Healthcare Property, Issue 4, July-August 2024

07/2024

JULY-AUGUST 2024

Advocating a simpler approach to the healthcare planning process

The implications of a new accountancy treatment on NHS leases

Designing mental health facilities closer to home

WELCOME

Election fever!

Following news that a General Election will be held on 4 July, the main political parties have been releasing details of their plans to reform health and social care services.

Manifesto pledges include improvements to social care services, better access to hospital care, improvements to primary and community care services and NHS dentistry, additional funding to address the COVID-19 backlog, and capital investment in NHS buildings and equipment.

And, while health and social care reform traditionally plays a large part in voters’ decision-making at the polls, for many Healthcare Property readers, capital spending commitments will be key to their professional futures too.

Reading through the manifestos, the Conservatives are continuing with their ambitious – and somewhat delayed – New Hospital Programme (NHP), which will aims to deliver 40 ‘new’ hospitals by 2030; while Labour has pledged £250m to double the number of CT and MRI scanners and will also continue with the NHP.

The Liberal Democrats are focusing on a 10-year plan to invest in the hospital and primary care estate and a £1.1bn-a-year investment in buildings and equipment.

These commitments come as the backlog maintenance bill for the NHS estate exceeds £12bn, with a number of hospitals suffering from major issues which threaten the safety of staff and patients.

Also key to most manifestos is the aim to shift services, where possible, away from acute settings and into communities, where they are more accessible to patients.

But this will mean diversification of the estate and the leasing of community-based facilities; and this will require changes to legislation around planning and finance.

In this edition of Healthcare Property you can read about a few of these challenges, including current issues with planning permissions (p11) and the capital restrictions associated with the new IFRS16 accounting treatment for leases (p15).

In the Finance and Property section you can also read about healthcare REITS (p25), and the launch of a new space management system which is supporting landlords across the health sector (p18).

Elsewhere, there are details of the latest carbon reduction efforts across health and social care (p44), news from estates and facilities management professionals (p37), and we look at some of the key drivers behind health and care design and construction practices (27).

In the next edition we will be looking at environmentally-friendly lighting solutions, the impact of arts in health projects, and the design of primary care facilities. If you can help with any of these please contact joanne.makosinski@nexusgroup.co.uk

Jo Makosinski Editor, Healthcare

Property

About Jo: Jo is the editor of Healthcare Property, having joined Nexus Media in November.

She has been specialising in design and construction best practice within the health and care sector for the past 15 years, working on the Building Better Healthcare

Awards and editing both Building Better Healthcare and Healthcare Design & Management magazines.

She has a special interest in the design of mental health and dementia care settings and in modern methods of construction and energy efficiency.

Chief executive officer

Alex Dampier

Chief operating officer

Sarah Hyman

Chief marketing officer

Julia Payne

Editor Joanne Makosinski

joanne.makosinski@nexusgroup.co.uk

Reporter and subeditor

Charles Wheeldon

Business development director

Mike Griffin

Advertising & event sales director

Caroline Bowern

Business development executive

Kirsty Parks

Sales manager

Luke Crist

Publisher Harry Hyman

11-13 Policy

Exploring the challenges of the current healthcare planning system

Management

New environmental measures unveiled to support NHS catering teams, how technology is helping to keep health settings clean, and we meet some of the unsung heroes from estates and facilities teams

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the support available, including 18 trusts winning government funding to support energy efficiency programmes, and the completion of a solar project at Poole Hospital 15

REITS; the implications of the new accounting treatment, IFRS 16; the launch of a new space management tool; and the lack of elderly care beds in Wales.

and Construction

The very latest best-practice approaches to healthcare architecture and construction. Articles look at the impact of AI on healthcare construction projects, why colour matters in care home design, and why environmental impact is becoming more important to architects

Delays to New Hospital Programme cost trusts £1m a month

NHS Providers has raised concerns that millions of pounds every month are being drained from scarce NHS funds due to ongoing delays to the New Hospital Programme (NHP) which promised 40 new hospitals in England by 2030.

Spiralling cost pressures, on-hold building projects, and the bill for having to patch up deteriorating sites sees some trusts in the NHP forking out upwards of £1m a month from underpressure budgets.

And, one year on from the Government’s renewed commitment to build 40 new hospitals by 2030, trust leaders have warned that, despite some progress, uncertainty over funding and shifting timetables risks putting their promised buildings even further out of reach.

Furthermore, Sir Julian Hartley, chief executive of NHS Providers, warns the issues with the NHP are just part of the much-bigger problem that is the scale of underinvestment in the NHS estate.

“More than 100 trusts applied to join the NHP and the NHS repairs bill is now at a staggering £11.6bn, much of it high risk. We cannot afford to let this problem get worse,” he said.

CONSEQUENCES

Trust leaders are warning than crumbling estates and out-ofdate equipment not only hamper care for patients, but also lead to staff becoming more demoralised.

In addition, public confidence is being undermined by the delays to the NHP.

Some trust leaders involved in the NHP have voiced their frustrations to NHS Providers, saying:

Trust leaders are now looking to the next government to commit to the current hospital building programme, as any delays caused by going back to the drawing board after the general election would be costly and undermine patient care.

“As we head towards a general election, trust leaders want a castiron commitment from all political parties to an NHS infrastructure programme that meets the needs of hospitals, mental health, community, and ambulance services”,

Sir Julian adds: “Patients, hard-working NHS staff and taxpayers deserve nothing less.”

Commenting on the issue, UNISON head of health, Helga Pile, describes the promises of a new hospitals programme as ‘more political spin than substance’, adding: “Ministers are failing to plan and finance critical upgrades to buildings across the NHS, leaving trusts with huge bills and hospitals in no fit state to deliver modern healthcare.”

Plans submitted for Bracknell Forest health centre

Frimley Health and Care Integrated Care System (ICS) has announced plans for a custom-made centre for health in Bracknell.

• “Further delays are only going to introduce further patient harm, disappoint our colleagues, and increase costs to the taxpayer”

• “Our teams are coming in, day in, day out, to infrastructure that is not fit for purpose. We don’t have the facilities to treat patients in the way that any of us aspire to”

• “In the past three years, we’ve seen a 25% increase in costs; that’s £200m more today than it would have cost three years ago”

• “Many of the new hospital plans have been around for a decade – we must now be given the opportunity to ensure all the plans align with modern healthcare provision”

A planning application, drafted by property consultants, Vail Williams, in conjunction with architects, Murphy Philipps, has been submitted to Bracknell Forest Council for a threestorey development to be sited next to the existing Skimped Hill Health Centre.

The building will house Evergreen Practice and Forest Health Group, as well as maternity services and some children and young people’s services and community clinics.

The project is part of a national drive to boost communitybased healthcare services, providing funding to bring multiple services together in the same place.

Subject to planning approval, it is hoped building work will begin next month, with completion of the build in early spring next year.

In feedback to NHS Providers, trust leaders warned they do not have the facilities to treat patients in the way they aspire to

Work underway on diagnostics centre

Monkwearmouth Development Ltd (MDL), a joint venture between Sir Robert McAlpine Capital Ventures and Argon Property Development Solutions, has handed over its first development to NTW Solutions at Monkwearmouth Hospital in Sunderland.

With funding from Railpen, the new, modern, fit-for-purpose building provides a welcoming, level, and accessible front entrance to the main outpatient facilities at the existing hospital.

In addition to the new entrance and reception area, the accommodation includes meeting rooms, flexible openplan workspaces, and breakout areas, as well as consultants’ offices on upper floors and areas for their support teams.

The building has created the perfect office environment for employees at the site and encourages collaborative working and support.

It also houses a Changing Places facility, and the new ‘Café Bede’ community café is open to the general public, visitors, staff, and service users across the hospital.

The café includes areas for inside and outside dining and is home to a time capsule that was placed in the ground during the construction works telling the story of the build, the history of the site, and the previous building for people to read in years to come.

Sir Robert McAlpine completed the construction of the 3,287sq m, three-storey building for MDL over 19 months, with the facility achieving a design-stage BREEAM ‘Excellent’ sustainability standard.

In addition to a replacement tree-lined staff car park, the development delivers level access and a landscaped piazza area including seating and extensive planting, along with a memorial garden.

The external works have transformed the previous parking area that fronts onto Newcastle Road and creates better connectivity within the estate for hospital users, staff, and visitors.

MDL worked with NTW Solutions, a limited company established by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, to provide premises that will enable NTW Solutions to deliver improved facilities and a range of important services to the trust.

David Peck from Monkwearmouth Development Ltd, said: “We could not be

more delighted with the outcome, which has been a true collaboration between all the parties involved, who have created a building that is streets ahead of the one it replaced and that will make a significant difference to patients who rely on it for their care and the people that use it as their place of work.”

David Hosken, project director at Sir Robert McAlpine Capital Ventures, added: “We are immensely proud of delivering a unique facility using an innovative development solution, helping NTW Solutions renew its estate with a quality building designed for modern ways of working.

“This fantastic project allows us to continue to build on our successes working alongside NHS trusts to deliver developments with positive outcomes for the people who will use them.”

Private finance supports delivery of diagnostic centre

To celebrate work beginning on the construction of a new diagnostic centre at Yeovil District Hospital, construction firm, Darwin Group, invited key partners in the delivery of the facility to attend a ground-breaking ceremony.

Somerset NHS Foundation Trust (FT) chief executive, Peter Lewis, was joined at the ceremony by clinicians at the trust, along with representatives from InHealth, which will provide radiology and endoscopy services; Prime plc, the trust’s strategic estates partner; and funder, M&G Investment.

The centre, which is expected to open later this year, will provide over 70,000 diagnostic tests and outpatient appointments a year.

The modern, state-of-the-art, stand-alone centre on the hospital site will benefit patients in Somerset and north west Dorset who will receive quicker diagnostic tests thanks to the additional capacity it will provide.

Open seven days a week, it will provide radiology, endoscopy, cardiology, and audiology diagnostic tests and outpatient appointments.

Thanks to Darwin Group’s innovative offsite modular construction methods, the project will be delivered up to 60% faster and with up to 90% less waste than traditional building methods, making it one of the most-efficient and sustainable

options in the marketplace.

Specialising in health and care property development, Prime collaborated closely with Darwin Group to design and develop a cutting-edge facility.

And the result will be a high-performing, sustainable, low-energy new build, meticulously designed to achieve net zero embodied carbon.

Furthermore, it is projected to yield a biodiversity net gain of 267%.

The facility will take shape quickly with 73 modules being delivered and installed overnight over the course of eight days, transforming the estate at pace, while minimising disruption to the busy active hospital site.

Jonathan Ockrim, a consultant colorectal surgeon and Somerset FT’s clinical lead for the Yeovil Community Diagnostic Centre, said: “I’ve worked at the hospital for 21 years and have never seen such an incredible

investment in new buildings and facilities at the hospital, which is giving us much more capacity to care for and treat our patients.

“Within the new CDC we’ll have a new audiology unit, a cardio diagnostic centre, as well as an imaging suite so we can get quicker and better-quality CT and MRI scans for our patients.

“In addition, the centre will house a new state-of-the-art endoscopy unit, which will help to relieve the pressure on our busy endoscopy unit in the main part of the hospital, so it can prioritise emergencies. We also expect waiting times for an endoscopy to be greatly reduced.”

The centre will also have a number of additional clinic rooms, as well as a conference room at the top for clinical meetings.

Kevin Vickers, director at M&G’s longlease real estate team, said: “We are delighted to support the NHS by funding this new diagnostic centre.

“By using private sector finance to fund public sector projects, it is proof that effective partnerships like this can help to stretch the public purse and enable further societal benefits.

“In addition, the provision of patient capital for this project also benefits the millions of savers on whose behalf we invest, through the generation of sustainable long-term returns for their pension funds.”

Mental health facility opens in Islington

Per Mertesacker, current manager of the Arsenal Academy, recently opened 1 Lowther Road, a new NHS Integrated Community Mental Health Centre in Islington.

The opening was also attended by representatives from contractor, Kier, as well as other key figures from the local community.

Kier recently handed over the new facility to the North London Mental Health Partnership (NLMHP).

The centre is part of the partnership’s St Pancras Transformation Programme and works included the demolition of the existing facility on site and construction of a new four-storey building with state-of-the-art facilities including interview, counselling, and treatment rooms, agile workspace for staff, a café, group collaboration zones;

and landscaping which includes a ‘pocket’ park to support visitor and staff wellbeing.

Kier was appointed to the project through the Procure Partnerships Framework, an £8bn framework created to support NHS trusts, local authorities, education providers, and blue-light services.

David Rowsell, managing director for Kier Construction London, said: “We’re delighted to have handed over this vitallyimportant integrated community mental health facility to Camden and Islington NHS Foundation Trust.

“We know this building will support staff and the trust to provide much-needed mental health support for the Islington community.”

Jinjer Kandola MBE, NLMHP chief executive, added: “The partnership is committed to improving the outcomes

for all our service users and the quality of the care we provide.

“Through our St Pancras Transformation Programme, we are delivering new leadingedge therapeutic environments for service users and carers and improved working environments for our staff.

