Setting the standard

While many of the NHS-based news items pick up on the core service delivery to patients in hospitals or highlight areas of success or failure in the clinical arena, much of the work carried out is underpinned by the facilities management team and their quiet, efficient and often unseen contribution. Without the facilities to work in core NHS service delivery cannot take place.

The media view
A recent press release from the Secular Society highlighted that the NHS spends some £40m on ‘Chaplaincy Services’ and bemoaned this fact noting that this could be “better spent on nurses and doctors”.
    
On the face of it a very laudable and positive comment, however, this statement doesn’t note any of the outcomes of chaplaincy services or the value that the services bring to patients and relatives lives.
    
This example of headline driven media is classic in that it fails to address the real issues behind the headline figure and is solely there to promote a particular viewpoint. As we look at the detailed workings of an organisation the size of the NHS, it is easy to read the headline figures and not give due consideration to the actual service delivery that they represent.
    
So how do we get away from the political and single agenda driven mentality into a proper consideration of the service being provided and its worth or value? Proper statistical analysis of inputs and outputs will provide a meaningful basis for such a review – or in plain speak – we benchmark.

Performance indicators
For many, the idea of benchmarking is only about standards setting: “Here is the quality benchmark – now work up to this.” But that is a very simplistic view. What we need to do is decide on a set of key performance indicators, monitor them over a period and progressively review the impact that changes in working practice and environmental considerations have on them.
    
A shining example of target setting in the facilities arena is that of energy consumptions. We all had a target of reducing by 15 per cent but at the same time there were massive developments in medical scanner technologies and a programme of installing new scanners, which consumed energy at a level that was never given consideration previously. Thus technological change can always drive a shift in targets.
    
As we strive to improve the standards and cost effectiveness of the facilities we provide for healthcare delivery we need to constantly monitor and review not just the services we provide but also the services that are required – it is a constantly changing goal. Benchmarking can help us in this process but perhaps first we ought to understand better what we mean by ‘benchmarking’:

• It should be proactive; identify relative performance in comparison with others; scope potential improvement; provide insights into better performance.
• Being flexible is important so benchmarking can be both internal (restricted to comparing units within our own organisation or even year on year) and external (sharing and building on the relationship with other organisations to help distil better practice).

The purposes of benchmarking are to:

• Increase awareness of what is done and how well it is done.
• Help set credible performance targets.
• Help identify what to change and why.
• Can significantly reduce waste and duplication.
• Help identify training needs.
• Encourage networking and sharing of best practice.

Comparing data
Benchmarking exercises have several common features and difficulties: deciding what to compare; deciding how to compare; the achievement of comparability and how to interpret the results. It is important to establish clear definitions of terminology that is useful to NHS organisation facilities directors and managers for describing, evaluating and planning facilities activities.
    
The data provided should be easily comparable with other organisations, and a computer database of information maintained for reference. There must be a continued process of establishing meaningful data and key indicators that will lead to accepted benchmarks and standards.
    
Within the current healthcare environment there are two core sets of benchmarking activity for estates and facilities. The first is run through the NPAG BM groups and looks at detailed, bottom end, work activity comparators.
    
The second is the HFC Benchmarking Club, which is based on the high level ERIC data set with additional analysis carried out by a specialist contractor. This has been run for many years and can now provide a decade’s worth of meaningful strategic benchmarks.

Time cycles
A simple benchmarking exercise needs to be run through at least three time cycles (often years) to provide a base line (year one), a primary review (year two) and a secondary review (year three) so that we can see what effect the changes implemented have in the primary review and if the change is sustained in the secondary review.
    
Obviously, longer term analysis will be needed if we continue to adapt and amend working practices but in practice the focus tends to be in key areas of interest for a while and then the focus moves on. Over recent years the NHS has been actively monitoring HCAI incidences and in some areas seeing how cleaning and other initiatives (like the implementation of alcohol gel for all people entering patient areas for example) impact on this important issue. Looking at mental health organisations, the standard of the core facilities, the provision of meals and waste disposal have been areas of interest as the facilities teams seek to support the core clinically driven service improvements.
    
To benchmark should not be onerous; it should be a natural activity that utilises the information already being gathered for the normal day to day management of our estates and facilities services. We all want to know that the services we provide are valued and benchmarking allows us to provide a measure of that value and see if we can improve or perhaps even help others improve where we find that we are at the leading edge of best practice.

HFC Annual Conference
This year’s HFC Annual Conference will be held 16–17 September at The Kassam Stadium, home ground of Oxford United Football Club. The venue is located centrally within the UK and has easy access to motorways, train stations and airports. We have chosen to remain with the same venue as overall we found the facilities met all of the current requirements to hold our event. For those travelling from Scotland and Northern Ireland transportation can be arranged from either Birmingham International Airport or an appropriate West Coast Mainline Railway station on the afternoon before the conference.
    
We believe that facilities management within the healthcare environment continues to flourish and have decided to continue with our conference strapline – “Flourishing FM – Enhancing Estates & Facilities Information” for our annual events headed up with a topical theme. This year’s theme “Looking forward – Building on the past – Planning for the future” has derived from the NHS Plan and the overarching desire, led by government and the various Departments of Health, to see the continual improvement in our healthcare facilities. In order to help focus on the theme and the key topics that come out of this we will again be running a single stream of core conference sessions with extra topics of interest included to widen our view.
    
Integral with the conference a wide and varied exhibition will be held focusing on products, services and general FM information that will be of interest to staff of all levels and should be helpful in ensuring the successful day to day running of healthcare FM departments.

Time to network
The conference holds ample networking opportunities as we understand that this is an important part of an event to enable attendees to discuss and share ideas, problems and solutions that we all come across working in the FM environment. The two days will allow time to network in between sessions and at coffee and lunch breaks. In addition we will be hosting a bowling ice breaker event with buffet on the evening of 15 September for those who wish to travel prior to the conference and a gala dinner with charity event and entertainment on the evening of Wednesday 16 September.
    
Appreciating the importance of cost constraints in the current climate our usual pre-funded delegate places are available to HFC Member organisations and in the light of the successful exhibition last year we are also offering early bird booking fees for exhibitors for the first time.

The HFC Benchmarking Club is a free service to HFC Member organisations and provides a breakdown of a range of key performance indicators by health sector. For more information contact the HFC on 01902 765620 or by e-mail to info@hfc.org.uk. www.hfc.org.uk.   

For more information
The NPAG Benchmarking groups are subscription services by work area. For more information contact Thames Management Services / National Performance Advisory Group on 01245 544600 or www.npag.org.uk.