Innovation in Estate and Asset Transformation
Simon Corben, Business Development Director
Capita, Property and Infrastructure (Health)
Scottish Healthcare Conference, 8th November, 2013 Crieff Hydro
Why the need to Innovate?
Unprecedented need to deliver better care at better value
Doing more of what we have always done is no longer an option – we
need to do things differently.
We need to radically transform the way we deliver services.
Key facts
• In 2047 more over 60 year olds than those under 15
• Patient groups more informed through IT
• Disparity in care - Fractured neck 16 days to 36 weeks
Innovation | has to be a part of what we do.
Key Estate Documents – what do they say?
Annual State of the NHSScotland Asset and Facilities
Report.
Key themes –
• The need to improve performance
• Rationalising the estate is essential
• Reducing backlog burden
• Look at long term partnerships
• Data collection to inform desicion making key
What should we consider?
Historically
• Salami slicing no good – its requires more
We need to ask - What is better value?
 Improved patient outcomes
 At a better cost of delivery
We need to think differently
• Total care pathways need considering
• Look at others
• Sectors - Airports/ manufacturing/ IT
• Countries – USA, China, India (reverse Innovation)
How does the estate react?
 Assets - Flexible / Bundled / Efficient /IT Enabled
The Estate/ Asset - Looking at other sectors
Hotels in Hospitals
An extended service for the convenience of family and friends of patients,
hospital staff, medical sales people and visiting professionals
Trust sells freehold or grants lease to developer/operator
Developer funds, designs, builds and secures operator to run and maintain
the facility which can be located within or adjacent to the hospital
The hotel can be funded through the developer operator who takes the
development and financial risk of occupancy levels
No ongoing annual revenue impact on the Trust but an opportunity to earn or
share the income streams
Opportunity to pre let whole floor for relatives accommodation suitably
branded with potential funding from charitable sources
Potential opportunities to release and dispose of existing residences
Improvement of a Trust’s corporate image and enhanced visitor experience
Improved parking
Common Challenges
 Lack of capacity








Poor utilisation
No pre-booking
Mostly cash parking
High operating costs
Enforcement difficult
Poor public perception
Planning constraints
Inadequate way finding
Parking Solutions
•
•
•
•
•
•
•
•
•
Benchmark and adjust tariffs
ANPR and cashless parking solutions
Allows pre booking of spaces
Improves utilisation of spaces
Reduces operating costs
Increases revenues
Linked to green travel plan
Opportunity to fund Introduce multi-storey
Institutional investment option for funding
A fresh face – The welcome centre
• A complete redesign and upgrade of the hospital front entrance to
provide a prominent and obvious main entrance with Improved sense of
arrival, with a reception and waiting area much closer to the entrance
• Good quality accommodation for patient services with appropriate high
quality retail facilities for all patients, visitors and staff to enjoy
• Improved way finding and patient flow, designed to allow electronic
check in service
• Accommodation for a community pharmacy service if required
• Funded in part or whole via retail income with Trust or granting lease to
developer/operator
• Improvement of a Trust’s corporate image and enhanced visitor
experience
Case Study 1 – Brain Lab
The Challenge
In response to NICE guidance ‘Improving Outcomes for People with Brain and other CNS (Central Nervous
System) Tumours’ a Brain Tumour Centre was established at NHNN.
The Solution
Due to the constant challenge and cost of space within this inner-city acute trust, we looked at innovative
models on how we could treat acute patients differently – the solution was to combine imaging with an
operating theatre. Team worked with a German company “Brain lab” and developed this first of a kind
bespoke facility. The projects was a great success and involved collaboration between, Siemens,
contractors and specialists in both the fields of imaging and brain surgery.
The Benefits
The aims of the project are:
• Tenfold improvement to patient outcome and care pathway
• To improve care for patients with brain tumours
• Reduce the length of stay for brain tumour patients
• Create additional bed capacity at NHNN
• Increase the uptake of clinical trials amongst brain tumour patients
• 50% less space requirement
• 50% less service impact
Case Study 2 – University Hospitals Bristol FT
Welcome Centre
Development
The Welcome Centre’s financial
model, which has been developed
by Capita, is funded through the
income derived from the retail
operations to ensure that the full
benefits of the scheme are retained
by the Trust and the community.
Case Study 3 – LLR Estates & Facilities
Facilities Management
Collaborative
NHS Trusts of Leicester,
Leicestershire and Rutland
(LLR) joined together to
manage facilities + estates
services, including health
centres, hospitals and
community services.
We are working with the
partnership to produce
business cases for their key
deliverables, including:
• £294m transformational cash
releasing savings over 7 yrs
• A growth strategy of 2% new income
• Total energy provider to save LLR
£25m over 15 yrs & meet carbon
reduction targets
• Providing extra car parking, a new
front entrance, welcome & retail
facilities, patient hotel to multiple sites
• Agile working to reduce office
accommodation by 20% and
delivering £3-4m annual savings
• Joint Venture maximising return on
assets, creating transformation and
joint working opportunities
• Increased rental income, space
savings and commercial management
of property portfolio
• Strategic partnership delivering
modern Pathology services
• New innovative model delivering basic
care in a patient’s home
• Patient Co-ordination Centres
Estate /Asset transformation – how to unlock it?
Partnerships that allow you to tailor
the way you regenerate you asset,
be it via
• Turnkey
• sale and lease back
• JV and beyond
Improved patient experience
Potential sales Income
Improved performance
Savings/optimisation
Reduced risk/liabilities
Cash savings via
Increased estate efficiency
 Operational efficiencies
 Estate modernisation
 Regenerating surplus assets
 Maximising income from core
assets
Appoint estate delivery partner
In summary
• Embrace new ideas
• Share knowledge
• Look to other sectors
• Look to other countries
• Don’t be afraid to come forward
• Enable innovation as a key part of the board agenda
• Think of your asset as a business
• Use the resources available
Any questions