“The cutting-edge design of Lowther Road was developed with input from service users, carers, our staff, and the local community, and can be adapted as our needs change over time.”

Financial close reached on Velindre Cancer Centre project

The consortium behind plans for the new Velindre Cancer Centre in Cardiff has announced it has achieved financial close for the development.

The ACORN consortium, made up of Sacyr, Kajima Partnerships, and abrdn, with White Arkitekter as lead designer, has secured funding for the flagship cancer care facility, which is being designed in compliance with the Wellbeing of Future Generations (Wales) Act 2015 and is set to become on the UK’s mostsustainable hospitals.

The facility is also part of Velindre University NHS Trust’s Transforming Cancer Services in South East Wales mission.

The hospital will bring high-grade, sustainable services, offering patients and carers effective treatments.

Additionally, it will lead national and international research and innovation in cancer care.

Aviva Investors, Siemens, Sumitomo Mitsui Trust Bank, CaixaBank, Norinchukin, Nomura, and Nord/LB are among the financiers backing the project.

Work is expected to start on site later this month, with the first patients receiving treatment in spring 2027.

GREEN THINKING

Targeting a BREEAM ‘Excellent’ sustainability rating, the building design prioritises local sourcing and natural

materials with low-carbon footprints that promote health and wellbeing.

The scheme has a hybrid structural strategy, with mass-timber structure to public areas.

And, thanks to the use of materials such as hempcrete and mineral plasters that are breathable and flexible, a natural and calming environment will be created for patients, relatives, and staff.

The building is also designed to be all electric to supporting low energy demand and low operational carbon.

In addition, the design seeks to reduce the amount of material used through an extremely-compact and efficient building plan and optimised structural and material use strategy.

Externally, the new hospital will be surrounded by a landscape garden designed to ensure minimum impact onthe site and to keep the Welsh landscape as wild as possible.

The landscape strategy aims to retain existing habitats and create new habitats alongside new landscape spaces, such as an orchard with Welsh apple varieties and a community kitchen garden.

By designing informal playgrounds and a variety of walking, cycling and relaxation areas, play and movement in nature is also encouraged.

Michael Woodford, director of White Arkitekter’s London studio, said: “The aim is to create a low-carbon healthcare environment for the future, which complements the medical treatment of patients as well as offers a state-of-the-art workplace for staff.”

FIT FOR THE FUTURE

Richard Coe, project director at Kajima Partnerships, added: “It is fantastic to achieve financial close on this exemplary new hospital, and we look forward to seeing the building take shape during the construction period.

“The project represents a paradigm shift in sustainable healthcare, providing cutting-edge facilities and treatment in a building designed with sustainable material innovation, community inclusion, and a commitment to preserving the environment, at its forefront.”

The ACORN consortium was appointed following a public procurement process run by Velindre University NHS Trust. It includes Sacyr, Abrdn, Kier Facilities Services, White Arkitekter, Socotec, Hydrock, Ingho, ICCA, MJ Medical, Turley, Studio Response, Camlins Landscape Architects, RSK, Bureau Veritas, Osborne Clarke, Operis, Howden, Mazars, Cloud Nine, Evolution Infrastructure, Addleshaw Goddard, Marsh, AECOM, Lloyds, Geldards, Pinsent Masons, and Artelia.

Siemens to build MRI cooling facility

Germany-based Siemens

Healthineers is building a facility in Oxfordshire to design and manufacture superconducting magnets used in healthcare facilities globally for MRI patient scans. With an investment of £250m, the site will be home to novel technology that minimises the use of helium, making scanners lighter, easier to install, and more sustainable.

It will be the UK’s first major production site for new socalled DryCool technology, which reduces the amount of helium required in an MRI scanner from 1,500 litres to under a single litre.

Construction has begun on the 56,000sq m site and it will open in 2026. It is being developed by Tritax Symmetry.

The facility will be operationally carbon neutral and should create more than 1,300 jobs when fully operational, including the retention of over 600 Oxfordshire-based jobs

currently at an existing Siemens Healthineers facility in Eynsham.

Many of the roles are for highly-skilled workers such

as physicists, engineers, technicians, and specialist support staff.

Prime Minister, Rishi Sunak, said: “I am delighted Siemens

Healthineers has chosen Oxfordshire for its new facility, supporting over 1,300 skilled jobs in the area, and reinforcing the region’s status as a vanguard in healthcare and R&D.

“But, as well as the incredible local benefits this will bring, this cutting-edge facility also presents an opportunity to enhance patient care globally –which means British innovation is saving lives around the world.”

Chief executive of Siemens Healthineers, Bernd Montag, added: “MRI technology plays a vital role in diagnosing disease, helping patients to get healthy and stay healthy.

“As a world leader in medical imaging, we are very proud to open the next chapter of our history here in Oxford.

“This factory will be the global centre for our innovative lowhelium magnet technology, meaning we consume far less of a scarce natural resource and enable access to MRIs for many more patients.”

Offsite approach for new surgical centre

Construction work has started on a £49.9m elective surgical centre at Southmead Hospital in Bristol.

The development is a joint project between North Bristol NHS Trust (NBT) and University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) supported by Bristol, North Somerset and South Gloucestershire Integrated Care Board, and NHS England.

And it will enable an additional 6,500 operations to be carried out every year.

The state-of-the-art facility is being built by specialist healthcare construction firm, Darwin Group, and it will have four surgical theatres, X-ray facilities, and 40 recovery beds, as well as 12 medirooms where patients prepare for, and recover from, surgery.

As the centre will be separated from emergency services, the surgical beds will be kept free for patients waiting for planned operations, reducing the risk of short-notice cancellations.

Modular units will be constructed offsite to deliver the project up to 60% faster and with up to 90% less waste than traditional building methods.

Once groundworks have been completed, the prefabricated units will be brought to Southmead Hospital to construct the building, which is due to open in spring 2025.

NBT chief Eexecutive, Maria Kane, said: “We are delighted to be working with our partners to bring nearly £50m worth of investment to the area’s NHS.

“Once completed this elective centre will transform and improve the way we provide elective care and enable us to treat our patients faster.

“It is wonderful to see work starting on the centre, which will be a fantastic asset for the whole of Bristol, North Somerset, and South Gloucestershire, and we look forward to welcoming our first patients in spring 2025.”

Professor Stuart Walker, UHBW interim chief executive, added: “This centre will

improve patients’ experiences of planned surgery, enabling them to receive lifechanging treatment sooner and spend time in better health with their loved ones.

“We are excited that work has started on the centre and look forward to continuing our collaboration with partners across Bristol, North Somerset, and South Gloucestershire to develop and deliver the centre and services for our patients.”

Reforming the planning system

In this article, Khosro Bashi, partner and architect at Tooley Foster, explores the challenges of the current healthcare planning system and why a simpler approach could help to overcome some of the problems facing investors, developers, and financers

This is not another architect complaining about how the planning system has become intolerably complex.

I wanted instead to concentrate the mind on how we might try to address a simpler approach.

This would be through recognition that we have largely dispensed with the outline planning application process because so many authorities insist in so much supporting evidence for outline applications that it has become almost as complex as full applications.

For example, a typical application for a care home 15 years ago was a simple set of drawings. But, year on year, more and more requirements for reporting have been added, starting with Design and Access Statements through to detailed analyses of various aspects of the scheme to the level that the planning authority, with ever-morerestricted budgets, does not have time to adequately digest it.

Moreover, if approved and the scheme goes ahead, the planning authorities do not have a checking role to ensure that the scheme is taking shape in the way prescribed in the approved drawings and reports. Instead they have a reactive role based on neighbourhood complaints that may come from the build or completed scheme.

Planning Application is RIBA (Royal Institute of British Architects) work stage 3: The RIBA plan of work is used across the industry and places

planning application in work stage 3 Spatial Coordination.

The core tasks in this stage are to ‘undertake design studies, engineering analysis, and cost exercises to test architectural concept resulting in spatially-coordinated design aligned to updated cost plan, project strategies and outline specification’.

There is absolutely no reference to anything being done to a detailed level of work that comes in work stage 4 and 5.

Don’t get me wrong, we have arrived in a very logical and supportable manner at a mass of information required for a planning application, so it is not easy to unpick.

As an example, below is Waltham Forest’s validation list for the applicant to figure what is required to make a valid application.

to a large degree on the quality of information disclosed

2. The application with full supporting information with, if refused, the right to appeal to the secretary of state – allow one year for the outcome. If approved,

the application is likely to have in the order of 30 planning conditions

3. Planning conditions discharge detailing each aspect of the scheme, with each treated as separate planning applications, although multiple conditions can be dealt with at the same time through a single application. However, the risk then is one being refused can jeopardise all the conditions included in the application

4. It is likely that the detailed design development process leads to a requirement for a Non-Material Amendment application or another type of application (Section 73 for example)

Let’s focus on item 4 for the moment. With the issues arising from the complexities in any development today, the chances of arriving say a year later with no changes through the detailed design development stage and no changes that the client requires are slim and will invariably lead to some return to the planning process in its current shape.

What a depressing thought with the timescales and inevitable costs involved.

But it really doesn’t have to be this way. Surely the system can be simplified by first looking at the principle and size of development so that the same requirements are not applied across the board on all developments?

How much better it would be if we could take planning in smaller, moremanageable steps.

What about three steps as follows:

Step 1: Quantum and principle of development should be a first stage application with the planning authority giving precisely what information they require for a more-detailed application in the next step and when that information is required i.e.

a) Pre-commencement

b) Pre-occupation

c) Post-occupation

Having the certainty that there is

mileage in the application in principle, the developer can invest the hefty sums involved in preparing the information required.

Step 2: RIBA stage 3 Concept Design Application – details/reports supporting the application may include archaeology, ecology, transport assessments, landscape, SuDs, daylight/sunlight studies, etc that are required in today’s applications i.e. the conditions discharges.

Step 3: RIBA stage 4 and 5 Detailed Design Application – any amendments arising from detailed design development stage and any non-material client changes There are matters which are part of early design, but which are covered in more detail under the Building Regulations.

I give you two examples below with a thought and question: What harm there would be if just some of these could perhaps be delegated from planning to be dealt with under Building Regulations?

1. SuDS: drainage may be a difficult issue on some sites, but these cases are rare, and one may say it’s part of due diligence on purchase of the site to check this issue. Is this really a planning matter or a technical issue that is delivered through building control?

2. Energy Assessments and Overheating: These matters are checked as desktop studies, but never on site and currently exist in Building Regulations, so why do we need to prove to the planning authority that the criteria are met? It is nothing less than blatant distrust in the professionals that design buildings to be able to deliver the targets set by planning authorities. Those targets should be set in Step 1 and left to the building control authority to monitor delivery to that target

The above are examples, but there are several others from the list that could simply be targets set at Step 1 and left to building control to deliver.

It really doesn’t have to be the lengthy painful process that we have all become so accustomed to working with that is evidently failing to deliver.

Ecology and Biodiversity net gain deserves its own attention.

The reports on biodiversity have to be timed to coincide with the emergence of various endangered species, therefore creating delays in obtaining ecology reports and hence being able to submit a valid planning application.

There are several laws governing the protection of endangered species and developers should beware that regardless of planning applications they have responsibilities under those laws.

Do we need also need planning law or can we divorce ecology from the planning application process and put in place a direct application route to Natural England which currently receives and decides on such matters?

This would allow developers to control the timing of their planning application and put the onus on the developers to submit an application direct to Natural England and obtain their approval before commencement of any works.

Of late some planning authorities have added to the list of reports, Fire Statements (item 26 on Waltham Forest’s list).

This has historically been a Building Regulation matter and I see no reason why it must be brought into the planning system at all.

It’s time to stop looking at the planning system as a one-stop shop that considers all statutory matters for a development and instead look at separating out a few key applications, directly with the statutory bodies that govern those aspects of a development, that can be divorced to lighten the load on our veryburdened planning authorities.

Planning authorities do not have a checking role to ensure that the scheme is taking shape in the way prescribed in the approved drawings and reports. Instead they have a reactive role based on neighbourhood complaints that may come from the build or completed scheme

What do the IFRS 16 accounting standards mean for NHS trusts?

Changes to accounting standards for NHS organisations are having a significant impact on estates managers, affecting leases and restricting the capital trusts have available to invest

Changes to accounting rules for NHS trusts are proving a challenge for estates and finance directors as they impact on leasing agreements which were previously off capital balance sheets.

The introduction of IFRS 16 for NHS trusts on 1 April 2022 has had far-reaching implications for already-tight NHS capital budgets and is leading to a rethink of how the health service utilises and expands its estate moving forward.

The IFRS 16 accounting standard replaced IAS 17 with the intention of providing greater transparency in financial reporting.

However, under the earlier standard, leases were classified as either ‘operating leases’ or ‘finance leases’ and the former did not impact NHS trusts’ Capital Departmental Expenditure Limits (CDEL), which restrict what public sector bodies can spend in terms of capital on an annual basis.

Under IFRS 16, leases which satisfy the tests set out under the accountancy

standard and do not fall within one of the limited exceptions are now accounted for on the balance sheet.

