Guidance to stop backlog maintenance 'crippling' the NHS

Department of Health announces publication of new guidance on backlog reporting processes

The Department of Health (DH) has announced it will be issuing new guidance in a bid to stop backlog maintenance from crippling the NHS estate.

Speaking this week at The Institute of Healthcare Engineering & Estate Management’s Healthcare Estates 2012 conference in Manchester, Peter Sellars, head of profession, estates and facilities management at the DH, claimed trusts were wrongly reporting the level of repair work needed and questioned the effectiveness of current policies.

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 said: “A total of £4.3billion of backlog maintenance is reported and we are investing between £500m-£600m a year, 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?

“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?’”

It is about breaking the service down into small bits and putting the policies in place to support that

The Government, he revealed, will issue new guidance in the next few weeks outlining changes to the way backlog maintenance is reported and the processes to address the problem.

“We are going to ask trusts to reconsider what they report as backlog,” Sellars said. “I have sat down with half a dozen estates managers and they are saying they are not reporting how the criteria has set our 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.”

He said that in talking to trusts it was clear there was huge variation in the amount of money spent on the estate. One trust spent 3% of its overall budget on the environment and had reported no serious backlog issues and had managed to refurbish all its wards. Another trust which spent just 0.5% was reporting major patient safety issues.

The way we currently manage our backlog just does not work and we need to get to a point where we can sensibly determine that risk and eliminate it

Sellars said: “We need to properly break it down and then we need to provide a solution that makes sure it does not slip back.

“The way we are currently managing our backlog just does not work and we need to get to a point where we can sensibly determine that risk and eliminate it.

“There are lots of challenges facing us and we need to provide a safe, clean, fit-for-purpose environment at a time when demand has never been so high. To achieve that we need to accept that it will mean radical change.”

And architects urged estates managers to be more forward-thinking when it came to addressing the need for improvements. John Cooper, chairman of Architects for Health, said: “One hospital we were working for was looking for a refurbishment to address its backlog maintenance problems, but after the work still would have been left with 40% of the backlog. For just 15% more money they could have had a new-build scheme and eradicated the problems completely.

“I don’t think we should ever get to a position where backlog maintenance is the main subject of discussion.”

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