Utilisation technology can transform estates

Poor estate conditions affect patient safety, reduce staff productivity, and limit the efficiency of healthcare services. Studies have revealed the scale of the problem, with investment in physical infrastructure failing to keep pace with rising demand.

The system is often characterised as bursting at the seams, but the solution is not just about building new facilities. There are enormous potential gains to be made by making better use of existing healthcare real estate. At the same time, the way healthcare is delivered is evolving with a shift towards out-of-hospital care. This also presents an opportunity.

Unlocking the capacity in community and primary healthcare spaces as well as hospitals and administrative centres could relieve much of the pressure related to space shortages in health service facilities.

Delivering estate transformation within the NHS is rarely straightforward. Since winning finance and approval for new buildings is hugely challenging, it should be a priority to ensure that existing space is used as effectively as possible.

Rethinking space utilisation

In many cases, perceived space shortages are 
not simply the result of insufficient buildings. Instead, 
they stem from limited visibility into how space is actually used.

A data-driven approach to estate management can help organisations:

• Optimise existing space to increase capacity.
• Improve flexibility as service demands evolve.
• Enhance staff wellbeing through better environments.
• Reduce operational inefficiencies and costs.

In many estates, actual utilisation levels are significantly lower than expected. Meeting rooms may be booked but unused. Clinic spaces may remain empty during certain periods. Office areas may sit largely vacant on particular days of the week. Without objective utilisation data, these patterns can remain hidden.

Where new facilities are required, utilisation data can also play a vital role in shaping design decisions. By understanding real usage patterns, organisations can often develop smaller, more efficient, and more affordable buildings.

The growing role of monitoring technology

A range of technologies now exists to help healthcare organisations understand how their estates are used.

• Occupancy sensors

Occupancy sensors provide continuous data on whether spaces are in use and how frequently they are used. These devices can be installed unobtrusively within rooms and collect anonymised information on occupancy patterns.

Abintra pioneered the use of occupancy sensors more than 20 years ago and has continued to develop new generations of monitoring technology capable of capturing detailed utilisation trends. The data generated can reveal:

• How often rooms are used.
• How many people use them at a time.
• How long they remain occupied.
• Patterns of use throughout the week.
• Discrepancies between booking systems and actual usage.

•  Access control data

Many NHS buildings already generate data through access control systems. Badge-swipes can reveal entry patterns and movement between departments. However, these systems typically provide only high-level insights rather than detailed room-level utilisation.

• Video analytics

Video monitoring systems combined with analytics software can measure footfall and circulation patterns in large public spaces. Threshold camera-based systems can be installed at entrances to count people in and out of a building or a particular floor or department but they are fallible.

Ceiling-mounted camera-based systems are useful in open plan areas but not as accurate as desk-mounted infrared sensors which can provide reliable data for a specific workstation or even a specific seat in a meeting room. Privacy considerations mean camera-based systems must be used carefully in healthcare environments and to ensure GDPR compliance.

•  Manual utilisation surveys

Traditional observational studies using manual recording can still provide useful snapshot insights. However, they are labour intensive and rarely capture long-term patterns of behaviour.

• Passive infrared (PiR) ‘desk’ sensors

Widely deployed in corporate office environments, purpose-built PiR sensors provide precise data about work patters down to desk or individual meeting room seat level. Relatively inexpensive and easy to install, they use discrete Wi-Fi to connect with number-crunching software so there is no requirement to integrate with existing IT systems.

• Environmental monitoring

Environmental sensors can monitor conditions such as temperature, humidity, carbon dioxide levels, and air quality. When combined with occupancy data, these insights can help estates teams understand how building systems perform under real operating conditions. This can support improved ventilation, better comfort levels, and more efficient energy management.

Integrating data for better decisions

No single technology provides a complete picture of estate utilisation. The most effective strategies combine multiple data sources. Occupancy sensors can provide detailed room-level insights. Environmental sensors show how building systems respond to occupancy. Access control systems and booking platforms provide additional operational context. By integrating these datasets, organisations can compare planned use with actual behaviour. This evidence allows estates teams to identify inefficiencies, optimise layouts, and make more informed strategic decisions.

Data enables change, but people drive it. While technology provides valuable insights, meaningful 
estate transformation depends on collaboration 
between estates teams, operational leaders, and frontline staff. Ultimately, data can reveal patterns, but staff experience helps explain them. Technology bridges the gap between perception and reality in space utilisation. But real change happens when estates teams and frontline staff work together to interpret the data and act on it.

