It’s all in the facilities

There are lots of numbers floating around at the moment in the Healthcare Facilities Management (FM) environment, some reflecting national concerns and campaigns and others impacting directly on the running of healthcare facilities. Before looking at these perhaps a quick definition to help in our understanding of what we mean by healthcare facilities.

Defining FM
Healthcare facilities simply means the facilities in which our healthcare is provided; but as always it can never be quite that simple. Looking from the patient or visitor perspective the facilities are what we first come across when visiting our local hospital – sign posting, car parking and the ‘smokers alley’ on the walk to the main entrance. These are the things that give the visitor and user of our services their first impression.
    
The very nice and sometimes ornate architectural sculpture in the middle of the roundabout at the site entrance is soon forgotten when the car parks are full, disabled bays are in a cul-de-sac or require a complete circular tour of the site to get back to the previous set when the nearest are all occupied. The grass overhanging the guttering in the very nice courtyard alongside the waiting area for outpatients does little to instil confidence, and the overflowing litter bin and the discarded traffic cone only reinforce the impression that we do not care for the facilities as a whole; so how can we care for the patients who are being treated within? It is all about that important first impression.

Numbers say it all
So to some of the numbers. How about 25, 42, 70 and 2012? Recent research indicates that 25 per cent of senior NHS Facilities Managers are due to retire by 2010; this leaves us with a real problem in terms of the loss of experience and structure in Healthcare FM.
    
42 per cent of senior NHS FM staff recognise the need for a workforce plan, but only half have a skills audit, and only around 10 per cent have plans in place, most of which are aimed at practical (training) skills, not managerial (development) skills. Worryingly this means that 58 per cent do not recognise the need for a workforce plan.
    
We will all recognise that 2012 indicates the London Olympics but how many of us have thought that this could contribute to a potential 70 per cent turnover in facilities staff? Already showing in building and engineering trades the draw of the workforce towards London will start to impact on the support services like cleaning, portering and catering as the day draws near. Within healthcare we have a great deal of relatively poorly paid hotel services staff for whom London pay packets could be a real draw. Workforce and succession planning will be really important in coming months and years if healthcare FM is to flourish.

Parking
Leaving the numbers aside, car parking can be a real problem and the NHS generally does not have the expertise to manage the constantly changing environment without either employing specialist managers or bringing in contract expertise from outside. Out of town DGH development was a good idea in the 70s but now suffers the penalty of the rapid growth in car ownership and use as well as the difficulties of public transport access to such sites. While some have successfully linked up with Park and Ride schemes to ease local congestion the rise in car parking charges in England has left a nasty taste in the mouth of the general public when free car parking is provided on hospital sites in Wales and Scotland.
    
Cleanliness is a real current topic and the drive by the Department of Health on a number of threads is often seen as being clinically driven. But the FM team make the real differences in patient perception. ‘Bare below the elbows’ clearly relates directly to staff having contact with patients but last winter’s deep cleans and the successful drive to lower HCAI rates are in no small way FM issues.

FM and infection control
At the recent Flourishing FM Conference in Oxford, Dr Liz Jones of the Department of Health backed up the announcement of the HCAI target being met of that very morning with some key points relating directly to FM involvement; control measures including cleaning of the environment are key in reducing HCAI transmission. In the strategy for where we want to be, Liz identified the importance to “Improve cleanliness across the NHS to provide backdrop for infection control, create better environment for patient care and increase public confidence.”
    
As part of its drive DH funded the development of the Credits for Cleaning (C4C®) package for cleaning management and at the Infection Prevention Society Conference in Harrogate the latest version of this Health Service developed application was being shown with links to a cleanliness monitor from hygiena international. This simply allows a swab to be taken and analysed for cleanliness with the result available in 15 seconds that can then be recorded against the monitoring report for the area. As a taster delegates had their hands swabbed and checked and while most showed a score of between 400 and 600 (200 would be considered a fail for a ward area) one member of the press scored an unimpressive 3450 – would you want to shake his hand?
    
It was very interesting to note that hand washing and not alcohol gel improved the scores but we must always remember that hand washing cleans the hands and alcohol gel acts against bacteria. The two go together.
    
Other issues like Clean by Design are clearly important as we look to new build and refurbishment and alongside this we must also be looking at sustainability issues – but perhaps for another day…