And this change has restricted the cash that NHS trusts can invest in buildings and equipment, as the full value of any leasing arrangement caught by IFRS 16 will now count towards their CDEL.

CHALLENGING TIMES

Speaking to Healthcare Property, Lisa Geary, health property partner at international law firm DAC Beachcroft, explains: “The NHS leases numerous buildings – particularly in mental and community health services – and under this accounting treatment many of those

A trust may decide to take a series of shorterterm leases – possibly including tenant options to renew – to bring the lease arrangements within the short-term exemption, but care and advice needs to be taken here

Finance and Property

leases which used to be off balance sheet will now sit on the balance sheet, impacting the amount of capital the NHS has to spend on maintaining and improving its estate.

“And not only does it impact leases creating a landlord and tenant relationship, but also some contracts where the ‘right to use’ an asset is granted and certain other tests are satisfied.”

Stan Campbell, partner and health property lead at DAC Beachcroft, adds: “In broad terms, this means that under IFRS 16 a trust entering into a lease incurs a charge against its CDEL limit based on the length of the term and the value of the rent in the financial year in which that lease is completed. This restricts the actual cash a trust can invest in buildings and equipment.

“And, of course, the consequences of IFRS 16 are greater for higher rents and longer leases.”

A GET-OUT CLAUSE

The exemptions available under IFRS 16 can mitigate its effect, including where leases are of low value or taken for a short term (12 months or less).

However, where the NHS is a tenant, these exemptions are largely non applicable as many of its occupational commitments are for periods of more than a year and are often linked to service contracts.

Geary says: “A trust may decide to take a series of shorter-term leases – possibly including tenant options to renew – to bring the lease arrangements within the short-term exemption, but care and advice needs to be taken here.

“If it is ‘reasonably certain’, taking account of the surrounding circumstances, that a tenant will extend a lease – for example if they are making capital improvements to the building or entering into a services contract linked to a building for a longer period of time, both of which evidence an intention to stay in the building long term – it may mean the exemption will not apply.”

PROTECTING BUDGETS

The effect of IFRS 16 has increased the pressure on trusts to look at other ways to protect their capital budgets and mitigate its impact.

A significant proportion of the capital investment in the NHS estate to date was secured via the now-defunct Private Finance Initiative (PFI) approach.

First introduced in 1992, the model involved private companies providing funding for the construction, refurbishment, and maintenance of NHS facilities in exchange for a long-term contract to deliver services.

Trusts should ensure they seek reliable accountancy advice on the value of the buildings they own and those that they lease, including how they can legitimately mitigate any value going on balance sheet depending on the terms of the lease

The private companies receive regular payments from the NHS over the duration of the contract, typically 25-30 years.

This allowed private investors to generate a return on their investment while also delivering vital healthcare services to the population and enabled the NHS to keep the payments off balance sheet.

However, the current Government stopped using the PFI model in 2018 and many of the existing contracts will come to an end between 2030-2050.

THE NEXT STEP

One attempt to raise private capital for infrastructure projects was the Regional Health Infrastructure Companies (RHIC) scheme conceived by Community Health Partnerships (CHP), which aimed to fundraise in a similar manner to the Local Improvement Finance Trust (LIFT) initiative, but for larger projects, though smaller than those previously agreed using PFI.

While the scheme was scrapped before it took off, a primary benefit was its intention to account for costs on an offbalance sheet basis, meaning projects would not be included in the NHS’s capital spending limits.

Campbell says: “One solution to the lack of capital for the NHS estate could be the creation of a Governmentbacked structure that would encourage private investment in healthcare infrastructure.

“There are an increasing number of investors interested in ‘doing well by doing good’ by investing in the UK’s health and social care infrastructure.

“With the strong covenant strength of the NHS, such a structure could provide the necessary reassurance to encourage private investment.”

However, at present, it remains unclear whether the Government will create a replacement for PFI or establish an alternative avenue for private investment.

Stan Campbell

Lisa Geary

And the recent introduction of IFRS 16 has only made funding the NHS estate more challenging.

SPACE UTILISATION

“We know from conversations with our clients that many NHS bodies and their finance teams would welcome a moresimplified route to infrastructure funding,” says Campbell.

Geary adds: “Trusts should ensure they seek reliable accountancy advice on the value of the buildings they own and those that they lease, including how they can legitimately mitigate any value going on balance sheet depending on the terms of the lease.

“Estates managers are already working hard to ‘sweat their assets’ by looking at how existing space can be used more efficiently, and identifying surplus land for sale or reletting for income generation purposes.

“The impact of IFRS 16 has further heightened the importance of doing this if it means that the leased estate can be reduced without any effect on the provision of quality care.

“There is underutilised space in the NHS estate and if some of these leases can be brought to an end and space used more efficiently, then this can help.

“Collaboration is key to this. The consolidation of space and an increased use of buildings which are shared with other

public sector bodies can help to mitigate the value of leasing arrangements which sit on balance sheet by reducing a trust’s leasing footprint.”

But, with a General Election on the horizon, many NHS trusts are hoping that whichever party gets into power decides to change the rules around IFRS 16 and/or CDEL limits.

Campbell says: “If we see a change of Government in July, one of the Labour Party’s plans is for more people to be treated in the community.

“Any required premises are likely to be leased and come onto the balance

sheet under IFRS 16 unless a change of Government also comes with a will to change either accountancy treatment or the control of capital expenditure.

“Whatever happens, the NHS is heading towards more primary and community care, rather than hospital-based care, so it will need to take on new buildings.

“And key questions remain: how will estates be funded going forward? Will there be a replacement for PFI? Will an alternative avenue for private investment be created? Will investment be purely taxpayer-funded?

“Only time will tell.” n

The consolidation of space and an increased use of buildings which are shared with other public sector bodies can help to mitigate the value of leasing arrangements which sit on balance sheet by reducing a trust’s leasing footprint

Space management tool supports healthcare landlords

NHS Property Services (NHSPS) has announced it will be relaunching its award-winning space management system, NHS Open Space, to benefit landlords across the entire health system.

First launched in 2016, NHS Open Space was developed by the NHS for the whole healthcare sector.

The complete space management system provides all NHS and public sector landlords with a suite of specialist estates management, booking, and analytics tools, complemented by expert support and guidance from healthcare sector specialists.

NHS Open Space helps landlords to better understand how their estate is being used, at a room, property, or portfolio level, through one-off utilisation studies or ongoing monitoring.

MAKING SPACE

Landlords can then use the tool to better manage their space, using it as either an internal booking system, or making the rooms available to other organisations to monetise underutilised space.

“We look forward to working with NHSPS to further improve and develop the work we are doing together, to ensure our clinicians and patients experience the efficiencies brought about by the recent system enhancements and feel assured that the new offer will further improve access to the excellent care delivered to patients

Some added benefits to customers created by the new NHS Open Space platform

studies and monitoring to understand

Decide on either an internal booking organisations to book and use space

This enables them to drive maximum value through new revenue streams and reduces ongoing costs.

The self-service booking platform remains at the heart of the NHS Open Space estate management system, providing users with the ability to search, book, and use space quickly, saving valuable administration time and resources.

Since its launch, around 7,000 users have successfully provided more than 160 services to patients over a staggering 3.5 million consultation hours.

Community Health Partnerships, which is head tenant in 308 health care buildings across England, is currently working together with NHS OpenSpace on a pilot scheme using the platform across 18 buildings in the Midlands and London regions.

CLARITY AND CONTROL

Chris King, head of Open Space for NHSPS, explained: “We have enhanced NHS Open Space based on what our customers told us they needed, and it now provides them with clarity and control to assess, manage, and evaluate their estate.

utilisation data collection and reduce administration time, increasing cost recovery for our NHS customers, which is critical as they focus on forecasting and budget management as we enter a new financial year.

“We’re also thrilled to be welcoming CHP onboard this month and look forward to collaborating with them as part of a pilot scheme to create an improved experience for their tenants and customers.”

Phil Brenner, strategic estates advisor at Staffordshire and Stoke on Trent Integrated Care Board, added: “We are pleased to see the extension of NHS Open Space to our estates colleagues and landlords across the NHS, having experienced for ourselves the benefits and positive

• Functionality on a room-by-room basis, giving customers full flexibility

• Self-service portal to manage properties, pricing, users, and access a suite of utilisation and financial reports

• Intuitive user interface to streamline management time and maximise usage

• Easy access from any device giving on-the-go flexibility

• Wide range of room types including clinical and non-clinical space, across 200+ locations

• Transparent pricing and room availability data

• Further strategic estates management advice available through NHSPS’ additional service provision

• Expert UK-based technical support n

NHS Open Space helps landlords to better understand how their estate is being used, at a room, property, or portfolio level, through one-off utilisation studies or ongoing monitoring

Elderly care bed shortage provides opportunities for developers

A new report from Christie & Co reveals a shortfall in social care beds for the elderly in Wales, providing significant opportunity for specialist developers, operators, funders, and private individuals

Care home closures and a rapidlyageing population have led to a shortfall in bed numbers for the elderly in Wales, according to a report from specialist business property adviser, Christie & Co.

Its Wales Healthcare Market Insight 2024 report analyses the elderly care home market across Wales and highlights the growing need for new-build, futureproofed care homes throughout the country.

MARKET OVERVIEW

Between 2020-2023, 40 elderly care homes in Wales closed and only four opened, says the report.

And, as of March 2024, there are 594 elderly care homes across Wales with an average capacity for 37 residents each.

They comprise a total of 21,820 care beds, 60% of which have en-suite provision, 25% have wetroom provision, and just 22% have dedicated dementia provision, according to Christie & Co’s benchmarking data.

These homes are primarily located in urban areas of higher population density, such as Cardiff, Swansea, and Wrexham, and there remains a significant shortfall of such beds in many rural areas where poor transport links and staffing challenges prohibit development.

The average home in Wales has an occupancy rate of 92%, a rise from 90% in 2022/23, and 89% in England.

SUPPLY AND DEMAND

Between 2020-2024, 604 Effective Market Capacity/future-proof (EMC) beds were developed in Wales, either through new registrations or the refurbishment of existing facilities –an increase of just 5% in four years.

Comparatively, the demand rose by 20%, meaning that, as of 2024, the overall demand for beds in Wales is circa 21,155 while there are only circa 12,501 EMC beds in supply – just 59% of the required demand.

And, according to the report, 74% of local authorities in Wales require EMC beds, yet only 26% currently have sufficient levels of supply, which further demonstrates the necessity of such provision.

THE FUTURE

Christie & Co forecasts that, by 2034, there will be a total undersupply of 1,672 EMC beds in North Wales and 7,423 EMC beds in South Wales.

Rob Kinsman, regional director for care at Christie & Co; and Will Edwards, healthcare development and investment lead, said of the report: “The figures in our report speak for themselves. There is a severe need for EMC beds in Wales and this demand is growing rapidly as people live longer and we see a rise in the closure of homes that are no longer fit for purpose.

“Wales is behind the curve with England and Scotland in terms of new futureproofed care bed provision coming forward.

“It is clear there is a significant opportunity for specialist developers,

operators, funders, and private individuals to benefit from early mover advantage into the Welsh market.

“Christie & Co deal activity for care and retirement development sites is starting to increase in the country, with two completions in the first half of this year and we look forward to working with market participants in facilitating futureproof bed supply to serve the growing need of the elderly population.”

To read the full report, visit www.christie. com/news-resources/publications/waleshealthcare-market-insight-2024/ n

Finance and Property Deals

Land deal paves the way for care home scheme

Christie & Co has announced the sale of a development site in Gravesend, Kent, which benefits from planning permission for a 75-bedroom care home.

The scheme, delivered by Frontier Estates, has been prepared as a bestin-class care home with 100% ensuite facilities, luxury resident amenities, and generous landscaped gardens.

of Britain pub.

Following a confidential sales process with Sara Hartill at Christie & Co, the site has been purchased by Simply UK and will operate under the Morar Living brand.

Neil Dobbie, land director at Simply UK, said: “We are delighted to have acquired this site for 75 beds which will deliver a best-inclass home.

“We believe the scheme will be an excellent addition to the Morar stable of homes and should welcome its first residents in the first quarter of 2025.

“We have ongoing requirements across the country and this purchase aligns with our national acquisition strategy, which continues to go from strength to strength.”

Hartill said there had been a ‘strong shift in operator appetite over recent months for quality sites’.

She added: “Northfleet is a highlyattractive market given its strong demographics and we are delighted to have represented Frontier Estates throughout the sales process.”

The land was sold for an undisclosed amount.

Green light for elderly care projects

Architects, Carless + Adams, has received planning approval for two new elderly care developments.

The first approval was in South Hams, Devon, as a variation in condition to a planning approval granted in 2018 for a 68-bedroom care home.

The original planning approval was extended due to the COVID pandemic and the design was also adapted to allow for considerations around isolation due to potential contagious illnesses among residents.

The variation also allowed the design to incorporate additional sedum roofs, a green wall, and additional outside space for residents via larger balconies and ground-floor terraces.

The second approval received was in Tunbridge Wells, Kent, for a 69-apartment care facility with integrated healthcare unit to enable residents to age in place in a home-from-home environment.

