How can acute space be better used?

In the 2013 paper on space utilisation in the NHS estate, Delivering better health care outcomes more efficiently: A £2.3 billion and Hyde Park sized opportunity,¹ Ellis and MacDonald reported that there remained in excess of 1.5 million square feet of under-utilised space in the NHS estate. While this headline figure obscures the hard reality of land-locked ageing facilities that are unable to be effectively used, there remains, nevertheless, a significant issue for NHS Trusts – which is to understand the underlying causes of poor space utilisation (and specifically that space utilisation which forms an essential resource for effective clinical service delivery). 

Lack of ‘visibility’

It is the lack of ‘visibility’ of the drivers of space utilisation – particularly those that negatively impact upon it, that I would argue is of significant concern. The evidence of this comes in part from the number of NHS Trusts that are now approaching us to help them expose these factors, and so enable them to identify mitigation strategies. Further evidence that fuels such concerns is provided in the Department of Health’s Premises Assurance Model (PAM),² which correlates ERIC returns data of clinical activity with the amount of operating space used by each Trust. In the 2013 PAM returns, very nearly half of all NHS Trusts were reported to have a space efficiency score of less than 80%, and a just under a third of the total had a space efficiency of less than 70%. (Figure 1)