Strategic Healthcare Planning - Healthcare consultancy company, supporting the NHS

Projects: Estates Planning: Liverpool Women's Hospital

Estate Strategy for Liverpool Women's Foundation NHS Trust

SHP has been working with the Trust and their team to develop an Estate Strategy to support the Trust's ambitious service development programme. A detailed analysis of service and capacity plans was followed by a workshop involving senior Trust managers and clinicians to establish the estate implications of the service strategy. A comprehensive functional suitability and space utilisation review of the existing estate was undertaken, leading to the identification of a number of permutations for future space allocation and use.

The Task
The Trust, a successful Foundation Trust, required an up to date Estate Strategy to identify potential changes to buildings and facilities to meet future service needs. SHP were asked to co-ordinate and facilitate a process to develop an understanding of future likely demands on the estate.
SHP considers that an effective Estate Strategy is vital for an NHS provider organisation to support ever-changing service needs and to maximise the value of its facilities. Key characteristics of the strategy are:

A "plan" for buildings and site development;
Driven by service needs;
Also driven by Estate needs;
Clarity around functional content (eg beds, theatres, clinical rooms etc);
Clarity around site organisation and control;
Sufficiently flexible, taking account of political and NHS-wide uncertainties;
Reviewable;
Strategic framework for future capital investment plans and business cases.

The Process
SHP uses a five-step process to derive an effective Estate Strategy:

1. Understanding the service vision and plans;
2. Translation of service requirements into functional content;
3. Surveys of the site to assess opportunities and constraints;
4. Identification of options for site developments to fulfil service vision;
5. Development of Estate Strategy documentation and site plans.

In Liverpool, the first stage of the process involved developing a sound understanding of the vision for each of the directorates over the next 5 to 10 years. SHP facilitated a workshop at which each Directorate was invited to present its service vision for the future, including consideration as to the likely impact on the estate. The workshop was structured as follows:

	understanding existing directorate service plans;
	identifying and assessing longer-term drivers for change in demand such as:
	• • •	changes driven by demand (geographic, epidemiological, demographic, technical, medical); changes driven by models of care (whole-health-economy level, local methods of care delivery); changes driven by improvements in efficiency (lengths of stay, daycase rates, avoidance of unnecessary admissions etc);
	identifying potential obstacles or constraints to the delivery of the vision; exploring the impact of these issues on the Trust's current capacity (beds, theatres, consulting rooms etc); this was informed by detailed analytical and benchmarking work carried out by SHP;
	assessing the current configuration and suitability of accommodation for each department;
	identifying the resulting implications for buildings and facilities.

In parallel with the service-driven assessment outlined above, a detailed review of the functional suitability and space utilisation of the Trust's physical estate, department by department, was undertaken.

The results of this work were examined and further developed at a second workshop with members of the Trust's senior executive.

The Outcome

The review identified a number of issues:

a number of service pressures which could only resolved through the provision of more space; a limited number of under-utilised areas; potential locations for any future new build development;

Following from this, a number of permutations for future development were identified, and a structured benefits / dis-benefits appraisal was carried out. A series of plans were produced for each clinical and service area.

The resulting document clearly identifies the strategic changes required to the estate over the next 5 years, together with a set of targets to enable monitoring of progress towards the key objectives.