The additional bedroom in the apartments gives the opportunity for a carer to stay or live in. This format will also mean that residents will not need to move into a care home, allowing them to truly age in place.

And the onsite facilities allow residents choice of how they would like to live, with restaurant, hydrotherapy pool, and gym being developed in addition to a community room which will form an integral part of the strategy for the provision of care for the elderly in the area.

Both designs will support the local elderly community and improve the quality of life and care for future residents going forward.

Melissa Magee, managing director and architect at Carless + Adams, said: “These approvals show recognition of the demand for care in the UK and ensuring people have the opportunity to move into appropriate, right-sized home environments.

“We couldn’t be prouder to be part of driving this change.”

The site sits on a highly-prominent 1.16-acre plot in Northfleet, Gravesend, which was formerly occupied by the Battle

Care operator takes over Hampshire freehold

Christie & Co has completed the freehold sale of White Rock Nursing Home in Barton-on-Sea, Hampshire.

Owned and operated by the same family since 1971, the property is a 30-registered care home benefitting from 24 bedrooms and a strong local reputation for providing an excellent level of care for residents.

The business has a ‘Good’ CQC rating and a dedicated staff team, and specialises in providing care for those with dementia.

The home is situated in a quiet treelined avenue in the small coastal resort of Barton-on-Sea, on the edge of the New Forest National Park.

Following a confidential sales process with Charles Phillips at Christie & Co, and with funding sourced through Neil Collins at Christie Finance, it has been purchased by Sally and David Price who own another care home in Hampshire as well as a domiciliary care agency.

Siobhan Dodd, director at White Rock Nursing Home, said: “White Rock has been an integral part of our family since we opened the care home in 1971 and it has been a very hard decision to sell, but we felt the time was right to retire from the sector and hand the business onto a new owner.

“We are delighted that Sally and David will be taking over the care home and with their experience in the care sector we are confident the home is in safe hands.”

Sally added: “As local residents, David and I have been aware of White Rock Nursing Home for a number of years and, when approached by Christie & Co to see

if we would be interested in purchasing it, we were immediately very interested.

“We already own one care home and also a domiciliary care agency in Hampshire and believe there will be great synergies among our businesses.”

White Rock Nursing Home was sold for an undisclosed price.

Four Seasons continues sell-off plan

Christie & Co has announced the mostrecent sub group completion which marks 57 UK care homes sold as part of the divestment project which Christie & Co is running on behalf of Four Seasons Health Care.

These homes comprise Four Seasons Health Care Group’s remaining freehold property portfolio and associated care home business, and as such represent a key milestone in the group’s ongoing restructuring process.

Joe O’Connor, chief executive of the Four Seasons Health Care Group, said: “The completion of the sale of these 57 care homes and their smooth handover to new owners continues the positive progress for the group’s sales process.

“We wish the homes, their residents, and teams well for the future.

“Throughout the sales process, our priority remains the continuity of care for all residents, and the group will

work closely with the buyers and other counterparties, as well as all relevant regulators, to ensure that any transition to new ownership is seamless.”

Four Seasons announced in June 2022 that it was selling 111 care homes.

But bosses recently announced they will retain a third of the portfolio in the near term.

Last month, group chief executive, Joe O’Connor, said: “We decided we would retain those care homes because they were performing strongly across all metrics including care quality and financially.

“We didn’t feel we were getting the right value for them in the sales process.”

Four Seasons Grove House

Four Seasons Park House

Four Seasons Ivybank

Finance and Property Deals

First-time buyers take on care home

Hillbrow House care home in Crediton, Devon, has been sold to new sector entrants, husband-and-wife team, Tintu Tojo and Nicy Sabastian.

Hillbrow House is an ‘Outstanding’-rated care home that occupies a well-maintained, attractive Grade II-listed property with 23 bedrooms and an enclosed rear garden and patio area.

It is located in a prominent position towards the outskirts of Crediton town centre.

The home has been owned by Barry and Denise Shears of Hillbrow Residential Care Home who, along with their daughter, Joanna Foulstone, operated it for over 20 years.

Barry and Denise were looking to sell to enable them to retire and, following a confidential sales process with Simon Harvey at Christie & Co, the home has been purchased Tojo and Sabastian.

Denise said of their decision to sell: “We bought the home in 2002 as a going concern.

“Hillbrow had already been in business as a care home for a number of years and, at that time, we were very involved in maintaining and improving its already-good reputation in the community, implementing new legislation and best practice as time went on.

“Joanna’s entry into the business management of the

reduce our involvement.

“During the COVID period, Joanna and the staff did a first-class job of keeping our residents protected and Joanna’s husband, Lewis, also joined our team during that time and gave a great amount of practical help and support on the maintenance side.

“So, to sum up, Hillbrow has been a family business with an ethos of serving the community and we wish

Harvey added: “The market in the South West remains particularly active, with a significant number of other transactions currently ongoing and demand for care homes across the region being very strong, in particular where homes have a ‘Good’ or, in this case, ‘Outstanding’ CQC rating, are trading profitably, and have an experienced manager in post.”

Hillbrow House was sold for an undisclosed price.

REIT signs lease for private hospital

Northwest Healthcare Properties REIT has announced it has signed a new 25-year lease with private hospital chain, Practice Plus Group, for a new private hospital in Edgbaston, Birmingham.

Edgbaston, known locally as The BMI Hospital, will be under the operation of Practice Plus Group.

To be known as Practice Plus Group Hospital, Birmingham, the building is configured over four floors and comprises 55 bedrooms, three operating theatres, an endoscopy suite, outpatient facilities including 10 consulting rooms, an imaging department, physio area, and staff and patient parking.

for referrals to Practice Plus Group, and from the summer private patients will be able to call the private patient contact centre to book a consultation directly through Wellsoon, Practice Plus Group’s private surgery brand.

The core services provided will be orthopaedic surgery, ophthalmology, diagnostics, and endoscopy.

Nicholas West, head of UK at Northwest Healthcare Properties REIT, said: “We are delighted to welcome Practice Plus Group to

our portfolio and excited to see the property repositioned under its company banner.

“The new lease is provided on ‘green lease’ terms and we believe the new hospital will be a welcome addition to the Birmingham healthcare landscape, providing affordable private healthcare and helping to reduce elevated NHS waiting lists in the local area.”

Practice Plus Group runs 10 hospitals and surgical centres around the country, all of which are rated ‘Outstanding’ or ‘Good’ by the Care Quality Commission (CQC).

With hospitals mostly concentrated in the south of England, this is the company’s first move into the West Midlands.

Jim Easton, chief executive of Practice Plus Group, said: “People that live in the Greater Birmingham area continue to suffer from long waiting lists for elective treatments in the wake of the COVID pandemic.

“We have a fantastic reputation for the quality of our surgery and are looking forward to partnering with the local NHS trusts to unlock access to affordable healthcare for those people who want fast access to high clinical quality.”

Real estate fund ploughs millions into elderly care sector

Elevation Healthcare Properties (EHP), a healthcare real estate fund advised by Elevation Advisors LLP, has raised £348m of equity and debt capital since the beginning of 2024, which it will be using to acquire and develop elderly care properties in the UK.

Following the last equity raise of £330m in Q4 of 2022, EHP raised an additional £157m of equity during Q1 of this year.

It also refinanced an existing debt facility of £153m for a further five-year term with a leading high street bank.

The term loan was converted into a Sustainability Linked Loan alongside Sustainability Linked Hedging, demonstrating EHP’s commitment to sustainability and advancing its existing ESG strategy.

The Sustainability Linked Loan will assess the progression of EHP against:

• The annual Global Real Estate

Sustainability Benchmark (GRESB) reporting which assesses a breadth of ESG and sustainability credentials

• The progression of EHP’s asset level certification against BREEAM in-use

• A commitment to fundraising and volunteering for the selected organisations EHP raised an additional £38m bank facility from Virgin Money, as part of the Berkley Care transaction detailed below.

The facility was rolled over as part of the transaction with over four years left on the term.

All of the debt raised is fully hedged in line with EHP’s interest rate risk policy through a combination of swaps, caps, and floors.

KEY TRANSACTIONS

• Acquired from Clariane S.E, 11 properties, simultaneously leased back to Berkley Care Group. Concurrently, Berkley Care’s existing leadership team agreed to acquire the operations of Berkley Care operations from Clariane. The total consideration to Clariane was £207m. This transaction cements and expands EHP’s existing relationship with Berkley Care, an operator of 12 modern award-winning care homes across England comprising 805 beds

• Acquired a 60-bed, modern purpose-built care home in Ormskirk Lancashire, with a simultaneous lease to operator, Torwood. Additionally, EHP has completed the acquisition of land and a forward-funding

agreement to support the development of a state-of-the-art 61-bed care home in Huddersfield to be developed and subsequently let to Torwood, a leading care operator with two care homes and more than five developments under construction

James Giles, investment director at Elevation, said: “We are excited to announce these transactions, demonstrating the stable and resilient growth of our wellestablished EHP vehicle.

“EHP seeks to address the structural undersupply of high-quality elderly care beds in the UK to deliver positive social impact through the provision of modern, high-quality care environments.

“These facilities are a vital part of the healthcare infrastructure fabric of the country and are designed to meet increasing environmental standards.

“These transactions are testament to the successful alignment of Elevation with its investors and stakeholders, supporting both sustainable returns and the provision of high-quality elderly care.

“Focused on the long-term, we are committed to delivering strong outcomes for our communities and are working towards completing our 2024 ambitions.”

Berkley Care’s Fernhill House

EHP is supporting development of a care home in Huddersfield

Torwood Abbey Wood Lodge

Investing in healthcare REITs

A deep dive into healthcare REITs with Matthew DiLallo, a senior energy and materials specialist at investment advisor, The Motley Fool

Real estate investment trusts (REITs) play a vital role in the healthcare industry.

Healthcare REITs operate many of the specialised facilities that healthcare systems and other health-related institutions need to deliver the best care for patients.

In this article we will consider whether these REITs are good investments and explore some attractive options that investors should consider.

UNDERSTANDING REITS

Healthcare REITs own, operate, manage, acquire, and develop healthcare-related real estate.

These facilities include senior living communities, hospitals, medical offices, outpatient facilities, life science innovation and research properties, and skilled nursing facilities.

Most healthcare REITs make money by leasing space in their facilities to tenants such as healthcare systems, primarily under triple net leases.

This lease structure requires the tenant to cover maintenance, real estate taxes, and building insurance.

And it provides REITS with a verypredictable stream of rental income, making them ideal stocks to invest in during a recession.

Some healthcare REITs also operate the facilities they own, such as senior living communities.

They typically hire a third-party manager who earns a fee for managing the property’s day-to-day operations.

The healthcare REIT generates net operating income from the fees paid on behalf of patients for their housing and any services provided. This income can vary due to fluctuations in occupancy levels and rates.

ADVANTAGES OF INVESTING

Healthcare REITs benefit from the massive and growing healthcare industry, one of the largest stock market sectors.

While healthcare spending in the US, for example, peaked at $3.8trillion in 2019, it declined by 2% in 2020 due to the COVID-19 pandemic.

However, it started growing again in 2021 and is on track to top $6trillion by 2028.

Forecasts suggest the demand for healthcare-related real estate should continue growing.

And REITs are likely to benefit from steadily-rising rental rates on existing properties.

In addition, they should be able to develop new properties to meet the growing needs of the healthcare industry.

One of the drivers of the sector’s projected growth is the aging of the baby boom generation.

People older than 80 are expected to be one of the fastest-growing age groups through 2029.

And the increase in the ranks of the elderly should drive demand for senior housing and skilled nursing facilities.

Such growth is likely to benefit healthcare REITs focused on those properties as they report higher occupancy levels, allowing them to raise their rates.

THE RISKS

While healthcare REITs are less risky than other healthcare stocks because of their generally-stable rental income, they’re not without risk.

Here are some of the risks they face:

• Leverage risk: REITs borrow heavily to acquire and develop real estate and the debt reduces their financial flexibility during economic recessions

• Interest rate risk: REITs are highly sensitive to changes in interest rates. Higher rates increase the cost of debt, given the sector’s use of leverage. In addition, higher interest rates give income-focused investors more investment options that offer an attractive income yield, such as government and corporate bonds, which can weigh on REIT stock prices

• Oversupply risk: Healthcare REITs need to match their development plans with demand. Given the highlyspecialised nature of most healthcare facilities, REITs need to be careful not to build too much supply or it might sit vacant

• Tenant risk: Healthcare REITs rely on their tenants to pay rent and manage senior living facilities effectively. However, healthcare margins are relatively thin, which can cause operators to run into financial trouble if they’re not vigilant. That can affect rental receipts and force a healthcare REIT to find a new tenant for their facility if an operator can’t meet its financial obligations

• Pandemic/flu season risk: Virus outbreaks can significantly affect healthcare REITs, especially those focused on senior housing. It can cause occupancy to decline as more patients check out than are admitted

THREE HEALTHCARE REITS TO CONSIDER IN 2024

According to the National Association of Real Estate Investment Trusts (NAREIT), 16 publicly-traded REITS focus on healthcare-related real estate. And that gives investors interested in the sector multiple options.

