039.
Act now
All NHS Trusts will need to identify routes towards Net Zero, and deliver continuous improvement against their Green Plans. The best approach is to address the challenge sooner rather than later, with the 80% reduction now only 5 years away. As a healthcare organisation, your approach to sustainability should recognise the link between built assets, operational impact, and your corporate responsibility, and a six-facet property appraisal can help guide this. In my experience, early engagement is key, and defining sustainability services which encompass the whole estate lifecycle is essential to transformation. This approach can mean that you build in a sustainability flavour to your six-facet survey data collection over and above that of the environmental management facet, to think beyond backlog maintenance, and maximise your outputs to serve multiple agendas, saving time and money in the process
A traditional approach to developing strategies to reduce carbon can be broken down into four key stages:
Building area, age, construction form, and condition – This data can be brought out of the physical condition facet through the typical elemental hierarchy.
Annual energy consumption and costs – this information can be brought out of the environmental management facets by analysing and presenting the consumption data within the report over and above the traditional benchmarking exercise, as prescribed in the Estatecode.
Occupancy levels – This data is already captured under space utilisation, and can be enhanced by capturing data at room level using digital technology, and IoT.
Carbon emissions – Not captured traditionally during a six-facet survey, but a methodology can be developed to incorporate this as part of the property appraisal exercise contemporaneously
Data requirements
With data the golden thread that runs throughout all four of these stages, the following list outlines the in-depth requirements of this data to support a decarbonisation plan, all of which could be incorporated into a six-facet property appraisal:
DECs (Display Energy Certificates) for each building.
Energy consumption for each building.
Energy costs per building.
Energy type per building.
Energy capacity and load per building.
Metering and monitoring per building (e.g. via a BMS).
Building area (approx.) per building.
Age and type of building.
Previous energy efficiency works.
Previous benchmarking and data analysis.
Carbon data if previously available.
Approaching a six-facet more ‘strategically’
At RLB, our approach isn’t just to capture a moment in time, but rather to help a Trust build a complete picture of where they are now, effectively providing them with a benchmark for their Net Zero carbon journey. Our goal is to remain independent, while collaborating closely with the Trust to make sure that our property appraisal outputs are a true reflection of an estate, and become a key partner in understanding it, not just now, but equally in the future as it develops.
To achieve this outcome, it is vital that your chosen consultant works not only with your Estates & Facilities team, but also with the organisation’s key clinical delivery teams. Collaboration and communication are key. For a successful appraisal, and for the optimal such process, the relevant Trust teams should regularly engage with the consultant and provide feedback on the operational estate, elemental performance, and how the portfolio performs 365 days of the year. Good collaboration, and investment in time from the Trust, will not only improve the quality and depth of the data collected, but will also result in the date being valued in the longer term by the team that invested its time and energy in its collection.
Ensuring that you have one version of the truth at the start of each project is fundamental to the veracity of, and trust in, the information. It also allows Estates managers to incorporate the data and knowledge into any report findings, and encourages adoption of a sound partnership model adopted. So, for example, recording not just carbon emissions at one particular point in time, but also embodied targets agreed by all stakeholders at the start of the process, and referenced across all reports, will ensure that progress can be logged and areas that are not improving investigated.
Piloting the study to ensure a trusted dataset
The benefits of having a trusted dataset for the future, and the extent to which it can help Estates managers, will depend very much on the individual scenario and the level to which data is actually collected. However, what will be apparent is that agile reporting on the property portfolio, rather than relying on anecdotal information, will be beneficial in many ways to all stakeholders
A robust pilot study is crucial to the successful delivery of any surveying commission. At RLB we recognise that no two commissions are the same, and that all clients have specific drivers, despite the sixfacet survey being an HBN requirement. A pilot survey exercise should be undertaken to help support the following:
Minimal disruption to the Trust at roll-out, with only a small area being surveyed initially.
The creation and design of access protocols for the remaining programme.
A communication plan and programme agreed with the Trust and clinical delivery teams, to facilitate access and a better understanding among all departments.
A deeper understanding of the Trust’s requirements for the programme.
Understanding how the six-facet survey fits in with wider strategy, in more detail, such as sustainability and Net Zero carbon objectives.
Formulating bespoke template spreadsheet and reporting dashboards.
Presenting and reviewing a Request for Information required by your consultant.
Testing of the process to upload/ download to a CAFM system if needed.
A concise mobilisation phase for the main programme.
Development of bespoke training materials and a Quality Plan.
Presenting the pilot study prior to Trust-wide roll-out to ensure that you are getting what you need.
Working with your Estates team to demonstrate the data in the future, and allow trust to be created in the data with a wider ownership of it.
Lessons learned being shared to support the long-term health of the dataset and reports.
