Hospital trusts offered helping hand from NHS trailblazer

Guy’s and St Thomas’ NHS Foundation Trust spin-out, Essentia, offers its expertise to NHS trusts looking to reduce operating costs and improve efficiency within their estates

The recladding of Guys Hospital tower was among the improvements made by Essentia

NHS trusts charged with reducing operating costs and improving efficiency are being offered a helping hand.

Essentia is part of Guy’s and St Thomas’ NHS Foundation Trust, helping to plan estate improvements, explore ways of enhancing infrastructure, and provide IT support.

Guy’s and St Thomas’ has an ambitious development programme, with a £500m capital investment plan over a five-year period. Essentia project manages all major improvement works and new builds, as well as driving efficiencies across a number of departments, for example improving outpatient services through the use of technology.

It is all about reducing operating costs to create a surplus that can then be used to enhance the environment through either building projects or the use of state-of-the-art technology

The introduction of energy-efficient systems, including a combined heat and power (CHP) plant – one of the largest in the NHS - has also helped to significantly drive down costs.

Now Essentia is drawing on this experience and expertise to provide similar solutions for clients elsewhere in the NHS and in other public sector organisations, through Essentia Trading, its recently-launched commercial arm. The company is wholly owned by Guy’s and St Thomas’ NHS Foundation Trust and all profits are reinvested back into the trust.

“We will be looking to help trusts fund capital developments,” explained Steve McGuire, chief executive of Essentia Trading and an executive director of Guy’s and St Thomas’ NHS Foundation Trust.

“It is all about reducing operating costs to create a surplus that can then be used to enhance the environment through either building projects or the use of state-of-the-art technology.”

The company’s offering is spread across seven main areas: Strategy development, estates management, capital development, healthcare planning, property consultancy, sustainability, IT services, and software asset management.

McGuire said: “We started with two large hospitals and we had some really big infrastructure challenges. The tower at Guy’s Hospital, for example, was starting to deteriorate and a complete overhaul was needed. Through Essentia, we put in a proposal to reclad it – and completed the project in 2014 on time and under budget. A number of high-profile projects are also taking place at St Thomas’ Hospital.

“In addition, we introduced CHP technology. We received a government grant to do that, with an expected payback of five years on the £10m investment. The payback period was actually four-and-a-half years and now we are saving £2m a year as a result of this initial investment in CHP.

We have learned that by using infrastructure better and by changing our systems we can use less estate or use what we have to see more patients

“If we had not received the grant we would have done this anyway because the results are so impressive. It’s about a spend-to-save approach, but managing that in the most-effective way.”

Essentia also helped the trust to make operational efficiencies. This included the creation of a new outpatient department at St Thomas’ Hospital. This was built around a technology platform linked into the electronic patient record. As a result services are now better managed and the department is smaller in size, taking less resource.

“We have learned that by using infrastructure better and by changing our systems we can use less estate or use what we have to see more patients,” said McGuire.

And Essentia is now looking to upgrade the Windows XP operating system across the trust so that staff will have the tools to work remotely and in a more-flexible way. It is these sorts of interventions that Essentia is now offering other trusts.

McGuire said: “In the current financial climate, considerable savings need to be made. Essentia has built up a strong team with the skills and expertise needed to tackle these challenges."

Already, Essentia is believed to employ more apprentices than any other NHS organisation in the capital.

“Last year we had a £150m turnover, and £50m of that was from organisations external to Guy’s and St Thomas’ NHS Foundation Trust,” said McGuire. “I feel really strongly that we can now help even more trusts to make similar efficiencies.

“As well as reducing operating costs, our approach can also improve the patient experience, which is a priority for all NHS organisations.”

To date the company has worked with a number of trusts including Great Ormond Street Hospital for Children NHS Foundation Trust, Kent and Medway NHS and Social Care Partnership Trust, and King’s College Hospital NHS Foundation Trust, as well as NHS England and overseas health providers including the Department of Health in Queensland, Australia.

Case Study - Guy’s and St Thomas’ Genetics, Rheumatology, Infection, Immunology and Dermatology (GRIDA)

Essentia helped the GRIDA directorate of Guy’s and St Thomas’ to develop a business case for investment to integrate management, improve use of space, and achieve a centralised estates solution through a network hub.

Key objectives for the project included bringing together clinical services with academic and educational laboratories and staff at two different sites dealing with tertiary inflammatory and allergic disease.

Meanwhile dermatology, rheumatology and lupus services provided care across nine locations, so there was significant scope to improve efficiency and patient experience through centralisation.

As the service is predominantly outpatient and daycare focused, a generic shared facility, with extended clinic hours and modern technology, was deemed to provide significant increased capacity.

The new facility has created a brighter, more-modern clinical environment which has enhanced the experience of patients using our dermatology outpatient services

Essentia led the development of the business case, providing advice and support including demand and capacity planning, space utilisation, user group co-ordination, options development and appraisal, development of a clinical and functional brief, design development, and benefits realisation.

Although the initial proposition was for a phased refurbishment costing £6m over three stages, the Integrated Programme Board at the trust challenged the team to complete the project on a reduced budget of just £3m. There was also a reduced timeframe due to a commercial research opportunity.

McGuire said: “By minimising the level of reconfiguration and challenging current ways of working to improve use of space, we were able to deliver a solution within the reduced budget.

“By co-locating services and taking a flexible approach to space we helped to achieve significant efficiency benefits. For example, we reduced the requirement of dermatology, rheumatology and lupus services from 39 rooms to 24, with an improvement in utilisation from 65% to 80%.”

Karen Rule, head of nursing for dermatology, allergy and sexual health, said: “The new facility has created a brighter, more-modern clinical environment which has enhanced the experience of patients using our dermatology outpatient services.”

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