A few stand out for their strong performance in recent years, including:

COMMUNITY HEALTHCARE TRUST

Community Healthcare Trust owns a diversified portfolio of healthcare facilities across tenant, geography, healthcare facility type, and industry segments.

The company’s portfolio includes acute inpatient behavioural facilities, physician clinics, behavioural health centres, specialty centres, inpatient rehabilitation facilities, long-term acute care hospitals, medical office buildings, and surgical centres and hospitals.

The company’s diversified approach has paid big dividends over the years, producing annualised total returns topping 18% during the past five years.

And, as of early 2022, it had increased its dividend payment every quarter since its initial public offering in 2015.

The factor driving its growth is a steady stream of acquisitions.

Community Healthcare Trust focuses on smaller off-market or lightlymarketed transactions.

By avoiding a competitive bidding process, it can acquire properties at higher cap rates (the net operating income yield on the investment).

This healthcare REIT is in an excellent position to continue increasing shareholder value. It has a conservative balance sheet, giving it the financial flexibility to acquire a diverse array of healthcare properties. And future deals should supply it with additional cash flow to continue increasing its dividend.

CARETRUST REIT

CareTrust acquires and leases senior housing and healthcare properties.

Most of its portfolio consists of skilled nursing facilities. However, it also owns assisted living facilities, senior living facilities, and campuses that include skilled nursing and assisted living facilities.

CareTrust primarily owns net lease properties, operating only seven of its 224 properties as of early 2022 and its lease structure provides it with a steady income.

Healthcare REITs operate many of the specialised facilities that healthcare systems and other health-related institutions need to deliver the best care for patients

This REIT’s strategy has paid off over the years and it has been one of the top three best-performing healthcare REITs over the past one-, three-, and fiveyear periods.

Aside from focusing on net lease properties, the other major driver of CareTrust’s success in creating shareholder value is its investment strategy.

It invests about $200m annually, focusing on opportunities with higher cap rates.

CareTrust should be able to continue growing in the coming years.

It had a relatively-low leverage ratio and a conservative dividend payout ratio, giving it ample financial flexibility to keep making acquisitions.

Meanwhile, it has a steady pipeline of investments as it leverages its relationships to find attractive opportunities.

MEDICAL PROPERTIES TRUST

Medical Properties Trust focuses on owning hospitals in the US and abroad.

As of early 2022, it was the secondlargest non-government owner of hospitals in the world.

In addition to hospitals, it also owns behavioural health facilities and freestanding urgent care facilities.

The company’s focus on hospitals has paid off over the years.

Over the past five years, it has produced an average annualised total return of 18%.

One factor driving this performance is its increased dividend in each of the past nine years.

Since the end of 2018, the hospital owner has increased its dividend at a 3.8% annual rate.

For comparison’s sake, dividends in the healthcare REIT sector have fallen by an average of 10% during that time, mainly because many have reduced their payments during the pandemic.

A steady stream of acquisitions has produced transformative growth since 2019.

This REIT has acquired $12.1bn worth of real estate, creating an estimated $5.4bn of shareholder value. With a solid balance sheet, growing funding sources, and a massive market opportunity, Medical Properties Trust should be able to continue increasing shareholder value in the coming years.

Healthcare REITs will be one of the beneficiaries of the healthcare sector’s continued growth. And these companies should continue raising rents while experiencing healthy occupancy levels as baby boomers age, making it an excellent sector for investors to consider.

An appetite for growth

the findings

Investment in healthcare real estate is experiencing a revival far ahead of other sectors, according to a new report from CBRE UK.

The real estate adviser’s 2024 UK Healthcare Sentiment Survey quizzed more than 1,400 investors, developers, and providers – collectively investing £8bn and operating 150,000 beds –to gain valuable insight into the market.

And it revealed that healthcare demand remained robust in 2023, with a high majority of investors and developers having maintained or increased their focus on the sector despite economic challenges and low investment volumes.

Market participants are also taking a long-term view on the sector based on increasing demand and strengthening operational performance, with ESG credentials key to decision making as they enhance the positive social impact healthcare services can deliver through the reduction of operational costs and the creation of operational efficiencies which support the provision of highquality care.

Sarah Livingston, head of UK healthcare at CBRE, told Healthcare Property: “What the report showed was that healthcare is a priority sector, which will likely rebound in September this year, ahead of many other sectors in the market.

“What has stopped real estate investment on the whole is that estates have not performed, but health and social care is the opposite and performance has improved.

“A large part of elderly care market occupancy is back to where it should

be and recruitment and staffing are being addressed.

“COVID recovery for private healthcare is also far exceeding pre-COVID levels, so we are seeing investment in the sector rebounding at pace.”

The report reveals that 80% of those questioned expect increased investment and development activity in the health sector in 2024, and 50% anticipate a return to stable market activity before the end of the year.

And more than 75% say ESG influences their strategy moving forward.

But it also highlights a gulf between the priorities of developers and investors.

For example, 50% of investors are interested in the senior living market, but only 30% of developers are interested in developing these facilities.

Developers, in contrast, are focusing their attention on primary care, which investors are less keen to fund.

Livingston said: “Senior living is tricky, with long lead times and issues with planning permissions, which are slow to come by, as are sites with the right access in the right location.

“While, in primary care, there are a large number of GPs operating from

buildings which are not fit for purpose.

“Developers are looking at models where you don’t just see a GP, but also other health and wellbeing providers, such as physiotherapists or mental health practitioners, all under one roof.

“This is attractive as it is seen as a long-term income.”

She added: “We are not really seeing much in the way of large-scale hospital projects, rather adaptations for diagnostics and outpatient services closer to home and with good public transport links for both patients and staff.

“A lot of work will be about repurposing these facilities and bringing them up to ESG standards. This is a particular focus for investors who need to prove their environmental credentials. That came across very strongly in the report.”

She concludes: “The overall sentiment is positive about healthcare because it is a well-known, long-term demand that’s not going anywhere

“With the population getting older and needing more-complex care, investors, developers, and providers are now looking at healthcare.” n

Exploring

of CBRE’s recently-released UK Healthcare Sentiment Survey

Digital construction: the key to unlocking the future of healthcare

With the recent Spring budget announcing £100m of extra funding for AI that will be partly channelled into healthcare, Mark Gibson, managing director of healthcare at Sir Robert McAlpine, looks at the value AI and digital tools can deliver on healthcare construction projects

announcing a new framework encouraging the use of ‘responsible experimentation’ with AI on public projects.

And health sector projects provide the perfect canvas to explore the transformative impact digital construction can have.

In the wake of COVID-19, improving the number and quality of hospitals remains high on the Government’s agenda, and embracing digital construction is the first step on this journey: opening up avenues to increased efficiency and productivity on projects, driving technical excellence, and leading to decreased costs, smoother collaboration, and improved use of resources.

DIGITAL TOOLS: THE FUTURE OF CONSTRUCTION

Digital construction methods cover both ends of the spectrum, from tools that assist with the day-to-day running of a site, to cutting-edge developments currently being trialled.

Health sector projects provide the perfect canvas to explore the transformative impact digital construction can have

For example, at IHP, the joint venture between VINCI Building and Sir Robert McAlpine, we are using Buildots technology while constructing the BEACH Building, part of the Royal Bournemouth Hospital estate.

This involves the use of helmetmounted 360-degree cameras which capture images that AI then combines with BIM, schedule data, and 3D modelling to provide project managers with detailed progress updates sitewide and immensely improve collaborative planning. This is a marked improvement

as reports used to be run manually, often resulting in package managers walking an 8km site per week.

Rigorous standards must be met when delivering healthcare projects, and digital tools can help in ensuring this.

HP Site Print robots are being trialled by IHP at Kingsway Hospital in Derby, allowing floor plans to be created and functions performed to an accuracy of 3mm.

As it is a psychiatric intensive care unit, precision is of the essence, and this guarantee of accuracy, along with improved

Mark Gibson

An aerial shot of Kingsway Hospital in Derby where Sir Robert McAlpine is trialling HP Site Print robots to create floor plans

speed – the robots deliver ten times faster than traditional methods – has made it an invaluable tool. Other BIM tools, like the Dalux BIM viewer, can help simplify highly-technical jobs.

By bringing together floor plans, site capture, and models, complex interface details can be visualised and construction sequencing easier to interpret.

Augmented-reality headsets, also being trialled at Derby Kingsway, can then allow teams to superimpose these BIM models onto structures already existing or in construction.

This allows installation processes to be streamlined, ultimately bringing time, materials, and cost benefits to a project.

DATA COLLECTION MADE EASY

Digital tools can be highly valuable when collecting data.

If effectively integrated into a project, data collection can deliver value while construction is ongoing and throughout the entire life cycle of the building. It can also enrich end users’ experience by sharing findings from any data collected.

With the Building Safety Act making it a legal requirement for projects to share up-to-date information on buildings, the benefits of digital construction tools have been made ever clearer.

They make it possible for data to be easily accessed and shared by others – essentially creating a log of past activity and providing a roadmap through a building’s history.

Once collected, data can also be used to benefit clients and end users post project completion.

For example, project data collected over the duration of the BEACH building’s construction has been shared with the University Hospitals Dorset NHS Foundation Trust to provide guidance on how best to operate and maintain the building, replacing the paper logs often used across the NHS.

Furthermore, the data has fed into enhanced digital security mechanisms put in place in the BEACH building’s maternity facilities, which trigger the automatic locking of doors when needed to keep babies safe.

THE TWIN CHALLENGES OF CULTURE AND EDUCATION

Construction has often been perceived as a traditional, slow-moving industry.

Now, however, there is a growing push to understand new ways of working and a move towards embracing digitisation, digital tools, and methods – particularly in the healthcare projects sector, where estates are often under increased pressure to deliver from the outset, with little room for error.

This is in part due to issues in accessing sites following completion as well as meeting a myriad of technical requirements to ensure that any risks are minimised. Digital construction methods should be

embedded throughout the construction process, seen as a way of working industrywide rather than siloed to specific teams within firms.

And this requires communication from within and throughout project teams, including clients, consultants, and executive leadership through to supply chain partners, and with other firms, too.

It is through this collaboration and communication that a culture of digital literacy can truly be fostered in the long term.

WIDER ENGAGEMENT IS KEY

The benefits of digital construction practices must be shared beyond internal stakeholders to ensure they are a longstanding feature of projects.

For instance, the supply chain should also be encouraged to engage with digital construction tools to foster greater digital best practice.

Similarly, we have seen firsthand how digital tools can facilitate engagement with key stakeholders.

Twinmotion, a visualisation software employed at Derby Kingsway, allowed nurses, doctors, and patients alike to feed in their preferences on the interior of a new hospital unit. This allowed end users to have a direct say on the project’s outcome and ensured quality could be met from the outset.

Joint ventures can also be an effective means for sharing best practice and spurring industry engagement with digital construction tools.

Opportunities for collaboration will allow businesses to share preferred methods of engagement, with the view to ultimately establishing an industry standard of best practice.

Where possible, firms can also put forward projects to take part in onsite trials, allowing future digital tools and technologies to flourish.

Ultimately, digital construction has the potential to vastly improve accuracy and precision when building a healthcare project – thus allowing the highest quality of construction to be achieved in tandem with timely, efficient delivery.

Potentially transformative for the healthcare sector and elsewhere, ensuring sufficient training and education exists for teams to effectively utilise digital construction tools and methods will be crucial in establishing it as a key pillar of construction going forward.

In a sector like healthcare, where projects demand precision and accuracy, digital construction might just be the key to unlocking the future. n

The BEACH Building, part of the Royal Bournemouth Hospital estate, where Buildots technology is being used to provide project managers with detailed progress updates

Hints and tips for care home interior design

Care home residents can spend a significant portion of their time indoors and, as a result, the design of the interior spaces can have a huge impact on their wellbeing. Dawn Scott, senior colour designer at Dulux Trade, explores the factors that contribute to good interior design and improved occupant wellbeing, including colour choice and placement

There are over 16,000 care homes in the UK, and over 70% of all care home residents have dementia or severe memory problems.

As such, when it comes to designing care homes, it is crucial to ensure the correct colours and design choices are made to effectively meet the needs of each occupant.

However, this is especially true for those with dementia or severe memory problems.

INDEPENDENCE

In care homes, colour can be used to help residents retain independence. Those with dementia may have trouble with spatial awareness and judging distances, but using colour correctly can help.

It is important to ensure that surfaces are easy to identify by using contrasting colours.

For example, if a soft tone is used on the main walls, then more-saturated colours can be used on doors and door frames to make these elements stand out and signal where the entrance/exit to the room is. The same concept can be applied to the

end of a corridor or the top of a stairwell to inform people that they have reached the end of the pathway – and choosing contrasting colours for different zones or floors can also aid wayfinding.

Likewise, in dining spaces, a contrasting colour can be used behind the serving station to make it more visible.

Standout shades should also be used to highlight potential hazards like pillars and radiators.

However, if there are any areas where access should be discouraged, it is recommended to use consistent colours to make them less noticeable.

For example, painting a door the same shade as the surrounding wall will make it harder to see and prevent residents from using it.

