DH announces 'critical review' of NHS backlog maintenance

Probe to determine if estate is breaching NHS Constitution or trusts are wrongly reporting risk

The Department of Health has written to every NHS chief executive, director of finance and head of estates and facilities to reveal plans for a review of the system for reporting building maintenance issues amid fears the condition of the estate could be contravening the NHS Constitution.

David Flory, deputy NHS chief executive, reveals in his letter that Peter Sellars, head of profession at the NHS Estates and Facilities Policy Division, will lead a Review of Critical Infrastructure Risk to decide whether the £1.2billion worth of supposedly ‘critical risk’ backlog maintenance reported as being necessary by English NHS trusts is actually putting lives in danger.

We have to ask ourselves is the money we invest being targeted at true backlog, or is the rate of deterioration happening at a greater rate than the investment?

The plan for an overhaul of the system was first revealed by BBH in October, when speaking at Healthcare Estates 2012 conference in Manchester, Sellars claimed trusts were wrongly reporting the level of repair work needed and questioned the effectiveness of the current reporting system.

He told the audience: “A total of £4.3billion of backlog maintenance is reported and we are investing between £500m-£600m a year addressing this, but the overall figure diminishes by only £20m-£30m, and in some cases it goes up. We have to ask ourselves is the money we invest being targeted at true backlog, or is the rate of deterioration happening at a greater rate than the investment?”

He added: “We have started to unpick this and of the £4.3billion we can see that 30% is categorised as critical or high risk. That’s where we need immediate investment as it has an impact on patient safety. The other 70%, it is fair to say, is not backlog maintenance in true terms, but is actually routine maintenance which organisations should be planning to do anyway and which is not a critical risk that will bring the system to a halt.

“It is time we reviewed our backlog with a view to asking ‘what do we really need?’”

The letter to trusts warns that, if the £1.2billion worth of major repairs are actually necessary and are posing a risk to patients, then the NHS ‘may not be fully meeting its commitments under the NHS Constitution to provide services from a clean and safe environment that is fit for purpose based on national best practice’. It may also be risking regulatory requirements to ensure ‘service users are protected against risks associated with unsafe and unsuitable premises’.

The review will explore existing practice, such as how backlog maintenance priorities are currently determined, and aims to ensure a system is put in place for the future that accurately identifies the investment required to address risks that are critical.

Estates managers are saying they are not reporting how the criteria has set out and if we can do this we will then understand the real risk

As part of the investigation, NHS trusts will have to review the robustness of their assessment of high and critical risk backlog maintenance, consider any identified risks and ensure reported backlog maintenance is logged and addressed.

This month the review team will develop a system for collating the information from each trust and will later determine the action needed and any change in the way backlog maintenance in traditionally reported.

Sellars said: “We are going to ask trusts to reconsider what they report as backlog. I have sat down with half a dozen estates managers and they are saying they are not reporting how the criteria has set out and if we can do this we will then understand the real risk.

“It is about breaking the service down into small bits and putting the policies in place to support that. Then we need to look at how we stop the estate from getting back to that situation and providing a solution that makes sure it does not slip back.”

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