Building Better Healthcare Awards 2014 - The winners (Estates and Facilities Management Class)

Find out who picked up the coveted awards in this year's competition

The Estates and Facilities Management Class was this extended this year to reflect the vital input of EFM in helping to achieve efficiencies for the NHS. Here are details of this year's winners

Award for Innovative Carbon Reduction Initiative (sponsored by Validair)

The judges considered:

  • Virtus Consult for Heart of England NHS Foundation Trust energy sustainability project
  • Barts Health NHS Trust for Operation TLC
  • Troup Bywaters + Anders for Lister Hospital energy infrastructure project
  • Barts Health NHS Trust and Skanska for ‘Revending’ recycling project
  • Medical Air Technology for ECO-flow clear air engineering solution
  • South Eastern Health & Social Care Trust reducing carbon emissions using photovoltaics
  • Sharpsmart for CO2 reduction project for Brighton and Sussex


Virtus Consult for Heart of England NHS Foundation Trust energy sustainability project

Heart of England NHS Foundation Trust has worked with Virtus Consult to develop a unique, innovative and transferable procurement and implementation process to deliver a wide range of initiatives guaranteeing energy savings of 10-20% and payback in less than five years.

The trust has successfully achieved guaranteed energy cost and carbon savings of 12%, equivalent to £635,000 and 3,837 tonnes of carbon per year. The scheme has also enabled the organisation to make considerable improvements on lifecycle maintenance where equipment has been upgraded.

Together with experts from Virtus Consult, the trust developed a process that attracted blue chip supplier capability and encouraged innovation while optimising commercial leverage and maximising guaranteed measurable savings.

The trust has already implemented CHP schemes across its estate and wanted to focus on other improvements. At the outset it wanted the projects to be market led, third party funded, offer value for money, and be paid for through the savings achieved.

With this in mind the trust and Virtus worked together to develop a strategy and process to deliver technology improvements, consumption reduction, and behavioural changes across the portfolio without disrupting the core function of the three hospitals.

The programme of works included the installation of solar photovoltaic panels, new lighting, refrigeration controls, pipe and valve insulation, pump replacement, and the use of energy display meters.

Adrian Stokes, the trust’s director of finance and performance and deputy chief executive, said: “From a financial perspective this project has been fantastic. Not only has it allowed us to secure our carbon reduction targets, but also our efficiency targets for 2013. The team thoroughly deserves to win this award.”

John Sellers, director of asset management, added: “We have been delighted with the innovative and forward-thinking approach that has managed to deliver significant long-term guaranteed savings for the trust without disrupting day-to-day function, as well as creating a framework that incentivises suppliers to find new saving opportunities.”

The BBH Awards judges said of the winner: “This demonstrates a wide-ranging approach to energy and carbon efficiency. This entry has really taken carbon reduction to a serious level. It is a way of saving money without impacting on patient care.”

Highly commended:

South Eastern Health & Social Care Trust reducing carbon emissions using photovoltaics

A total of 2,091 photovoltaic panels with 526kW total power-generating capacity have been installed across the South Eastern Health and Social Care Trust’s main estate.

The move will achieve annual savings of 468.14mWh in grid electricity, £70,221.00 in electricity costs, and 253 tonnes of CO2. It has also led to a CRC cost reduction of £4,052.21, reduction in NIROC payments of £44,941; and a total saving of £119,214.21.

Since completion at the end of May this year, the systems have provided 31.38mWh of onsite electrical generation, saving £6,119.19 and 16.97 tonnes of CO2.

Verification of figures was provided by the installed trend Energy Manager software, reading pulses per kWh of electricity supplied through metering on the photovoltaic panels/inverters.

Over the next year, the PV systems will contribute to the trust’s compliance with its own business plan 2014/15 targets.

The savings of the scheme have been calculated on a site-by-site basis with a payback of between seven and nine years depending on the size of the array and location. Total spend was approximately £1m plus £250,000 for contingencies. This contingency fund will largely be utilised to provide additional panels, allowing the trust to increase its feasible saving levels.

To allow for the application of correct whole lifecycle costing, the systems have been warranted for a guaranteed 20 years, with insurances held independently should the supplier go out of business. This guarantees saving levels and ongoing operation of the arrays. Whole lifecycle costing will also be used in conjunction with metered data after a year as proof to other trusts in Northern Ireland via the regional sustainability group.

Beyond the estates team, the current trust-wide savings are communicated live to the public via 55ins LED displays in the foyers of the Ulster Hospital and the Downe Hospital.

“This is a serious PV investment and a great commitment to technologies that have longer payback, but are guaranteed to deliver,” said the BBH judges.

