Annual State of NHSScotland Assets and Facilities Report for 2013

7.0 Forward Look to 2014 and 2015

7.1 Innovation and Collaborative Working

Assets and facilities services can be a key enabler for achieving NHSScotland's Quality Ambitions and for delivering the Scottish Government's "20:20 Vision" for sustainable high quality in health including integrated health and social care.

Advances in technology are driving changes in healthcare that are likely to significantly impact on the NHSScotland's asset base. These technologies are enabling care pathways to be developed which deliver more care outside of hospitals and therefore there is likely to be less reliance in the future on buildings to deliver services. Hence, it is essential that the asset base is closely aligned with these changes in service delivery models. This will include the need to carefully examine the balance of investment needs across the different types of assets going forward if the NHS is to maximise the potential benefits of the new technologies and the innovative and collaborative working.

Delivering improvements in quality at lower cost

It is clear that demographic trends and global pressures on health spending will not allow increases to quality that increase costs. The Scottish Government is working with Boards to identify opportunities to deliver improvements in quality at lower cost.

The NHSScotland Efficiency and Productivity Framework is clear that conventional approaches to efficiency will be insufficient to deliver the depth and duration of efficiency savings required over the next three to four years. The purpose of the Efficiency and Productivity Framework is to give real focus to identifying a range of changes which will support Boards to achieve this alongside the Quality Strategy and to support Boards to redesign services bringing together all of the dimensions of quality, including value for money. The State of NHSScotland's Assets and Facilities Report is part of this initiative to identify changes that support Boards to deliver improvements in quality and reduce costs by providing an annual high level assessment of the progress that NHSScotland is making on improving the performance management of assets and facilities services. The focus for improving performance is expected to be on estate rationalisation, space utilisation and benchmarking.

The case studies included in this report demonstrate that some Boards are at the forefront of the initiatives on innovative and collaborative working and delivering improvements in quality at lower costs. The inclusion of these case studies in this report is aimed at enabling Estates and Facilities Teams within Boards to identify, share and spread good practice and act on opportunities to improve performance.

7.2 Future State of the NHSScotland Assets and Facilities Reports

The development of the 2014 and 2015 State of NHSScotland Assets and Facilities Reports will see work on:

• Further improving the quality and consistency of the information on assets and facilities, particularly in respect of the wider range of assets (vehicles, medical equipment and IM&T). This will include the implementation of further measures to improve the alignment of the ISD Cost Book with the operational assets and facilities information systems such as EAMS and eMART.
• Further development of the Asset and Facilities Performance Framework as a key tool for monitoring performance at national, Board and local levels. This will include further work on the setting of performance targets with particular focus on ensuring that they are realistic and achievable within available resources. It will also include the development of KPIs for vehicles, medical equipment and IM&T assets which are similar to those for property and facilities services and provide a balanced approach to measuring quality, efficiency and risk.
• The development of the 2020 Capital and Facilities Change Management Plan will be undertaken in partnership with all stakeholders to ensure that it reflects national priorities and local need, supporting quality ambitions whilst taking cognisance of issues relating to sustainability. This State of Assets and Facilities Services Report will need to be aligned with this work and is expected to be the key monitoring tool for delivery of the Change Management Plan.
• The recently commenced national initiative on developing a more formal approach to capital planning and prioritisation is expected to increase the effectiveness of investment and reduce the expenditure that is required to meet performance or increase the performance for the same level of expenditure. This work includes examining the potential from utilising innovative capital planning systems. This annual SAFR report, and in particular the Performance Framework, provide an ongoing opportunity to demonstrate improved investment decision-making.
• Further work on establishing a library of best practice case studies and presenting them in this report. The aim being to draw on the outcomes from these studies to provide an evidence base for informing decisions on future investment in assets and for modelling the potential for future performance improvement.
• The 2014 report will include the work and outcomes of the NHSScotland Soft FM Review. This review will deliver a report on soft facilities services identifying improvement opportunities relating to:

• Utilising relevant technological innovations from across the world to improve service effectiveness and efficiency,
• Synergies and efficiencies that can be achieved by joining up service delivery across Health Board boundaries, regions, pan Scotland or delivered in conjunction with other public bodies,
• Ensuring that best practice is identified and as far as is practical is put into operation across as much of NHSScotland as it would be practical to do so,
• Applying new evidence based practice to Soft FM and to stop historical practices which have evolved over time with limited or no basis in evidence,
• Identifying opportunities to generate income for NHSScotland through improved retail delivery and careful marketing of spare (contingency) production capacity,
• Assessing the advantages / disadvantages from contracting out work to other public sector providers.

The work on these future State of Assets and Facilities Reports provides an opportunity to identify and find solutions to some of the issues and barriers to improving performance that have been identified to date. These future reports will focus on demonstrating success, and ensuring that important seeds are sown for the delivery of longer term benefits, performance and efficiency improvements in the assets and facilities services across NHSScotland. This annual report is expected to continue to develop as the key reference documents for monitoring asset and facilities services performance.