THE RIGHT PRODUCT

As well as colour, it is important to think about the type of paint specified. Care homes are incredibly-busy environments and surfaces need to be able to withstand regular knocks and scuffs – so the paint needs to be durable and cleanable.

For example, Dulux Trade Diamond Matt can withstand 10,000 scrubs and it delivers resistance to water-based and oilbased stains, including coffee and food. This helps to stop stains from being absorbed into the surface and makes them easier to clean off.

Surfaces treated with these sorts of paints will therefore look newer and fresher for longer, which means that redecoration does not need to be carried out as often and disruption is kept to a minimum.

The paint finish is also key.

All surfaces should be painted with a flat and non-reflective paint as a glossy finish produces glare and light bounce, which can be confusing and disorientating for those with dementia.

In conclusion, when redecorating care homes, it is important to think about where colours are placed to help aid wayfinding and independence.

The type of paint selected is also crucial, to ensure the professional finish applied lasts the test of time, while enhancing the lives of care home residents. n

MISSED AN ISSUE?

Inside issue 02, March-April 2024

• The future of PFI — trusts told to act now before it’s too late

• NHS capital budgets must double to protect the estate

• Decommissioning medical gases helps to drive carbon efficiencies

• The evolution of healthcare fencing design

Inside issue 03, May-June 2024

• Milestone for £85m maternity hospital development in Belfast

• Spotlight on best practice for dementiainclusive design

• Framework agreements provide support for next-generation healthcare buildings

Work begins on psychiatric intensive care unit for children

This article explores the design approach to the delivery of a new paediatric mental health facility in Bournemouth

Construction work has begun on an eight-bed Child and Adolescent Mental Health Services (CAMHS) Psychiatric Intensive Care Unit (PICU) for Dorset HealthCare at its Alumhurst Road site in Bournemouth.

Designed by Medical Architecture alongside the NHS trust, and being built by Kier Construction, the new building will take advantage of its elevated woodland site to create a safe and therapeutic space for the recovery of a vulnerable patient group. There is currently a shortage of facilities in the south of England for children and young people with an acute mental health illness who cannot be safely cared for on a general adolescent unit.

And this proposed facility will enable staff to effectively treat patients who display highly-complex and challenging behaviours in a secure and dignified setting.

Suitable for patients between 12-18 years old, the building includes eight inpatient beds, day spaces, a two-classroom school

facility, treatment spaces, tribunal room, seclusion room, de-escalation room, and an extra-care suite.

A SECLUDED SETTING

The site for the new unit is close to an existing Grade II-listed hospital building and features attractive grounds that provide a secluded and therapeutic setting.

The building design has been influenced by the challenges and opportunities presented by the site’s constraints, as well as the very-specific requirements of the patient group.

Taking advantage of the steeply-sloping site and woodland setting, the new building is located on an existing plateau, elevating the patient accommodation so there is a direct connection to the surrounding tree canopies.

Staff accommodation is located at a lower-ground-floor level, with access to an external landscaped area and attractive views from their working environment.

SPECIALIST FACILITIES

Considering the complex needs of the patient group, the building has been designed to ensure the safety and wellbeing of patients and staff.

Clear zoning of accommodation enables patients to co-exist in harmony, with opportunities for separation to de-escalate tension.

And all patient accommodation and clinical space is located on a single level, linked by comfortably-wide circulation spaces, enabling an ease of movement between zones and clear sight lines for staff to manage risk.

A large central courtyard acts as a focal point to the patient accommodation, providing a secure and accessible outdoor area for activity.

Day spaces, including a television room, games room, and lounge, are arranged around the courtyard, offering a choice of engaging views to the surrounding woodland.

Characterised by generous amounts of glazing, they offer bright, vibrant environments with opportunities for passive observation.

Through a choreographed approach to placemaking, strategically-located rooflights highlight a series of special spaces within the building, including a snug seating area within the central corridor.

SAFE SANCTUARY

The ensuite bedrooms form an important safe sanctuary for the young patients and have been designed to provide a comfortable and private space with good daylight.

A large secure window, combined with the stepped nature of the landscape, provides a sense of being nestled among the treetops.

And a window seat provides a personal space that encourages calm contemplation, while looking out onto a biodiverse landscape.

The beds and wardrobes have been designed as bespoke built-in joinery, subtly integrating the requirements for safety and robustness, while providing

a display for personal items to create a familiar environment.

QUALITY AND VALUE

The new building is to be positioned at the rear of the existing hospital site at a lower elevation to the main access route and listed building. As a result, the roof forms a prominent visual feature which is key to the sensitive response to the building’s context.

The design also proposes a high-quality standing seam zinc roof finish and a buff brick base which complement the heritage buildings on the site, creating a simple and elegant form.

One of the early cohort of the New Hospital Programme (NHP), the scheme has helped to define future NHP projects in terms of forward-thinking buildability and room standardisation.

The new facilities will enable Dorset HealthCare to provide a high-quality service for young people closer to home and their support network, resulting in reduced waiting times for admissions, faster recovery, and reduced cost to the NHS. This will all be delivered in a healing

Set against a stunning backdrop, the unit will enhance the provision of care and provide a therapeutic environment for a vulnerable patient group

THE PROJECT TEAM

Client:

Dorset HealthCare University

NHS Foundation Trust

Architect:

Medical Architecture

Contractor:

Kier Construction

Services Engineer: Hoare Lea

Structure and Civil Engineer: Calcinotto

Landscape:

UBU Design

Project Management:

MMC Project Consulting

Quantity Surveying:

MMC Project Consulting

Planning Consultant: Savills

Principal Designer: Sweco

Fire Consultant:

Bureau Veritas

BREEAM Consultant:

RPS Group

Arboriculture Consultant: Hellis Solutions

environment which exploits the quality of its therapeutic setting.

Yvonne Ophaus, associate at Medical Architecture, said: “The unit’s distinctive requirements, coupled with the complex topography of the site, presented challenges that we successfully navigated through close collaboration with the client, the design team, and the contractor.

“Set against a stunning backdrop, the unit will enhance the provision of care, and provide a therapeutic environment for a vulnerable patient group.”

Matthew Bryant, chief executive at Dorset HealthCare, added: “This facility will represent a major step forward for children’s mental health services in Dorset.

“It will allow us to care for seriously-ill young people close to family and friends in purpose-built, modern accommodation, greatly reducing the need for out-of-area placements and improving their chances of recovery.

“We are very pleased with the design of the facility, developed in conjunction with our construction partner, Kier, alongside patients, staff and peer specialists.

“It has taken into account the constraints and sensitivities of the site, and we are confident it will provide a first-class environment which meets both the clinical and educational needs of our patients.” n

Two thirds of architects now calculate environmental impact

NBS’s Digital Construction Report reveals a major drive for green metrics

More architects are using digital tools to calculate the environmental impact of building projects than ever before, according to NBS, the UK’s leading specification platform.

Results from its latest Digital Construction Report, a study on the industry’s evolving relationship between digital technology, safety, and sustainability, found that two thirds of architects now use digital tools to calculate environmental-related metrics.

In particular, two in five (41%) use technology to assess the energy demands of a project before construction begins – an important step in measuring carbon emissions and meeting sustainability goals.

A similar figure (39%) also use digital methods to understand the

embodied carbon attached to a project and the components that go into it –that is the amount of CO2 emitted during construction.

Despite room for improvement, these figures show a clear push towards lower carbon outcomes.

FROM CRADLE TO GRAVE

Another important finding in report was around attitudes toward products and the wider construction lifecycle.

Over a quarter of architects (26%) now analyse the lifecycle of building products before including them within specifications.

This shows a growing effort to choose environmentally-friendly products that could potentially be recycled or reused. Growing concerns around the use of water are also increasingly important

for architects, with nearly a fifth (18%) turning to technology to predict project water demands.

OFFSITE ON THE UP

Continuing with the theme of sustainable construction, NBS also analysed levels of offsite construction, an area often associated with greener building practices, due to greater control of materials and waste.

And the results found that Modern Methods of Construction (MMC) continue to gather pace.

Over half of architects (57%) had been part of a construction project that had used or required offsite construction within the last year.

This is an increase of 13% since 2021 and comes despite the closure of several high-profile MMC factories.

Delving deeper, manufacturers are the group most likely to be involved with MMC – seven in 10 had worked with an offsite element, followed by nearly two-thirds of contractors (63%) and over half of consultants (58%).

This increase could reflect an industry drive towards net zero as well as recent government backing for further standardisation within MMC.

TAKING FULL RESPONSIBILITY

NBS’s report also highlighted increases in the number of professionals following naming conventions when sharing information (77%, up from 2021 figures) – an area that can improve the organisation and management of data.

Additionally, over half of respondents reported using interoperable formats like IFC, revealing the growing importance of easily-shareable construction data. However, the report also showed there are more opportunities to be unlocked by using digital technologies to help with compliance.

The study found that only a third of respondents (34%) were involved with detailed responsibility matrixes (DRM), a process that sets out responsibility for each element of

Worryingly, this figure has dropped since 2021 (39%).

And, notably, this figure hovered at around half for architects.

This comes despite increased levels of legislation attached to the Building Safety Act, such as the introduction of planning ‘gateways’ which requires a detailed breakdown of responsibilities on an individual level.

Additionally, less than a third of suppliers (28%) currently use a PIM system to manage product information, pointing to information gaps in the construction supply chain.

Nevertheless, well over half (56%) provide digital objects for the majority or all their products, a positive result.

Commenting on the survey’s results, David Bain, NBS’s research manager, said: “The uptick in professionals seeking environmental-related metrics shows an industry putting sustainability front and centre. The drive towards net zero has no doubt been a catalyst alongside the evolving legislative landscape – there’s never been a greater emphasis on the environmental impact of building practices.

“The study has also yielded unexpectedly-positive stats around offsite construction.

“Despite media headlines and high-profile factory closures giving the impression that MMC isn’t a popular choice, the results show a different story: more professionals are embracing offsite elements than ever before.

“Overall, we’ve seen some marked improvements that the industry should be proud of.

“There’s an opportunity here to improve digital information sharing, for which professionals have a legal requirement.

“The ‘golden thread’ and the use of structured data is creating a safer future for all.” n

The drive towards net zero has no doubt been a catalyst alongside the evolving legislative landscape – there’s never been a greater emphasis on the environmental

A clean bill of health!

We look at the ways technology – such as floor-cleaning robots –can help to keep healthcare facilities clean and hygienic

Clean healthcare facilities are critical to ensuring a safe and positive patient experience.

Cleaning and FM professionals consequently need to maintain ultraclean environments that reduce the risk of infection, with the added pressures of high footfall and urgent events taking place on a near-constant basis.

Here, Kristal Goodwin, national sales manager for Robert Scott’s cobotics division, looks at how cutting-edge cleaning robots could be the perfect partner for operatives working in these environments.

A GROWING TREND

The cleaning industry is undergoing a significant transformation with the advent of advanced robotics and intelligent management systems.

The proliferation of smart connected technologies, the rise of the Internet of Things, and advancements in AI have all facilitated the transition to automated systems.

Household-name brands have spurred adoption within the consumer sector, and now the commercial cleaning sector – especially in healthcare settings – is beginning to see similar momentum.

Google Trends data corroborates this shift, showing a decline in searches for ‘deep cleaning services’ throughout 2021 and 2022, while inquiries for ‘robot vacuum’ have surged by 120%.

These technological innovations offer clear advantages and are particularly beneficial in environments requiring stringent sanitation.

Healthcare facilities represent a prime setting where autonomous cleaning robots can enhance cleanliness and safety in areas frequented by both patients and staff.

INTEGRATING ROBOTS

Today, a variety of robotic cleaning solutions are available, each with its own benefits and limitations.

Among these, cobotics – where robots work collaboratively with human

workers – stands out as a particularlypromising approach.

In healthcare environments, cobots are invaluable for managing the cleaning of large areas such as corridors, waiting rooms, and operating theatres.

They achieve consistently-high cleaning standards and complement human labour by freeing staff to focus on critical tasks like sanitising high-touch surfaces and specialised medical equipment.

Rather than replace human labour, cobots instead act as a tool that helps cleaning operatives accomplish more in the time they have with great efficiency. This is particularly important in healthcare cleaning, where the human touch remains crucial.

Indeed, the National Standards of Healthcare Cleanliness 2021 report emphasises that cleaning staff are vital members of the healthcare team; and cleaning is one of the most-important tasks in keeping patients safe from infection.

Image: mspark0 from Pixabay

THE BENEFITS

Cobotic machines are expertly designed for optimal cleaning and boast user-friendly operation, ideal for maintaining large, open spaces that would otherwise require significant human labour.

For instance, autonomous floor scrubber driers can be equipped with various attachments for scrubbing, sweeping, polishing, and drying floors. This eliminates the risk of accidents from wet floors, a crucial aspect in healthcare settings, where slips, trips, and falls must be avoided.

It’s important also to select machines engineered with precision navigation that can clean close to edges and detect even small objects.

Advanced obstacle avoidance ensures the safety of patients and the facility from damage.

