Our Strategic Review of Soft Facilities Management Team Brief September 2014
Note from Martin Henry Welcome to the Autumn Soft FM Review update, I hope you find the information useful. I would like to thank all involved in the process to date. You will probably be aware that the Soft FM Review report was presented to the NHS Board Chief Executives Group in early August for approval with recommendations for Catering, Domestic, Laundry, Portering and Retail Services. We will now produce a detailed programme for consideration by both internal and external governance groups. The reviews objective remains Improving Efficiency and Quality to Patients throughout NHSScotland. To this end, the recommendations for each service are detailed within this document. It is likely that a number of Strategic Review Groups will be re-established to enable progression of these. Martin Henry
Our aims Review all Soft Facilities Management Services across NHSScotland to see how the current service works and look at options to improve efficiency, patient safety and user satisfaction. In order to complete this review we need to involve a wide range of individuals from the service across Scotland including partnership representatives. The outcome of this work will be a review report which will be presented to NHS Chief Executives and NHS Efficiency Portfolio Board to agree which options will be taken forward.
Background The Shared Services programme is part of the NHSScotland s longstanding commitment to the people of Scotland to ensure that our quality services are good value for money. The purpose of this Strategic Review of Soft Facilities Management is to take stock of how Facilities Management is being delivered across NHSScotland in different health board areas. It will also look to find out if there are better ways that the NHS can provide these services. Soft Facilities Management includes the following services; - Catering - Laundry - Domestic - Portering - Retail
Progress so far Strategic Service Review Groups The groups have finalised their work, reviewing the data that has been collected and their assessments of the potential service improvement opportunities. The Strategic Review report was approved by the Facilities Review & Shared Services Programme Board (June), and the NHS Boards Chief Executives Group (August). The report s findings and recommendations include: To see who the members of the groups are and how they have been doing please visit the HFS website: http://www.hfs.scot.nhs.uk/services/strategic-review-of-soft-fm/
Catering Findings The total food and labour cost per patient bed day ranges across NHS Boards from 9.11 to 27.28. The non-patient catering deficit NHS Boards is approx. 2.5m (off set) - ranging from a 190k surplus to a 740k deficit. Unserved meals account for approximately 6% of all meals produced - over 1.4m in food wastage across NHSScotland. The pilot implementation of a bespoke Catering Information System based on excel has shown a confirmed recurring saving of 119k across 3 Boards by the end of 2013/14 following an investment of 27k.
Catering Recommendations A planned rollout of Catering Information System across all catering services in NHSScotland and further development of an electronic meal ordering application currently being trialled. Develop a national strategy which will set out the provision of catering production facilities across NHSScotland through a national strategic group. NHSScotland should ultimately move to a standardised national range of menus which take account of religious, dietary and other demographic factors.
Domestic Findings & Recommendations The cost of cleaning a square metre ranges across NHS Boards from 25.60 to 55.65. The national procurement of generic domestic floor cleaning equipment and materials Boards should also identify an annual budget or investment profile for the purchase, maintenance and replacement of domestic services equipment. A national Domestic Productivity Tool, which can provide accurate costs for cleaning existing and future NHS sites, should be developed and implemented across NHSScotland. Conduct service reviews on a Board-by Board basis - similar to that conducted for Catering services - following the pilot reviews currently being carried out in NHS Lothian, Shetland and Tayside.
Laundry Findings The backlog maintenance cost of the Laundry Production Units across NHS Boards is over 9.5m with 7.4m associated with one single facility. The cost of processing a single item, before any external income is taken into account, ranges across NHS Boards from 24p to 1.05. When external income is taken into account the costs range from 17p to 1.02 per item. The majority of Boards are already using, or are moving towards using, fitted rather than flat bedding.
Laundry Recommendations Development of a business case, which will identify the most appropriate provision of Laundry Production Units across NHSScotland. A national linen policy or guidance document should be developed in conjunction with Health Protection Scotland which also specifies bed changing frequencies.
Portering Findings The total cost per square metre ranges across NHS Boards from 6.54 to 34.45 and the total cost per occupied bed day also ranges from 4.40 to 22.14. There is no method for accurately capturing the number or type of tasks that portering services perform across NHSScotland.
Portering Recommendations A planned rollout of a fully automated Porter Task Tracking Systems in appropriately sized Hospitals (over 350 beds) across NHSScotland will enable porters to be fully utilised 80% of the available time and ensure an audit trail of portering tasks. In a 500-bedded hospital the return on investment has proven to be approx 3:1 over a 5-year period in an NHS Trust in England. Conduct service reviews on a Board-by Board basis - similar to that conducted for Catering services - following the pilot reviews currently being carried out in NHS Lothian, Shetland and Tayside.
Retail Findings There are 101 retail outlets (cafes, shops and pharmacies) covering over 6,200 square meters of NHSScotland estate and providing an annual income of approx. 1.5m per annum. 64% of these outlets are operated by the RVS or other charitable organisations, 10% are pharmacies and 26% are private retail cafes and shops. This does not include PFI/PPP sites. The total annual retail income per square metre ranges across NHSScotland from 17 to 542. In addition to the retail outlets above, there are approx. 20 NHS-operated cafes, including the NHS-owned Aroma cafes. Only 4 Boards have formal lease agreements with the RVS or other charitable organisations for retail services which deliver a fixed income. Boards also receive variable donations from charitable organisations which are not in all cases, linked to the performance of the retail outlets.
Retail Recommendations Development of a national framework and guidance for lease agreements in NHSScotland which also takes account of the range in demographics and footfall across different sites. Boards should actively review available space to explore if there are any retail opportunities that would enhance the patient experience and offer an additional income stream. Aroma cafes and retail outlets should be assessed initially before any external organisations are considered.
Next Steps As the work of the Programme moves into a new phase, the progamme will seek funding and set up the projects required to take forward the recommendations from the Strategic Review report. More information on how the programme s direction will be available in the next team brief.
Partnership Representatives Service Unite Unison Catering Ann Crozier Raymond Marshall Laundry Tony McGrory Domestic Irene Clark Rose Anderson Portering Thomas Mowbray Charles Leslie Retail Ewing Hope On the Facilities Review & Shared Services Programme Board the Partnership representatives are now Joe Lynch, Ewing Hope and George Walsh. If you have any questions. Email: nss.facilities-shared-services-programme@nhs.net
The Programme Team Website http://www.hfs.scot.nhs.uk/services/strategic-review-of-soft-fm/ Martin Henry, Programme Director Bobby Alikhani, Project Manager martin.henry@nhs.net bobby.alikhani@nhs.net Kim Carter, Finance Support kimcarter@nhs.net