The Impact on the NHS from the Economic Downturn We shape our buildings; thereafter they shape us Healthy citizens are the greatest asset any country can have . Winston Churchill. NHS Facilities Management. What do Trust Boards need Strategy Leadership Assurance. The NHS Challenges Ahead.
The Impact on the NHS from the Economic Downturn
We shape our buildings; thereafter they shape us Healthy citizens are the greatest asset any country can have.
What do Trust Boards need
Treasury U-turn on PFI takes pressure off DH capital budgetExperts had warned that the amount of NHS assets due to come on to balance sheets would bring the DH dangerously close to breaching the Treasury’s strict limits on departmental annual capital spending, resulting in squeeze on the NHS capital pot.
PSBR at its highest ever level
NHS funded by taxation
Comprehensive spending review: up-to 2011 budget settlement above inflation
Productivity gains required in future years
£2.6Bn paid back to HMT and capital halved
65% of NHS costs on staff
Trusts will have to deliver between £15 billion and £20 billion in efficiency savings over three years from 2011 to 2014, David Nicholson, the NHS chief executive, told health service finance directors in a speech delivered behind closed doors.
The operational framework calls for better use of underused and therefore surplus estate. With the opportunity to save £3Bn of investment
This will require new ways of working and ownership of the estate. The DH estimate saving up to £100 million per annum.
5.0% to 12.4%
12.5% to 20%
Percent of Population Age 60+:2020
Significant growth in “young elderly” before 2020
Significant growth in “old elderly” after 2020
Age Groups as a Percentage of the Total Population
65 - 74 yrs
0 - 14 yrs
The scale of this challenge is underlined further by increasing levels of demand and low and declining levels of NHS productivity.
The demand on the health service is set to increase as the result of an ageing population and a higher incidence of chronic disease.
And although NHS outputs (operations, patients treated etc) have been increasing since 2000, NHS inputs (money) have been increasing at a faster rate and hence productivity in the service has fallen.
Future productivity gains will be essential if the NHS is to cope in a period of austerity.
Assurance to the Board
The Corporate Manslaughter and Corporate Homicide Act 2007 (CMCHA) came into effect on 6th April 2008.
The Health and Safety Offences Act 228 came into effect on 16th January 2009
The Regulatory Reform Act (Fire Safety) came into law on 1st October 2006
Quality and Regulation
Value for money
47,709 The additional full time equivalent “infrastructure support” staff employed in the NHS between 1998 and 2008
£200m The approximate value of a 0.5 per cent cut in prices paid for hospital activity
£1bn The annual saving the Treasury says can be made through shortened hospital stays and extending the tariff
7.4 per cent The real terms growth in NHS funds between 2002 and 2008
2.3 per cent The Institute for Fiscal Studies predicted real terms cut for government departments from 2011-12 onwards
Bring in extra revenue: Productivity increase and efficiency gains
Reduce cost: supply chain management in a recession
Reduce operational expenditure: Spend where income generated management
Improve and protect revenues: Knowledge management and best practice
New Ideas for creating Value
Next Generation of FM performance criteria
An updated methodology for a Asset Strategy and Investment Plan
Systems and protocols for Assurance
Innovation to deliver accommodation solutions in a changing NHS
Trusts need to manage a range of difficult balancing acts between NHS values, commercial activity and pursuing the bottom line while keeping the patient first
Matching demand to clinical productivity and programmed admissions are probably the greatest opportunity gains.
FM directors need to have a handle on their operations like they have never had before. The concept of service-line management and Space utilisation
The next three years requires an even greater focus on quality, safety and leadership.
A politician needs the ability to foretell what is going to happen tomorrow, next week, next month, and next year. And to have the ability afterwards to explain why it didn't happen. Winston Churchill