Integrated care systems – the impact on estates
Details
While the idea of integrated care systems (ICSs) is not new on the agenda, the white paper has reinforced that they are certainly here to stay and are more prevalent than ever. When delivering the paper to the House of Commons, the health and social care secretary of state Matt Hancock stated: “We want to help integrated care systems play a greater role, delivering the best possible care, with different parts of the NHS joining up better; and the NHS and local government forming dynamic partnerships to address some of society’s most complex health problems. It will help us deliver our Manifesto Commitments, including 50,000 more nurses and 40 new hospitals”.
The NHS Five Year Forward View, published in 2014, set out the plans for developing sustainability and transformation plans (STPs). ICSs have evolved from STPs and take the lead in planning and commissioning care for their population. The NHS Long Term Plan, published in January 2019, confirmed that all parts of England would be served by an ICS from April 2021.
The white paper has confirmed plans to bring forward measures for statutory ICSs and these will bring together the NHS, local government and other partners. The aim is to remove divisions between hospitals, GPs, physical and mental health and the government. This will therefore bring partnering arrangements with the NHS and the local authorities to the forefront of any future plans on estates.
The introduction of ICSs will see the need for our NHS clients to work collaboratively and pragmatically with other providers, such as the local authority, to look at their current estate and the requirements/improvement needed to deliver centralised and streamlined care. The estate implications of developing ICSs is therefore going to be of significance in the coming months. It is important that the productivity of the estate is maximised and funding released to develop transformation projects. While providers will remain legally responsible for maintaining the estates, the ICSs will need to work together to ensure organisational plans are consistent with system plans. This communication will be key to making efficient use of the current estates.
To achieve this, providers will need to work together to avoid planning in isolation and to consider the potential and possibilities as early as possible. The need for modern, efficient buildings within primary care has been well documented throughout the years and this provides an opportunity to undertake these early conversations and not to delay these until a later date, when the service redesign has already taken place.
With such change comes significant opportunities, and alongside the Health Infrastructure Plan, this move towards integrated care can be seen an exciting opportunity for clients to look at their existing estates and maximise the potential while working collaboratively with other providers.
How technology will drive the reconfiguration and redevelopment of NHS estates
The structure of the NHS is changing and as part of the process it is likely that the use of the estate will need to be considered more closely. There will be a focus on how sites are used and how reconfiguration, as well as redevelopment, can take place. Implementation of the proposed changes in the white paper, will require the NHS to review its estate to consider requirements / improvement needed to deliver centralised and streamlined care, along with partnering arrangements to achieve this. The gathering and using of data to drive this change will be increasingly important, implemented, potentially, by the use of key technologies which will measure how estates can be used more efficiently. Technology is already being used widely across the NHS to generate data to support the running of the estate, use of technology to obtain data on actual use and how this might be improved, however, has been patchy.
There are a number of key technologies with the potential to upscale and alter the use of the estate. Examples include scheduling platforms to support the booking of space as well as real time use capture, sensor technology to collect valuable utilisation data and make unallocated seating/space automatically available, touchless technology including desk sensors and digital signage to assist staff and visitors to find the right workspaces/areas within the estate quickly and visitor management technology that automates and streamlines the visitor process. These technologies will help pool resources, demonstrating availability of space in the estate in real time allowing efficient space utilisation and assessment of areas that have the potential to be repurposed or redeveloped. They will also promote the creation of a smarter and integrated estate, with the potential to use the estate collaboratively and effectively, maximising the use opportunities that the estate may offer.