South Eastern Health and Social Care Trust was highly commended for its efforts to reduce carbon emissions through the use of photovoltaics

Barts Health NHS Trust for Operation TLC

Operation TLC is a collaborative behavioural change programme between Barts Health NHS Trust, GE, Skanska and the charity, Global Action Plan. It empowers individuals to take action to reduce energy and carbon, accurately measuring and recording changes and positively impacting on the patient experience while also identifying potential savings of £35m across the NHS.

By linking energy-saving actions to patient safety, comfort and dignity, Operation TLC has won support from senior management and frontline staff, encouraging them to take action.

The programme had four aims: to achieve financial and carbon savings; to demonstrate whether energy-efficient behaviours improve the patient experience; to create a replicable model other NHS trusts can follow; and to prove cross-sector collaboration is effective at tackling tough challenges.

The message is simple: provide the best environment for patients with three actions that everyone can do - turn off, lights out, close doors.

As part of the project, trusted on-the-ground influencers became Operation TLC advocates, inspiring staff action and identifying one-off changes that delivered high energy savings. In addition the sustainability team visited wards to share success stories and senior staff reinforced the message via screensavers and a short TLC film, giving staff the ‘permission’ needed to take action.

In total, the programme reached 15,000 Barts Health staff and their partners through sitewide communications.

A trust spokesman said: “We are the first NHS trust to do this and the model is already being used in other trusts to drive change. We hope our continued research into this area will drive improved engagement across the healthcare sector and beyond and that the programme will encourage others to form strong private/public/third sector partnerships for success.”

Award for Best Evidence-Based Compliance with Estates and Facilities-related CQC Standards

The judges considered:

  • C365Cloud and East Cheshire NHS Trust
  • Rapleys and Integrated Dental Holdings
  • Barts Health NHS Trust


C365Cloud and East Cheshire NHS Trust

East Cheshire NHS Trust was challenged with managing health and safety and statutory compliance to the rigorous requirements of the Care Quality Commission (CQC) and Premises Assurance Model (PAM).

To achieve efficiency while driving best practise, the trust recognised numerous disparate systems would need to be replaced with one, overarching compliance management system. It would need to integrate with the existing help desk, support the estates team and performance manage the numerous third party suppliers.

The trust selected C365 Cloud. Its modular design ensured the system was configured to be consistent with the trust’s Estates Strategic Plan, compliance targets and KPIs. It was configured by compliance type, building, assets and staff requirement offering.

Benefits include workload prioritised in accordance with risk; compliance managed by exception; accurate reporting to inform decisions around best-value procurement; barcoded assets located by site, building, floor and room; and follow-up remedial actions integrated with the help desk to track to completion.

Rob Few, head of estates operations, said: “With the ever-growing CQC focus on legal compliance, we recognised our estates team needed a system to support us. After reviewing the market we selected C365Cloud as a platform to manage our key compliance areas across the hospital estate. C365Cloud now manages reactive and PPM compliance. Work is carried out on mobile iPads using our best practise forms.”

The judging panel said of the project: “This is an excellent software approach to evidencing CQC compliance. Significant work has been done to develop the standards relevant to estates and facilities into a dynamic e-based dashboard allowing ease of use. It shows a triology between technology, people and processes, winning the hearts and minds of small, intricate estates teams and allowing these people to lead an ongoing and sustainable change in culture across the trust.”

C365Cloud and East Cheshire NHS Trust were named winners of the Award for Best Evidence-Based Compliance with Estates and Facilities-related CQC Standards

Highly commended:

Barts Health NHS Trust

In early 2013 Barts Health identified specific services that required standardisation and quality and safety improvements in order to increase confidence and trust in care.

Due diligence reviews were undertaken and shortfalls were identified through joint working with the clinical teams, infection control team, decontamination team and estates and facilities team. The group also undertook specialist compliance audits and assessments, including joint FM and clinical wal rounds, mock P.L.A.C.E audits, and fire assessments and technical audits.

Staff engagement saw the creation of the #becausewecare campaign. This encourages staff to share learning and best practice and to take ownership for meeting brand standards and compliance. The initiative provided an opportunity to focus on patients, keeping them safe and creating a climate of care and safety.

Care folders were introduced on every ward, highlighting the standards of care that should be achieved and showing evidence of where issues were identified and actions taken. Since its rollout, standards have improved, with wards able to demonstrate improvements in the delivery of care for patients.

A self-auditing compliance tool was also developed for the estates site team. And, as a part of the learning all EFM teams were given face-to-face training and guidance on the outcome 10 standards.

The BBH judges said: “This shows good evidence of how the estates and facilities team played a part in a campaign with clinical teams and engaged at ward level to create a vehicle to immediately address issues affecting the delivery of care.”