Ensuring cost control
A well-executed pilot survey will encourage a collaborative approach throughout the entire programme, ensure cost control, and allow stakeholders to build trust in the survey data from the outset. Lessons learned can then be carried forward into the rest of the programme for the benefit of the end-result. This has become increasingly important recently, with significant increases in the costs of materials and labour affecting replacement costs, and having a big impact on backlog profiles and values. It’s vital that this is communicated to Estates teams at an early stage to build awareness of the impact on their backlog maintenance, and how they can explain it to their internal stakeholders
Once the dataset has been collected, we recommend a three-step plan of action:
1 Create a series of bespoke dashboard reports to summarise and signpost the collated information into true actionable intelligence – start with the end-goal in mind, and capture the appropriate data in a way that drives your end-results. This is a key area where sustainability themes can be bought forward into the dashboard reporting – identifying key elements inside the six-facet methodology that would be part of a decarbonisation plan, for example – and bring those elements to the forefront of the reports. This can help to identify projects that would traditionally sit under a ‘business as usual’ backlog maintenance project that can be potentially funded separately, or prioritised as part of the capital planning activity.
2 Run collaborative workshops with the appropriate Estates team or FM provider representatives to discuss underlying mechanical, electrical, and building fabric issues for individual buildings. The aim of the workshops should be to assess the history and performance throughout the year and across the seasons of the building fabric, and the fixed assets within. It is often managerial staff and service engineers who understand the issues and recurring maintenance issues on site, and are able to draw attention to problems that could otherwise be missed during a snapshot condition survey. These workshops build trust in the data set by the Estates team, meaning that any suggested measures have more chance of being adopted to help shape the future of the estate as a baseline data set.
3 End the project thinking about a strategy for reviewing the data in accordance with the NHS Estatecode and the annual review process. Analyse your data in a holistic way to drive real value and outcomes that give Trusts best value for their capital. We have recently worked with a Trust which identified a ‘fabric first’ approach to sustainability and data from a sixfacet survey. The information was drawn out from elemental data on windows, roofing and insulation, and external walls, and compared against buildings that had significant energy usage, and poor occupancy levels and space utilisation. This identified a significant portion of the Trust’s backlog maintenance that could be prioritised as part of its Sustainability Programme
Developing an Enterprise Asset Management system
A longer term solution to meet the needs of Estates departments is an Enterprise Asset Management (EAM) system that can be used to track and manage assets throughout their lifecycle, and help drive your six-facet property appraisal objectives – including how they operate from a sustainability standpoint. EAM systems typically include features for tracking asset location, maintenance history, and financial data. Many EAM systems also include functionality for scheduling maintenance, managing inventory, and generating reports, all of which can be used to help reach Net Carbon Zero goals. Elements captured in a six-facet survey would be part of this programme, and can be incorporated by collecting additional information on certain equipment, and creating a hybrid asset register with a six-facet property appraisal.
Having this accurate data that fits your current and future needs can continuously drive forward substitutability, giving agility to Estates managers on reporting on the prioritisation of future works without the need to commission further surveys to tell them what a six-facet survey can already inform them, especially if collected via an easy-to-use reporting methodology.
What will be apparent is that agile reporting on the property portfolio, and not relying on anecdotal information, will be beneficial in many ways to all stakeholders as part of the development of the EAMs:
It will bring an appraisal of each asset or building within the portfolio in a holistic way.
Feeding in the sustainability agenda with an additional layer of prioritisation over and above the risk-based methodology. What assets should be focused on that have significant impact on operating costs and utility consumption, and how are they prioritised?
Opportunities for intelligent and informed procurement where trends in material can be captured in a more strategic and sustainable way, and potentially procured under one contract.
Maximising the remaining life of existing assets by operating a condition and risk-based approach, meaning you can de-risk your portfolio with target capital spend.
Six-facet survey information can be adapted and formulated into more traditional EAM systems that tend to be driven by asset registers. I have included a typical process map that was deployed on a previous project, where a Trust was deciding on whether to proceed with the installation of a CAFM system over and above its typical spreadsheet internal system, and where the following stages guided them through the process. I have also indicated where this could be adapted to include sustainability information and outcomes.
Conclusions
There is no doubt that capturing sustainability performance will continue to help healthcare estates teams work towards their Net Zero carbon agenda, and will remain as important, if not increase in importance, in the future. Understanding how to capture accurate baseline information of all assets will drive multiple agendas – avoiding having to undertake the same job twice, and bring efficiencies to health estates teams. Accurate data will be the key to decision-making, with insights and analysis defining and prioritising maintenance and reconfiguration requirements. The need to bring in stakeholders outside of Estates teams and work collaboratively will remain essential to achieve both sustainability and productive goals. As we move into the future, how we operate our healthcare estates to be kinder to the environment, and how we drive efficiencies through them, will both remain a focus, and I believe the six-facet survey will remain one of the key processes to enable us to do just this.
Brook Smith
Brook Smith is a Partner at independent property consultants, RLB, and head of Building Surveying in the company’s Birmingham office, as well as being Regional Health Sector lead and National lead of Six-Facet Property Appraisal. He has 15 years’ experience working in healthcare, primarily in the delivery of estates strategies and multi-facet property appraisals, and has an indepth knowledge of the challenges faced by healthcare estates and facilities departments in managing their complex property portfolios.
He brings multi-sector experience to healthcare, and has developed many bespoke asset management solutions in the retail, education, and public sectors.
Over the last two years he has worked closely with some of the UK’s largest healthcare Trusts on solutions that maximise the benefits of six-facet surveys, and on creating a methodology that can give the Trusts more information beyond the ERIC returns.