In 2020/2021 the total cost of running the NHS estate in England was £10.2 billion – a 4.8 per cent increase on 2019/20, with total energy usage from all sources across this estate 11.4 billion kWh, 1.6 per higher than in the previous year.
According to the latest ERIC return data from all English NHS Trusts – released on 14 October, eradicating backlog at NHS hospitals across England would now cost £9.2 billion, up by 2.2 per cent on the previous financial year. In 2014/15, the comparable backlog maintenance figure for was £4.3 bn, and the cost of eradicating this backlog has risen steadily year-on-year since. Unsurprisingly, given the impact of COVID-19, the total cost for cleaning services in 2020/21 – at £1.1 billion – was 5 per cent higher than in 2019/20.
Under a mandatory system, all NHS Trusts in England must collect and submit annually their ERIC (Estates Returns Information Collection) data, detailing the costs of providing and maintaining their NHS estate, including information on the cost of maintaining and equipping their buildings, the provision of FM services such as laundry and food, and the costs and consumption of utilities. NHS Digital says that as part of its analysis of the 2020/21 data, an enhanced data quality assurance exercise was conducted in conjunction with NHS England/Improvement (the collection sponsors). Both organisations worked closely with Trusts to clarify requirements and support accurate reporting.
NHSE/I and NHS Digital consider the accuracy of the ERIC data highly important, particularly given that it is used to secure funding in the Comprehensive Spending Review and the New Hospital Programme, is required at ICS level to inform estates strategy, and is a key element in assuring Trust Boards of statutory compliance and guiding Trusts’ Capital Investment Programme and estates strategies. Accordingly, for the 2020/21 year, 62 NHS Trusts across England were selected to be part of a BLM (Backlog Maintenance) audit and validation exercise, with the Trusts chosen including those with the highest BLM by value, those with the largest backlog maintenance increases in the year, and those with no change in their BLM figure over 2019/2020. Other Trusts known to have buildings that incorporate Reinforced Autoclaved Aerated Concrete, or RAAC – a lightweight ‘bubbly’ form of concrete used widely in many public buildings from the 1960s to the 1980s over which safety concerns have been raised, were also included. A number of the Trusts met multiple selection criteria
The audit also saw participating Trusts asked number of pertinent questions. For instance, asked whether their backlog values had been signed off by their Trust Board, just 32 per cent said ‘yes’,48 per cent answered ‘no’, and 20 per cent gave no response. In answer to the question, ‘Are your ‘high’ and ‘significant’ risks reflected on the Trust’s Risk Register, 45 per cent answered ‘yes’, 27 per cent ‘No’, and 28 per cent gave no response.
An IHEEM West Midlands Branch online seminar held on 14 October, the day the latest ERIC data was released, saw speakers including Jo Dolby, National lead for Capital and Commercial at NHSE/I (pictured), Steve Lawley, NHSI/E’s Deputy National lead for Capital and Commercial, Chetan Tailor, Principal analyst at NHSE/I, and Lisa Sculpher, Strategic Estates lead, NHSE/I, North West, discuss the latest ERIC data and the rationale behind, and mechanics of, the BLM audit and valuation initiative.
Among the audit and valuation exercise’s overall conclusions were that:
• There is currently an inconsistent approach and methodology among Trusts for backlog data capture.
• There is a need for an increase in Six Facet Surveys.
• There is inconsistent use of cost models.
• There is limited awareness of backlog risk at Trust Board level.
NHSE/ and NHS Digital say that based on this year’s ERIC returns and the BLM validation / audit exercise, they intended to re-undertake the validation exercise for the 2021/22 collection. They will also be seeking ‘greater granularity’ on investment and incidents, will work closely with Finance colleagues on capital allocation methodology and guidance, and will publish a Communications Plan ‘to ensure that backlog is an ongoing process for data collection and management’. They also plan to develop a scope for standardisation of a 6-Facet Survey detailing the required outputs and standardised templates for completion, to link data sources such as ERIC and the Premises Assurance Model (PAM), to utilise the survey results to develop a business case for ‘next steps support’, and to create a central supplier framework and benchmark costs, ‘with quality monitoring of all suppliers’.