By combining objective evidence with operational knowledge, organisations can develop practical 
solutions that improve both efficiency and working environments.

Case study: Livewell Southwest

A recent project with Livewell Southwest, a community healthcare provider in Devon, demonstrates the impact of data-led estate planning.

The organisation faced a major challenge when its proposed Children, Young People and Family Hub reached Outline Business Case stage but proved unaffordable to progress further. Services remained 
in unsuitable buildings, while some teams lacked permanent workspaces. Working together, consultants Baxendale and Abintra deployed occupancy sensors across several buildings for a three-month study. Sensors were installed in:

• Clinical spaces.
• Office areas.
• Meeting rooms.
• Training spaces.

The study generated detailed data on occupancy patterns and utilisation levels. The data revealed that, across the estate, utilisation levels averaged around 40 per cent, significantly below target levels. It also highlighted:

• Significant variation in usage across the week.
• Peak occupancy midweek.
• Low utilisation on Mondays and Fridays.
• Mismatches between room bookings and actual use.

Interactive heatmaps allowed teams to visualise these patterns clearly.

The findings allowed Livewell Southwest to rethink how its estate was organised. Changes included:

• Improving clinic scheduling processes.
• Integrating booking systems with appointment scheduling.
• Relocating teams into more appropriate buildings.

The result was increased clinical capacity and better collaboration between teams — without the need for a new building.

Case study: Lewisham Children’s Hospital

Utilisation monitoring can also play a vital role in improving patient safety and building security. Lewisham Children’s Hospital faced a unique challenge: balancing public access with the need to create calm, secure environments for young patients and their families. With concerns around unauthorised access and a complex building layout, the hospital sought data-led insight to inform better space planning.

The sensitive hospital setting demanded a non-intrusive, highly accurate solution. We deployed our purpose-built, ultra-precise PiR sensors across the site to conduct a comprehensive 12-week occupancy survey. Across the main hospital building’s six floors, a total of 512 sensors were installed for the three-month period of the survey. These ran 24/7, collecting reams of data which revealed key patterns of movement, including how routes were being used through the building, which stairwells were busiest and when, and how clinical and public areas varied in occupancy over time.

Thanks to these reports, hospital estate managers were able to:

• Identify high-traffic zones and avoid mixing them with sensitive clinical areas.
• Create compartmentalised zones to separate family-friendly spaces from general public routes.
• Enhance overall safety by addressing concerns around unauthorised access.

The survey provided the evidence needed to reconfigure the hospital layout intelligently and with confidence. It was not only a logistical success, but a crucial step in improving both security and patient experience. The findings enabled the hospital to redesign circulation routes and strengthen access control.

Hospitals are complex environments, and in a children’s hospital every decision about space has a direct impact on the wellbeing of young patients and their families. Redirecting footfall away from sensitive areas improved privacy, reduced disruption, and strengthened security within the building.

Managing office and administrative space

The healthcare estate is, of course, not confined to clinical spaces. Across both the NHS and private healthcare, finance, IT, HR, administrative support, and other non-clinical workers occupy a huge amount of space, meaning estate managers face many of the same challenges as their private sector counterparts with only offices to manage.

One of those challenges is flexible working. Despite bold pronouncements about a full return to the office, the reality is very different. Flexible working is not a temporary experiment but a permanent shift in how people engage with work. Even organisations that have called employees back to their desks are discovering that people favour hybrid or flex-first models.

There is a widening gap between what leaders may expect and what happens. Teams now have varied workstyles: some value the energy of face-to-face collaboration while others prize the focus and balance that remote work offers. The result is a workplace landscape that is dynamic, diverse, and often under-utilised.

Underused office space is more than just a cost — it is a missed opportunity. Effectively utilised workspace not only optimises real estate investment but also enhances employee experience, providing the right mix of spaces for collaboration, concentration, and connection.

The answer lies in embracing innovation — using data, sensor technology, and software to make decisions grounded in evidence, not assumption. By leveraging these insights, organisations can design offices that reflect how people work. That might mean modular layouts, more shared or multi-purpose spaces, and environments that flex as teams and priorities change.

Building smarter healthcare estates

Healthcare estates will continue to face significant pressures in the coming years. While new developments remain important, the ability to optimise existing assets will become increasingly critical. By combining utilisation monitoring technology with strategic estate planning and staff engagement, NHS organisations can unlock hidden capacity within their estates.

Understanding how buildings are used today provides the foundation for designing more efficient, flexible, and sustainable healthcare environments for the future.