Estates and facilities managers in healthcare are under constant pressure to do more with less, but as the way healthcare staff work continues to evolve, so too must the environments that support them. Flexible working models — such as hybrid, compressed hours, and job sharing — are now formally recognised across the public sector. While clinical teams must remain on site, many administrative and support roles are increasingly mobile. This shift presents both opportunities and challenges for estates teams.
In this evolving landscape, the role of estates and facilities managers and other estates professionals is no longer just about maintaining buildings; it’s about supporting better care through smarter, more responsive environments. With up to £10 bn of new NHS investment earmarked for digital transformation, there’s a clear opportunity to harness data and technology to drive more efficient, patient-focused estate strategies — but only when done right. Therefore, it leaves one pressing question: How is the role of estates and facilities managers evolving in response to the balancing act of modern healthcare, where rising expectations and limited resources demand smarter, technology-driven approaches to managing space?
Competing demands in the modern workplace
Hybrid working has transformed the way that space is being used across healthcare — but not evenly. Despite clinical teams needing to remain on site, many administrative, managerial, and support staff can now work more flexibly. However, these evolving work patterns are often at odds with how NHS spaces were originally designed and are currently managed.
The result? A growing disconnect between planned space allocation and actual usage. This mismatch presents a significant challenge for estates and facilities teams. Unlike in the corporate world, where space can often be consolidated or repurposed quickly, NHS facilities must balance clinical priorities, safety regulations, and public accountability. Spaces that were once fully occupied may now sit empty for days, while others are stretched beyond capacity. Without accurate visibility into how space is being used, it becomes difficult to plan effectively, or to respond to shifting demands.
Reactive maintenance
At the same time, reactive maintenance continues to dominate budgets across the NHS estate. The recently announced £750 m in government funding — described by the NHS Confederation as a ‘small downpayment’ on a £14 bn maintenance backlog — is being directed toward urgent infrastructure issues such as leaking roofs, faulty wiring, and poor ventilation. While this funding is essential to keep facilities safe and operational, it leaves little room for proactive space optimisation, particularly at a time when estates teams are expected to support new ways of working.
Administrative and support staff increasingly seek flexible working arrangements and better working conditions, while clinical teams require consistent, well-equipped environments. This dual demand places further strain on estates teams, who must balance safety-critical repairs with the need to create adaptable, efficient spaces that support both wellbeing and productivity.
Findings from the Verdantix Global Corporate Survey: Real Estate Technology Budgets, Priorities & Preferences For 2025 further highlight that across sectors, space utilisation is now a higher priority than managing hybrid work or enhancing occupant wellbeing. Yet, many organisations still lack the tools to track it effectively. While 25 per cent of respondents plan to adopt space planning and utilisation software for the first time, just as many have no plans to invest, often relying instead on proxy data from room bookings or visitor logs. In healthcare, this lack of visibility continues to lead to costly inefficiencies.
This fluctuating dynamic only translates to unpredictable office occupancy, where spaces may be quiet one day and overcrowded the next. That lack of clarity about who will be in the office on any given day makes resource allocation even more difficult. Superficial tracking methods like badge swipes or card scans offer little insight into how spaces are used or how long staff stay, while trends like ‘coffee badging’, where employees briefly check in to meet attendance expectations, further distort the picture.
Estates and facilities teams therefore find themselves in a delicate position. Without reliable real-time data, it’s almost impossible to figure out not only who’s in the office, but also for how long, or how spaces are being used.
Ill-equipped ‘traditional’ office management methods
‘Traditional’ office management methods simply aren’t equipped to answer these questions, especially in a healthcare setting, where every square metre must support patient care, staff wellbeing, or operational efficiency. To address these challenges, estates and facilities managers need real-time insights and data-driven strategies that reflect the complexity of modern healthcare work.
Almost two-thirds (62%) of NHS managers face significant management-related challenges that hinder their ability to act. From navigating complex internal systems to balancing competing demands, estates and facilities leaders are often left without the clarity or tools they need to make confident decisions. In this context, clear, actionable real-time data becomes a powerful enabler, allowing them to cut through complexity, and helping teams move into a more modern way of working.
