Is this an opportunity to disrupt the estates and facilities model in the NHS?

Date Published


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5 mins read


Phil Bishop

For the past decade, PFI (private finance initiative) contracts have been in place to support NHS trusts with the management of their existing estates and facilities.

As these start to come to an end in the next few years, trusts will be forced to decide how to continue the running and development of NHS buildings. As highlighted by the Public Accounts Committee, the recommendation is to plan several years in advance.

What are the considerations?

There are different options for a trust for the ongoing management of the asset and it’s important that these are considered well in advance of the contract expiry. While some will choose to renegotiate a new contract with the existing provider or take the work in-house, another option will be to set up a subsidiary company to manage the assets. This could also include establishing an organisation in its own right, trusts will be able to ensure that their assets are being looked after by a firm they’ve created. In addition to establishing trust and quality, the services of a new company can also be offered to other public organisations like schools, who need additional support with their facilities management or development.

This also provides the opportunity to assess and develop the use of new technology in their hospitals. For example, implementing augmented reality technology to support facilities managers in monitoring the safety of buildings. The new systems would show teams exactly where things are within the building, such as fire safety equipment or electronic wiring, meaning managers can more easily take decisions about where key business services need to be applied. Another exciting development is RFID technology, which will allow employees to tag equipment, monitor its use and find it more quickly. If hospital beds were tagged, the technology could instantly alert staff to their exact location, saving time and increasing efficiency.

Within these companies, multidisciplinary teams will need to be established, to make sure they are able to handle all the tasks that are likely to arise. From the day-to-day smooth running of the hospital, through to more complex technical challenges like internal wiring and structural work, trusts need to be sure that every aspect of the building is going to be attended to by the new entity they establish. In order to create a multidisciplinary team that can successfully take over the running of these assets, collaboration will be essential.

Workforce challenges

Bringing two cultures together can be challenging, but trusts can guide employees and support them through the transition period. From teambuilding exercises to additional training, workshops, one-to-one mentoring, goalsetting and educational tools, there’s plenty of ways that leaders can unite teams. Each trust will need to analyse the skills and morale of their individual teams to determine how best to encourage collaboration. In addition to integrating new starters into the workplace, they will also need to be mindful of the impact that the pandemic has had on organisational culture. With flexible working and hybrid offices now becoming the norm, these transitions will need to be managed in a more complex space than ever before.

For some trusts, merging staff from different organisations will present challenges, and managers will need to be prepared for what lies ahead. When a business changes ownership, employees are protected under the Transfer of Undertakings Protection Employment (TUPE). This applies to organisations and businesses across the UK, including the NHS. For the health and care system, combining workforces between the public and private sector is unlikely to be an easy task. In addition to merging workplace behaviour and culture, procedures and operations will also need to be in-sync. In the short-term, employees will be entitled to retain their existing contracts if they move into the NHS from a private sector organisation, something which might cause tensions in teams.

Employees from the private sector may be used to working under separate guidance and regulations, and it can take time to migrate them into new ways of operating. They might also have learnt certain skills which were relevant to the specific role they were in and can be adapted. It will be the responsibility of trusts to integrate these dynamic capabilities to form improved teams, learning from the best of both worlds.

Workplace cultural changes are already underway within the NHS, so now is the time for leaders to start developing plans and support networks within their teams to adapt as quickly as possible. By working together and putting strategy in place from the outset, we can ensure a more harmonious integration of different teams, where each individual feels valued and secure in their job.

Find out how we can help to manage the lifecycle of your private finance initiative (PFI) contract

Written by

Phil Bishop

Phil Bishop

Associate Director – Healthcare

Phil joined the Local Public services team in April this year, he has depth of experience working directly for public sector including the NHS also Social Housing and local Fire and Rescue Service. Working within senior management across sectors has enabled him to gain a depth of knowledge through experience of delivering safety compliance and fire risk management.

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