Machines with a zero-degree turn radius can manoeuvre into and clean tight spaces. Additionally, operatives are relieved from tasks like disposing of waste water and refilling freshwater during cleans, as machines that autonomously handle these processes offer the most benefit.

Furthermore, these machines can be programmed to perform cleaning

Household-name brands have spurred adoption within the consumer sector, and now the commercial cleaning sector – especially in healthcare settings – is beginning to see similar momentum

tasks during quieter hours, ensuring continuous floor care without disrupting medical operations.

Operators can also benefit from intelligent performance data capture and tracking features. They can optimise daily cleaning schedules based on comprehensive data, such as area coverage and operation times, and set benchmarks to evaluate their performance against established KPIs for continuous improvement.

Cobotic solutions generally use fewer cleaning products and less water than traditional floor cleaning methods, too.

And some require no water, using bacteriaremoving microfibre to clean floors, which reduces slip risks and cuts down on waste water.

Modern battery-charging cobots can be powered for as little as 35p per hour, with a battery life of up to 20 hours.

EASY TO IMPLEMENT

There can be a perception that automated systems can be complex to install and maintain, but this isn’t the case.

Cobotic machines with a user-friendly design ease the transition to advanced

Kristal Goodwin

Working with a supplier that has dedicated cobotic expertise should ensure a trouble-free onboarding process through comprehensive training, in-person installation of the equipment, and ongoing support

for troubleshooting and maintenance

cleaning technology and users typically find that with a brief training period, they can operate the machines with confidence and skill.

Working with a supplier that has dedicated cobotic expertise should ensure a trouble-free onboarding process through comprehensive training, in-person installation of the equipment, and ongoing support for troubleshooting and maintenance.

Once everything is set up, maintenance is usually a simple process too. With the systems we offer, for example, users are simply required to wipe and inspect attachments and flush out the hose on a regular basis.

Moreover, existing technology is advanced enough that major infrastructure changes should not be necessary to introduce cleaning robots.

BUILDING TRUST

Cobots can also bring some wider, often-underappreciated, benefits.

Recent data from Sodexo Health & Care/YouGov found that 50% of inpatients agreed that cleanliness impacts their hospital experience, ranking as the second-most-important factor after the friendliness of clinical staff.

And the presence of advanced cleaning technology can, therefore, act to build trust and confidence among patients, staff, and visitors.

The visible use of state-of-the-art cobotic solutions demonstrates a commitment to maintaining the highest hygiene standards.

For healthcare workers, meanwhile, knowing that their environment is maintained with reliable, efficient technology can alleviate some of the stress associated with infection prevention and control and environmental hygiene.

Cobotic cleaning systems offer an exciting future across various sectors. In healthcare settings, they provide significant benefits: from reducing disruption to patient care to enhancing the overall cleanliness and safety of the facility.

www.metabots.uk n

Estates and Facilities Management

Surplus land could generate income

More than 121,000 hectares of NHS land could be repurposed or sold off to generate capital to improve services, according to the latest figures from NHS England.

The most-recent NHS Surplus Land report, published this month and covering the period to March 2024, reveals there are 128 surplus land plots covering a total area of 121,86 hectares which are surplus to requirements. There is also 0.6 million sq m of internal floor area which is not fully utilised.

And 199 potentially-surplus land ‘opportunities’ were identified, covering a total land area of 309.12 hectares and a gross internal floor space of 685,000sq m.

In addition, 50 plots were identified as no longer being surplus, having previously been declared as such; and 53 plots had been sold or are in the process of being sold, covering 21.85 hectares and 41,000 sq m of internal floorspace.

£47.1m was declared as the total sales receipt for land sold and the estimated sales receipt for surplus or potentially-surplus land was £0.8bn.

The investment required to dispose of this land is estimated at £1.8bn.

NHS Surplus Land collection data has existed since 2008 and was originally designed to provide information to the Department of Health and Social Care (DHSC), Homes England, and the Office of Government Property (OGP) on sites that can be disposed of, thereby contributing to the Public Land for Housing Programme.

The collection currently monitors the contribution made by the NHS to the release of publicly-owned land to ensure the efficient and strategic use of the NHS estate.

It covers all ambulance trusts, care trusts, hospital trusts, mental health trusts, and NHS trusts and is reported quarterly.

In response to a Parliamentary question in June last year, the then Minister of State for the DHSC, Will Quince, said of NHS surplus land: “NHS organisations decide locally on the use of their land based on their requirements for facilities to support the efficient and effective delivery of their healthcare services.

“All surplus NHS property is expected to be sold as soon as possible to minimise ongoing running costs.

“Before any commercial sale takes place, details of NHS surplus land are circulated to public sector organisations, for them to express an interest in acquiring.

“Outline planning permission is often sought prior to sale to maximise the value of the site realised for reinvestment and achieve best value and this will include an assessment of local planning considerations and public and stakeholder engagement.”

And, also in June last year, the NHS Homes Alliance published a White Paper titled A People Driven Approach; Delivering NHS Homes, which set out a vision to use the NHS estate to build affordable, high-quality, and sustainable homes near hospitals and clinics for health and care workers.

EFM team drives improvements

The East London NHS Foundation Trust’s estates, facilities and capital development team was named Estates & Facilities Team of the Year at the annual Design in

The team – which is responsible for the management, maintenance, and strategic development of land, buildings, and facilities across east London and Bedfordshire –was commended for its commitment to collaboration with patients and clinical colleagues alike to address urgent estates and facilities concerns.

And the judges were impressed with the extent to which service users were involved in the day-to-day planning and decision making.

The team introduced an innovative Patient-Led Assessments of the Care Environment (PLACE) Programme with service user coproduction – providing them with comprehensive training to ensure transparent and thorough feedback, helping to drive improvements.

Environmental Assurance Groups (EAGs) have also been implemented across all inpatient units to provide service users with a platform to actively engage with the management of their care environment.

This is in addition to the appointment of service users via People Participation –a service at the trust which enables those with lived experiences to play an active role in improving quality by providing fresh, inside perspectives.

ELFT’s chief executive, Lorraine Sunduza OBE, said: “Our estates and facilities team has shown on numerous occasions that it prioritises service user-centred care and values the insights patients bring to the table.

“I would like to thank colleagues and service users for their dedication in ensuring we can continue to provide high-quality care across all of our services.”

Image, Michal Jarmoluk from Pixabay

From DIY lover to female plumber

National Healthcare Estates and Facilities Day was held on 19 June, throwing the spotlight on those members of staff who work so diligently behind the scenes to keep the estate ticking over. Here, we profile Christine Latham’s journey

Christine Latham changed career path at age 55, going from a healthcare domestic assistant to maintenance assistant at NHS Property Services (NHSPS).

A dedicated employee, her journey exemplifies the power of courage, passion, and that dreams can be sought after at any age.

“At a stage in life when many are contemplating retirement, Christine embarked on a new career path that not only fulfilled her lifelong passion for DIY, but also brought her professional satisfaction,” said a spokesman for NHSPS.

In 2022, after years as a domestic assistant, Latham attended a taster day for maintenance operatives.

“That single day changed my life,” she said.

“Before I could blink, I got an interview for the role of maintenance assistant.

“I didn’t hesitate; I was ready to go for it.”

With her inherent knack for DIY, honed by years of practice and a family tradition of making and fixing, Latham aced the interview and began her dream job in April 2023.

Now, encouraged by her line manager, she has decided to pursue an apprenticeship and is on track to become a fullyqualified plumber by the age of 59.

“I only wish I’d done it sooner,” she says.

“Imagine getting paid to do what you love? It has changed the way I look at everything. The sky’s the limit for me now!””

Imagine getting paid to do what you love? It has changed the way I look at everything. The sky’s the limit for me now!

Her story is not just about professional success; it’s about personal transformation.

“I adore everything about my job,” she said.

“Nothing gets the better of me.

“I love the variety of jobs and mucking in to deliver the best-possible customer service.

I enjoy a chat and a laugh with customers; I treat them the way I want to be treated; and I’ve always got a smile to brighten their day.”

National Estates and Facilities Day shines a spotlight on the unsung heroes of the healthcare system, and Latham’s story stands out as inspiration.

Her message to others contemplating a change is clear: “Just do it!

“You may discover a bigger passion than you ever imagined.”

Her story comes amid a national shortage of healthcare estates and facilities professionals.

The NHS Estates and Facilities Workforce Action Plan, released in 2022, revealed that there are currently more than 100,000 estates and facilities management (EFM) employees across the health service, representing a significant 8% of the NHS workforce.

However, with more than 300 distinct roles within NHS EFM, there are key areas where there are shortfalls, and sickness absence rates among EFM staff remain the second highest among NHS staff groups.

There are believed to be more than 4,000 vacancies within EFM roles, with the Healthcare Estates and Facilities Management Association (HEFMA) and the Institute of Healthcare Engineering & Estate Management (IHEEM) coming together to encourage new entrants and better training opportunities.

Estates and Facilities Management

Purchasing agreement supports NHS caterers

For the first time, NHS caterers will be able to use new environmental measures for farms as part of their procurement of food and drink.

The Soil Association Exchange is set to deliver the environmental measures for farms in public sector purchasing as part of the Crown Commercial Service’s (CCS) Buying Better Food and Drink framework agreement. This agreement will be available for all UK public sector organisations to use for purchasing food and drink through a single online access point.

As well as a shift to more-dynamic food procurement – which removes barriers to allow small producers to contribute to larger public sector orders – the updated service will also use Exchange’s holistic farm assessments for sustainability. Exchange measures the environmental impact of farm operations by assessing six key areas – soil, water, carbon, animal welfare, social impacts, and biodiversity.

and bird counts, alongside considering the food production and community benefits a farm provides.

“Exchange is already working with hundreds of farms who have helped to develop our wide-ranging sustainability metrics.

“These measurements consider the full picture and can help to show schools and hospitals all of the brilliant things that farmers are doing to support nature while producing good-quality food.”

The move seeks to deliver greater transparency and break down barriers for small and medium-sized enterprises (SME).

The AgileChain technology being used does this via smart automation, making fulfilment along short supply chains more efficient for producers, distributors, and wholesalers.

It does this by collecting data through onthe-ground farm surveys, satellite imagery, and other datasets on metrics like soil carbon

Soil Association Exchange chief executive, Joseph Gridley, said: “It is hugely important for our public institutions to serve food that supports sustainable British farm businesses, and we are excited to start delivering data that will help to make this easier.

Buying Better Food and Drink agreement from CCS will set new parameters for procurement, enabling more-informed sourcing decisions based on individual farm levels and the social, environmental, and economic impact of food and drink choices.

Public sector buyers can express interest in the agreement, which is due to launch later this year. And any farmer can get involved by obtaining a free-of-charge sustainability score from Soil Association Exchange.

Soil Association Exchange will help farmers unlock the financial benefits of regenerative land use and sustainable farming practices. Image, André Rathgeber from Pixabay

A person using the Soil Association Exchange framework

18 NHS trusts awarded energy efficiency funding

The recipients of more than half a million pounds of funding to decarbonise public buildings have been announced.

Phase 3c of the Public Sector Decarbonisation Scheme (PSDS), delivered for the Government’s Department for Energy Security and Net Zero by Salix Finance, sees 18 trusts awarded funding for projects to install low-carbon heating and other energy-saving measures.

Among the big NHS recipients in Phase 3c is Royal United Hospitals Bath NHS Foundation Trust, which has been awarded over £21m to decarbonise three buildings by installing new heat pumps alongside other measures including wall, loft and roof insulation, double glazing, and LED lighting.

The trust’s chief executive, Cara CharlesBarks, said: “We are beginning to make great strides to reduce our emissions through initiatives such as decommissioning our entire nitrous oxide manifold and a sustainable travel plan.

“This grant is therefore invaluable. It will enable us to make these essential changes in the coming years and will have a positive impact on the environment and the experience of being in hospital.

“We know that getting this right will be better for the health and wellbeing of the people we care for, the people we work with, and the people in our community.”

Over 1,000 projects have now received funding since 2020 to upgrade thousands of buildings through the Public Sector Decarbonisation Scheme.

NHS recipients in Phase 3c are:

• Berkshire Healthcare NHS Foundation Trust: £2,633,950

• Birmingham Community Healthcare

NHS Foundation Trust: £7,347,236

• Cambridge University Hospitals

NHS Foundation Trust: £7,329,715

• County Durham and Darlington

NHS Foundation Trust: £665,892

• East Midlands Ambulance Service

NHS Trust: £135,552

• East Sussex Healthcare NHS Trust: £1,247,446

• Gloucestershire Health and Care

NHS Foundation Trust: £1,121,880

• Imperial College Healthcare

NHS Trust: £41,825,807

• Liverpool University Hospitals

NHS Foundation Trust: £832,984

• Manchester University

NHS Foundation Trust: £18,974,330

• Medway NHS Foundation Trust: £25,886,516

• North Bristol NHS Trust: £7,293,707

• Royal United Hospitals Bath

NHS Foundation Trust: £21,639,542

Royal United Hospitals Bath NHS Foundation Trust received more than £21m in the latest funding round, which it will use to de-steam the estate

an estimated 24% annual reduction in carbon emissions over which the trust has direct control.