By harnessing data correctly, healthcare estates teams can better understand how space is used, where inefficiencies lie, and how to adapt environments to meet evolving needs. Whether it’s reallocating underused areas, supporting hybrid working, or improving the patient and staff experience, data provides the foundation for smarter, more responsive estate management.
The first step is understanding how space has been used historically. For example, fstates and facilities managers can understand past trends and identify inefficiencies when analysing past data, such as office bookings or occupancy sensors. This data can show which areas are popular at specific times of the day, and which are underused. In a sense, it reveals a ‘past view’ of how spaces have been used.
Recently, this was seen in action when an NHS Trust analysed occupancy data to identify a need for more meeting rooms. From there, 30 out of 160 desks were replaced with an extra meeting room, saving about £65,000 per year by eliminating the cost of booking external meeting spaces.
Informing practical decisions
Once historical patterns are understood, the next step is to combine that insight with on-the-ground knowledge and simple technologies to inform practical decisions. For instance, pairing occupancy data with local feedback from EFM teams can help identify underused areas or mismatched allocations. In some cases, this approach has allowed healthcare providers to unlock capacity for additional services or community health initiatives within their existing footprint.
Real-time data then offers a ‘present view’ of how spaces are being used at any given moment. This is particularly valuable in healthcare settings, where demand can fluctuate rapidly. Estates teams can use live occupancy data to temporarily close off underused areas — saving energy — or reconfigure layouts where possible to address overcrowding.
Integrating environmental sensors, for example, can also provide real-time usage reports on what’s being used and where. Even with the likes of sensors in entryways or booking systems for shared clinical rooms, teams can gain actionable insights. From here, managing wider resources such as lighting or heating can also be applied only when needed — reducing costs and creating an adaptive environment that works for everyone.
Predictive insights then take this even further, allowing managers to anticipate future workspace trends while ensuring that spaces are both functional and efficient. If data suggests higher attendance on specific days of the week, estates and facilities teams can prepare by allocating resources accordingly. This could include scheduling cleaning, adjusting HVAC systems, or ensuring that enough space is available.
Estates and facilities managers thus benefit from this proactive approach, or a ‘future view’ of workplace trends. This kind of foresight is especially valuable in healthcare, where operational disruptions can have knock-on effects on patient care.
To make this possible, however, the right systems must be in place. The most effective strategies avoid siloed, one-off solutions in favour of integrated platforms that provide a unified view of how space is being used — all without compromising privacy. For healthcare estates teams, this means gaining the clarity needed to make informed decisions across clinical, administrative, and shared environments.
Of course, the effectiveness of any data-driven strategy depends on the quality of the data itself. Flawed or incomplete occupancy data can undermine even the most advanced systems. High-quality inputs are therefore essential for generating reliable insights. In healthcare, where decisions about space can affect patient flow or staff wellbeing, having trustworthy, contextual data becomes critical.
Ultimately, by understanding data and usage patterns, estates and facilities managers can create environments that support flexible working, improve staff wellbeing, and make the most of limited resources. More importantly, it allows teams to move from reactive to strategic, arming them with the insights needed to successfully adapt to any changes that may come their way.
Finding the right balance
From outpatient clinics to administrative hubs, understanding how spaces are used — and how they could be used better — is essential to delivering safe, efficient, and responsive care environments. As the demands on healthcare estates continue to grow, the role of EFM professionals evolves. No longer focused solely on maintenance and compliance, they are now central to shaping environments that support flexible work, improve staff wellbeing, and enhance patient care. This shift reflects the broader balancing act at the heart of modern healthcare: managing rising expectations with limited resources.
To meet this challenge, data and technology are no longer optional. They are essential. Integrated workspace management systems provide the insights needed to make smarter, faster decisions. From historical usage trends to real-time occupancy and predictive analytics, these tools allow estates teams to move from reactive problem-solving to proactive planning.
The role of estates and facilities managers is becoming more strategic, more data-driven, and more critical than ever before. It’s now up to them to use the right tools and insights to create spaces that are not only efficient and adaptable, but also supportive of the people who rely on them every day.