Award for the Most-Innovative Cost-Saving Ideas in Estates and Facilities Services

The judges considered:

  • Solent NHS Trust for Portsmouth Community Care estates programme
  • ADSM and Barts Health NHS Trust for the largest water-saving project in the NHS
  • South Staffordshire and Shropshire NHS Foundation Trust Facilities & Estates Shared Services


ADSM and Barts Health NHS Trust for the largest water-saving project in the NHS

With a turnover of £1.25billion and a workforce of 15,000, Bart’s Health NHS Trust is the largest NHS organisation in the country and one of Britain’s leading healthcare providers. Every year Bart’s Health uses more than 815m litres of water, enough to fill three million baths, 2,174 swimming pools, or 326 Olympic-size swimming pools and costing £2m.

With water becoming an increasingly-scarce commodity in the UK, charges are only going to increase, yet water plays an important part in keeping patients safe and well while they are in hospital. It is also an essential part of the hospitals’ heating and cooling systems and hygiene and handwashing protocols.

As part of the trust’s commitment to improving the efficiency of its buildings and saving money, it joined forces with water management specialist, ADSM, to start to address and reduce costs and the environmental impact.

The project is a ‘turnkey’ total water management solution designed to capture every facet of water use and cost in order to reduce consumption, identify usage anomalies, and maintain reductions across the entire NHS estate.

The initiative captures all data related to all sites, including water billing information, costs and consumption. It then reduces the physical volume of water used through the installation of high-tech water-saving equipment including AMR, and maintains these reductions over a five-year period, during which the trust receives 50% of actual savings achieved. All this is done at absolutely no capital or ongoing cost to the trust through the implementation of the grant scheme, AquaFund.

To date the work has cut costs by £1.2m; saved more than 643million litres of water, saved over 308 tonnes of CO2; improved workforce skills, and improved the efficiency of buildings. The trust now boasts a fully-managed water management system to take into the future, meaning it is prepared for the deregulation of the water markets in 2017 and the threat of water scarcity.

Kevin Oxley, head judge in the estates and facilities management class, said: “This is a significant and forward-thinking scheme that targets savings that have no quality impact on the delivery of patient care. It has led to savings in excess of £1m and many ‘green’ benefits.

“Saving water might seem quite obvious, but we have to believe that it is the next big money-saving idea for every hospital. Millions of gallons of water is flushed down the drain every year and there’s a big cost associated with this. We all tend to think about heating and electricity, so it’s a very strong entry.”

Highly commended:

Solent NHS Trust for Portsmouth Community Care estates programme

The Portsmouth Community Care Estate Programme rationalised accommodation at St Mary’s and St James’ health campuses in Portsmouth into a long-term and sustainable configuration while modernising and improving patient care by moving resources away from maintaining expensive and outdated real estate into frontline patient care.

St Mary’s Community Health Campus and St James’ Hospital are 1.2 miles apart and there has been significant investment in both over the last few years. However, they had large amounts of surplus space and several buildings at St James’ were no longer suited to the delivery of modern health services. The total clinical activity in the main block was less than 5%.

To address the issue, a project team was established with health partners and local stakeholders to progress the rationalisation programme.

A number of options were explored alongside a ‘do nothing’ baseline case with the option selected to relocate the child development centre to an offsite location at the Battenburg Avenue Clinic; refurbish vacant areas at St Mary’s Community Health Campus; and reprovide accommodation for the remaining clinical services funded from the sale of surplus land combined with efficiency improvements.

Overall the result is reduced operating costs in the region of £3.2m per year, investment in local services for patients, and the disposal of surplus land towards the Government’s housing target, which will benefit the local economy.

South Staffordshire and Shropshire NHS Foundation Trust Facilities & Estates Shared Services

Facilities & Estates Shared Services is a directorate of South Staffordshire and Shropshire NHS Foundation Trust.

Through pro-active engagement with service directorates and clients, it delivers an extensive programme of cost improvement and saving initiatives.

Between January 2013 and June this year the team challenged its own approach with value management technicians. This introduced a pro-active approach of engagement with internal and external clients and stakeholders within a governance framework to manage, develop, challenge and monitor through efficiency groups, management team meetings, and operational forums.

The directorate also introduced the FISH initiative for staff engagement and motivation that focuses on attitudes. This approach is promoted by setting clear objectives aligned with CQC core dimensions and PAMS methods.

The team delivered £1m cost improvement programme savings over 2013/14, the majority of which is recurring. Initiatives included introducing new ways of working using mobile technology, rationalisation of premises, improved procurement packages, the expansion of embedded flexible working; collaborative accommodation sharing, centralised telephony, and centralised utility meter reading links to suppliers.

A spokesman said: “The openness to fresh ideas and addressing economic challenges while maintaining quality is core to this team and to the trust. The organisation is deserving of acknowledgement of these achievements.”

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