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A technological revolution is sorely needed in all aspects of the UK’s health system.

Olly Thomas explains why the PFI handback provides a prime opportunity for digital transformation in one core area of healthcare provision – the management and maintenance of estates and assets.

IN 2023 a bold new healthcare scheme was launched in earnest with a contract award for the Federated Data Platform (FDP).

Described by one newspaper as a ‘boring name belying big ambitions’, the scheme is designed to connect currently disparate and highly fragmented datasets across the UK’s National Health Service (NHS).

Its laudable objective is to drive efficiencies through the reduced time and effort that will be required by hospital teams to locate information when it is joined up and easily accessible. Its proponents say it will support quicker diagnoses and shorter hospital stays.

In all aspects of the healthcare system, the potential for the use of technology to save time, money and generate better patient outcomes, has long been identified.

The principle was recognised in the NHS’s Five Year Forward View , where it stated that “new technologies and ways of working must be encouraged and harnessed to improve the quality of care and patient experience.”

But, for individual schemes, the impetus has been frequently lost as frontline priorities take over and new ‘crises’ emerge. Within the NHS, 10 per cent of hospitals are still paper-based.

Now, for one aspect of healthcare delivery – the management and maintenance of hospital facilities and core physical infrastructure – a new impetus has been given  for reform.

That impetus is the Private Finance Initiative – the hand-back by private companies of assets to the public sector as the contracts (typically 25-30 years) expire.

With the handback of the physical hospital assets, the private finance companies will also be transferring back a wealth of asset data and information.

And this transition period marks a key time for trusts and health boards to be considering – what is the best and most cost-effective way of managing our facilities/assets? How could our approach be more effective? What do digital approaches and new solutions have to offer us and how we deliver care?

Handback and the digital hospital

In its February 2022 report, Preparing for PFI Contract Expiry, the Infrastructure Projects Authority, the government’s centre of expertise for infrastructure and major projects, stated just this. It said that the end of such a long-term arrangement provides an “imperative” for contracting authorities to rethink the future.

Technology, digitalisation and standards, it stated, have evolved significantly since PFI contracts were established. New areas of strategic policy focus, such as carbon net zero, have emerged. These considerations, it urged, should inform how contracting authorities approach the expiry period.

I agree with these sentiments completely. The end goals of any contracting authority in the expiry planning process are not just about the transition itself – but about the requirements for the assets and the services being delivered after the PFI contract ends.

The possibilities that could be generated by a digital-first approach to how we design, build, operate and maintain our healthcare estates have been illuminated at scale in the New Hospitals Programme.

The programme has four main objectives which include, ‘creating intelligent hospitals’ and ‘delivering a better, faster and sustainable legacy.” Digital technology, the programme states, “will change the way healthcare is delivered in these facilities.”

My colleagues have been privileged to support this programme. In 2021 we co-led the development of the digital approach for the programme (48 hospitals) ahead of the appointment of the Interim Delivery and Commercial Partners. We are currently supporting the Interim Delivery Partner on the Connected Data Environment Strategy.

We have advised multiple NHS Trusts/Boards on digital capabilities, including asset management, information management and information security.

Through this extensive portfolio of work we understand the benefits that can be generated not just for asset management but for healthcare delivery through adopting a modernised, data-driven approach to the management and maintenance of physical assets and the information about them.

the end of such a long-term arrangement provides an “imperative” for contracting authorities to rethink the future.

Digital: Building the case

Of course, cost comes into the equation. And building the case for a ‘big bang’ digital transformation programme is difficult and risky.

But instead trusts/boards could look to initial pilots to provide evidence of the impacts that could be achieved and to start teams thinking about asset management and wider delivery with a mindset of innovation and transformation.

The PFI handback – both of assets and the information about them, presents a challenge, but it also presents an opportunity: To ensure a long-term effective asset management strategy and assets which are fit not just for today but for the decades to come.

Olly Thomas will be speaking on this subject at the NHS Data and Information Conference on 18 June. You can book a meeting with him at the event, here: Book a meeting

For more information on the support we are providing for PFI information and asset data transfer, please supply brief details below and one of our team will get in touch:


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