Healthcare facilities face unique challenges when compared with other types of facility, as they need consistent high availability of assets and systems so that patient care is never compromised. At the same time, the NHS faces a maintenance backlog of £11.6 bn, a figure which is currently growing. This puts strain onto teams as they strive to maintain complex systems alongside legacy assets.
Alongside this full-time responsibility, healthcare estates and facilities management teams also face intense pressure to increase efficiency, improve sustainability, and bring outdated systems up to modern standards within limited budgets. One way to reduce the strain is to use a service-partner to provide technical expertise and insight where and when it is needed. This will extend the reach of in-house teams without taking them away from their ‘day jobs’. A partner can advise on the status and condition of existing equipment, map out a route to increase automation or save energy, support modernisation of key assets, provide 24/7 data-driven support, deliver training, and supply spare parts.
Helping to ‘overcome the skills gap’
Such a service-partner can overcome the skills gap, especially in niche areas where it is difficult to recruit, train, and retain skilled workers. As they cover a wide range of facilities and industries, a service-partner will have a large team of technical experts — and this gives them the scale to provide a career path for people in specialist areas.
An estates and facilities manager can gain most advantage with a service-partner that is technology-agnostic. That means that they will bring broad knowledge across many electrical technologies from different vendors. As a result, they can help to get the best out of existing assets. Working with such a partner will guarantee healthcare FM teams access to those skills without the HR overheads. Whichever direction a healthcare facility goes in its digital transformation journey, they will be supported with qualified and certified engineers that directly meet the needs of the site.
Using a service-partner is a low-risk way for teams to apply the latest technologies to existing infrastructure. Typically, maintenance-as-a-service starts with an expert in electrical technology visiting a site to audit the condition and criticality of assets and look for untapped efficiencies.
They will produce an audit report that provides a snapshot view of the site that the estates and facilities manager can use to understand the current state of their systems. This provides a baseline to map out a route to achieve targets for uptime, energy use, and modernisation.
One important benefit is that a partner can draw on experience and insight from other facilities. This means that they can quickly identify risks and issues, and then recommend solutions. A recent whitepaper highlighted this by analysing 400 electrical audit reports from industrial and commercial buildings around the world. It found that 89 per cent of sites faced electrical risk because they lacked a complete single line diagram. This is a simple diagram that shows the layout of a facility’s electrical systems, and is perhaps the most important foundation for electrical maintenance. Without an up-to-date and accurate single line diagram, estates and facilities manager may be putting operators and system continuity at risk, and in turn, compromising on patient care. For example, an operator may not be certain whether they’ve isolated the right circuit or whether critical equipment is connected downstream.
Highlighting priorities
The big output of an audit is that it will highlight priorities and recommend actions. One recommendation might be to digitise the single line diagram so that the in-house team can update it in real time. Another recommendation could be installing sensors to gather data from critical equipment. This data can then be used to feed the digital single line diagram, making it into a digital twin of the real-world facility.
Another challenge a service-partner can resolve is when a site’s electrical equipment is regularly cutting out unexpectedly, or overheating and creating a potential fire risk. The root cause of these issues may be power quality phenomena called harmonics and voltage distortion. Harmonics occur when patterns of current and voltage become distorted. This can happen inside devices that convert alternating current (AC) from the grid into direct current (DC). In the healthcare sector, that can include equipment such as MRI machines, UPS systems, IT infrastructure, or even LED lighting.
A power quality audit from a service partner can help FM teams in two ways — firstly identifying the root cause of power quality problems and recommending a solution. The other benefit is that when planning to install new equipment, a consultant with knowledge of harmonic effects can evaluate the existing system and check that it has the right capacity to support the new systems. As a result, the in-house team can take action in advance, and ensure that new equipment comes online as planned, without any surprises or delay to patient care.
Supported modernisation
The NHS backlog has created a situation where healthcare facilities must make the most of existing equipment. This leaves little time for estates and facilities managers to work on plans to modernise assets in healthcare facilities, let alone prepare for the additional challenge of Net Zero operations.
The answer is incremental modernisation. Using this approach, an estates and facilities manager can upgrade technology on a step-by-step basis and within the available budget. For example, a maintenance visit could also be an opportunity to deploy sensors on critical equipment without scheduling a dedicated visit by a technician — the point being that a service-partner builds a foundation for any modernisation. This supports healthcare FM teams as they work to strict budgets and schedules, removing the common barriers to digital transformation advancement in the sector.
It’s useful to draw on service support when planning brand new, energy-efficient equipment. New equipment can help to solve maintenance challenges by safeguarding availability and cut energy use. However, it introduces new tasks and technologies for FM teams to master. A service partner can help here by providing training and remote technical support to bed in new systems.
Importance of circularity
Circularity is an important principle to protect resources during modernisation. For example, by retrofitting only time-served components and retaining assets like cabinets and cabling that remain in good condition, healthcare facilities can save on resources and CO2 emissions associated with new equipment. This practice also limits on-site disruption, which improves productivity, and protects uptime for critical systems.
Apart from investment, one of the biggest challenges to addressing the maintenance backlog is time. Frontline teams are time-pressured, and often need to carry out firefighting to address unplanned outages and maintain patient care. This is particularly true when relying on scheduled or reactive maintenance, as staff need to react to events when they happen. It’s also important when a site or building doesn’t have dedicated on-site engineering staff, as teams need to take account of travel time, as well as the time to maintain or repair equipment.
Adopting digitisation will help, saving time by providing remote access to live data on asset health, regardless of where those assets are located. In addition, it will enable predictive maintenance, where operators use analytical data to get advance warning of failures before they happen. As a result, they can plan repairs around the site’s schedule, and avoid the ‘firefighting’ that’s needed to react to unexpected outages.
Acting on digital insight can also reduce the total cost of ownership associated with complex equipment. That is because proactive maintenance actively extends equipment lifespan by avoiding the excessive wear on systems when individual components are run to failure.
Data can also be used to support the strict compliance reporting in healthcare. Teams can save time by using digitised maintenance records, energy use and real-time asset health data as sources for reporting.
The result is that estates and facilities managers, maintenance professionals, and leadership personnel can save time, freeing them up to navigate the maintenance backlog and work towards Net Zero goals. One challenge, however, is that digitisation relies on deploying sensors, and this may seem like a large expense and a major effort. However, sensors can be installed on a step-by-step basis, prioritising critical equipment during planned maintenance outages, without healthcare facilities having to shut down.
Maintenance that adapts with a facility
Healthcare facilities grow and develop over time. New wings, new services such as MRI, CT, PET, and other diagnostic suites, and new critical care units may have been added, but in most cases, the power distribution system will not have advanced at the same rate. For example, original switchgear and control equipment is often still in operation after many years, while other equipment has been replaced or upgraded.
Without adequate consideration, changes in the environment may lead to unplanned outages due to lack of insight into system health. A digitally-based maintenance-as-a-service strategy delivers a clear picture of infrastructure health that mirrors real world conditions. Legacy equipment can be upgraded with minimal disruption to patient care, while reducing both planned and unplanned downtime. A service-partner cuts the associated risks by essentially packaging the capabilities of digital transformation from new and advanced healthcare facilities, and applying them to existing facilities on a step-by-step basis. FM teams with digital insight can then plan and schedule upgrades in advance. This is particularly relevant for NHS facilities operating under strict budgets.
Maintenance-as-a-service offers expertise in power, automation, digital technology, and dedicated skills for healthcare facilities management teams to meet the challenges of the sector and future-proof operations. It provides the advantage that the latest digital capabilities do not have to be tied to massive infrastructure investments, as technology can be deployed incrementally through supported modernisation to ensure that advancement never compromises the number one priority of continuous availability.
Addressing the maintenance backlog
The NHS maintenance backlog is a persistent challenge for estates and facilities managers that requires new ways of thinking about ongoing operations. Maintenance and modernisation can both be approached under a services partnership that combines traditional and digital services — including condition monitoring, alarming and diagnostics, remote support, and access to on-site technicians. This will support healthcare estates and facilities managers as they strive to achieve more with less.