This equates to just over 3,400 tonnes of carbon dioxide – the equivalent of just under 1,000 return flights to Seoul, or more than 150,000 car journeys from Bath to London every year.

COMING SOON

Recently a new approach was confirmed for allocating funding for Phase 4.

• NHS Trust: £16,200,691

• South Tees Hospitals

NHS Foundation Trust: £28,431,899

• South Warwickshire

NHS Foundation Trust: £6,149,168

• South Western Ambulance Service

NHS Foundation Trust: £321,408

• University Hospitals Birmingham

At Bath, most of the vital funds will be used to de-steam the trust’s 52-acre estate, a process that will see the hospital’s ageing heating systems replaced with more-energy-efficient options such as heat pumps.

When the proposed improvements are completed, by 2026, they will result in

In response to feedback from the public sector, the ‘fastest-finger-first’ approach will be replaced with a more-targeted system that will prioritise projects where the mostdirect carbon emissions will be saved.

Phase 4 guidance and criteria will also place additional emphasis on the importance of considering heat networks within the range of low-carbon heating technology options.

The full guidance for Phase 4 will be published in summer.

Solar partnership drives energy efficiency

Centrica Business Solutions is set to complete a solar PV design and installation project at Poole Hospital in Dorset, alongside new energy partner, Aztec Solar Energy.

The installation is part of University Hospitals Dorset NHS Trust’s transition to net zero carbon and involves five interconnected roofs on one building being fitted with 470 PV panels, five SolarEdge inverters, and 261 optimisers.

Estimates show that it will generate 200,000 kWh a year to save 50 tonnes of CO2 annually.

Aztec Solar will connect, commission, and test the new solar PV system over two days after installing the panels, inverters, and other equipment.

Phil Bryant, head of public sector sales for Centrica Business Solutions, said: “Aztec Solar is an excellent addition to our energy partner programme and given its experience in the health sector and expertise in installing solar PV systems on commercial buildings, it was the ideal company to partner with for the delivery of the project at Poole Hospital.

“We’re seeing an uptick in demand from public sector and commercial organisations looking to take advantage of the space above their heads for solar schemes.

“This provides cost certainty and a source of green power, supporting long-term sustainability ambitions.”

on top of the Phillip Arnold blocks and the Dorset Cancer Centre.

Commenting on the project, Chris Cowling, commercial director at Aztec Solar, said: “Poole Hospital is one of many healthcare buildings

so we understand how important it is to work closely with Centrica Business Solutions to minimise the effects of our installation and the electrical shutdown on patient wellbeing and medical equipment.”

Previous recipients of PSDS funding have included Nottingham University Hospitals NHS Trust, which has built an energy centre and installed new heating and cooling systems

Leading the charge Environmental

Healthcare communications provider, Cymphony, is leading the way in the sector’s sustainability charge, having successfully reached net-zero carbon status.

Cymphony’s mission is to help healthcare providers improve day-to-day operations such as bookings and communications and it has placed sustainability alongside technology at the centre of operations.

Neil Davies, managing director, said: “Our purpose runs deeper than delivering the best communication solutions for our healthcare providers.

“We understand the impact we have on the environment and have made a number of conscious steps to minimise the damaging effects our organisation has on the planet.

“As of today, I’m unaware of any other industry player which has not only committed, but also achieved, this level of sustainability across its operations.

“Having partnered with Carbon Footprint Limited, everyone at Cymphony

understood our goal of minimising our carbon footprint.

“Essential processes such as independent assessments, surpassing targets for continual improvements, and operating via a remote model, kept us on track to net zero.

“And our focus isn’t just inwards; we have also focused overseas efforts on offsetting our carbon emissions and supporting targeted schemes.

“Partnering with clean water and cooking initiatives in Uganda and China are actively curbing local communities’ reliance on greenhouse gasemitting measures.

“Certain emissions we cannot help, but have to emit, and this is why we take part in these annual reviews to determine key areas where we can proactively offset emissions in other areas. Offsetting enough to counter the unavoidable contributed a valuable role to our net-zero commitment.”

The action comes as the NHS has set a net-zero target of 2040 for the emissions it can directly control.

Davies said: “It’s great to see UK healthcare, particularly the NHS, take action and set much-needed targets to ensure carbon emissions and the

knock-on effects they cause are omitted entirely.

“Cymphony is proud to lead the industry in achieving netzero status ahead of the curve.

“It brings better health and environmental benefits and sets the standard for the rest of the industry to show that net zero is a possibility worth achieving.

“Our clients can take solace in the fact that partnering to achieve a more-streamlined healthcare service has a minimal effect on our environment, for not just the present, but for future generations too.”

He adds: “Here at Cymphony, we want to continue setting the standard for the best communication solutions for our healthcare sector and it is imperative that our net-zero processes do not fall off.

“Ensuring that the steps and processes we have taken thus far to achieve net zero are upheld is crucial to reducing our effect on our environment.

“Furthermore, we want to continue leading the way for UK healthcare and demonstrate that net-zero status is justifiable and achievable.”

£16m wellbeing programme supports NHS staff

NHS Charities Together has launched a £16m Workforce Wellbeing Programme to support NHS staff across the UK.

The ambitious programme aims to improve NHS staff health and wellbeing, in turn making sure patients are provided with the care they need.

NHS Charities Together will commit an initial £6.0152m to support healthcare staff across the UK, with the fund being shared proportionately across the four nations, along with aspirations to fund a further £5m over the duration of the programme.

In England the independent charity’s contribution will be match funded by NHS England, which will contribute £5m as part of its Long Term Workforce Plan to support staff wellbeing.

The Workforce Wellbeing Programme will run for three years with initiatives co-designed and co-led by NHS staff.

MEETING NEEDS

Support will be tailored to the individual needs of the NHS organisations and their workforces, supplementing existing support provided to staff.

After a period of co design with NHS staff, NHS England, and others over the summer, the charity will invite NHS charities in partnership with their associated NHS trusts or health boards to apply for grants from the Autumn.

And the impact of projects will be monitored and evaluated so that learnings can be shared and scaled across the UK.

Ellie Orton OBE, chief executive of NHS Charities Together, said: “NHS staff work under immense pressure with unprecedented staff shortages and vacancies and the extra help we provide to support their wellbeing and

mental health is now more important than ever.

“There’s lot of work going on across trusts to support the wellbeing and mental health of NHS staff, but more needs to be done and we are delighted that NHS England has matched our £5m investment in support across England, and we are also putting proportionate investment across the devolved nations.

“We have ambitions for this programme to grow so that we can make sure we continue to deliver this important and muchneeded support for as long as it’s needed.”

PROMOTING WELLBEING

One example of where previous rounds of funding are having a lasting impact on staff wellbeing is expanding and renovating the faith facilities at Royal Bolton Hospital in recognition of the role spiritual

wellbeing plays in staff experience and satisfaction. Another is the Oasis Health and Wellbeing Centre and Garden in Berkshire – a central wellbeing hub for NHS staff. Jointly funded by the Royal Berks Charity and the Royal Berkshire NHS Foundation Trust, and supported by a grant from NHS Charities Together, it offers

a range of activities and services aimed at promoting staff health and wellbeing.

And the trust has seen a 40% increase in positive responses to staff surveys regarding support for health and wellbeing since the campus opened, with the trust now proudly one of the top-performing acute NHS organisations in the area.

New faith facilities have opened at Royal Bolton Hospital

The Oasis Health and Wellbeing Centre and Garden in Berkshire

Christie & Co appoints head of healthcare

Specialist business property adviser, Christie & Co, has appointed Hannah Haines as its new head of healthcare consultancy.

Haines joined Christie & Co as an analyst in the company’s consultancy team in 2015 and was promoted to director in 2021.

Her new position will see her further develop Christie & Co’s healthcare consultancy services, working in collaboration with the existing team members and sector colleagues across the business.

She takes over from Mike Hodges who

consultancy function in 2013 and was recently appointed managing director of the company’s capital markets division.

Haines said: “I am excited for this opportunity to further develop our consultancy services across our healthcare sectors in the UK and Europe.

“Having worked side by side with Mike and other colleagues for the past nine years, I look forward to continuing on our path of success in leveraging our data, analytics capabilities, and experience to provide the

New leader of BDP’s Bristol studio

Architecture director, Akshay Khera, has been appointed as head of the Bristol studio of global design practice, BDP. With more than a decade of experience designing buildings and spaces in Bristol, the South West, and Wales, his appointment supports the continued growth of BDP in the region as a socially-progressive practice with an embedded multidisciplinary approach across healthcare, housing, education, and workplace sectors.

He said: “The opportunity for growth in the region in all sectors remains strong and as a multidisciplinary consultancy we are perfectly placed to help our local clients understand their investment and property portfolio strategies.”

BDP is currently working on a number of projects across the South West including a series of healthcare projects such as the new elective care centre at Southmead Hospital.

DUDLEYS EXPANDS NORTH WEST DIVISION

Structural and civil engineering consultancy, Dudleys, has announced two new senior appointments at its North West office following a relocation to Manchester city centre.

The award-winning practice recently moved from Prestwich to new offices at 76 King Street in Manchester to facilitate expansion.

And the move has helped to attract highly-respected and well-known individuals within the industry in the form of Chris Brady as technical director, and Adil Yasin as structural engineer.

Brady brings more than 30 years of development planning and civil engineering industry experience, while Yasin has 19 years of structural engineering experience.

Andy Walker, managing director at Dudleys, said:

“Relocating to a super prime location in Manchester city centre not only helps us to attract the best talent, but also places us in the heart of the commercial property business community and we are very excited for what the future holds.”

Law firm expands healthcare team

International law firm, DAC Beachcroft, has promoted three colleagues to the position of partner in its market-leading health and social care team.

The new partners are Jemma Gillson (mental health regulation), Stuart Keyden (clinical risk), and Alison Martin (infrastructure and projects).

DACB’s annual round of promotions also sees AnneMarie Gregory (public law and corporate governance) promoted to legal director, while Yasmin Allan, Claire Anderson, Emily Broad, Nikki Green, Helen Jones, Kirstyn MacFarlane, Bridie Mahoney, Holli Prescott, Susanna Read, and Nico Tilche become senior associates.

The promotions – which take effect on 1 May – mark

a continuation of DACB’s investment in the firm’s health and social care business to meet its clients’ needs, and follow the recent appointments of healthcare regulatory expert, Susan Trigg, and health property specialists Victoria Armstrong and Lisa Geary as partners.

Country chief executive appointed at Bureau Veritas

Hamza Drabu, partner and head of health at DACB, said: “DACB remains the platform for the most-talented health and social care lawyers to fulfil their potential, with our continuous growth across the sector and the provision of the right support network creating opportunities for them to develop professionally and realise their ambitions.

“The 14 promoted colleagues will not only add further strength and depth to our

Bureau Veritas, a global leader in testing, inspection, and certification, has appointed Antoine Giros as country chief executive for its operations in the UK and Ireland.

able to deliver the bespoke solutions and exceptional service our health sector clients deserve.”

CONSTRUCTION BOSS JOINS ROYAL BAM GROUP

Royal BAM Group has announced the appointment of Kim Sides as the new executive director of construction for its UK and Ireland division.

Sides will sit on the BAM UK and Ireland divisional leadership team and report to chief operating officer, John Wilkinson. With over 25 years experience in global property development and infrastructure, Sides has held leadership roles across operations, stakeholder management, construction, finance, and legal for some of the world’s biggest developers, including Laing O’Rourke and Lendlease.

During this time she has helped deliver some iconic projects including the

‘Barangaroo’ project in Sydney, and then worked in a commercial capacity on the Malaysian development The Exchange, TRX in Kuala Lumpur. And, most recently, she was the chief strategy officer and general counsel at Mura Technology.

Commenting on the appointment, Wilkinson said: “I am delighted Kim has agreed to jointhe UK and Ireland team.

“She is a proven leader who puts a focus on bringing diverse and complex teams together, providing healthy support and challenge and getting positive results.

“She also brings a commercial and contractual edge, a deep understanding of risk and is someone who delivers.”

Speaking about her appointment, Sides adds: “I am excited to be joining BAM and I look forward to getting to work with the BAM Construction team so we can build on its heritage and acknowledged expertise in delivering sustainable, quality projects for its clients and communities.

He supersedes Ken Smith, who moves into the role of vice president of sustainability and safety for the South & West Europe Operating Group.

In this new role, Giros will focus on elevating the overall financial performance by leading the definition and implementation of Bureau Veritas’ strategic plan, LEAP2028

This is designed to propel the business forward by scaling and expanding the core operations, diversifying the service portfolio, and capitalising on emerging growth opportunities.

Laurent Louail, executive vice president at Bureau Veritas, said: “I am delighted to welcome Antoine Giros to the south and west Europe leadership team.

“With his technical expertise, indepth knowledge of Bureau Veritas, and business acumen, he will drive and lead our future ambitions in UK and Ireland.”

Giros added: “In a fastchanging world that is urging organisations to adapt their models, I firmly believe that Bureau Veritas has a critical role to play.

“Building on the diversity of our portfolio and our solid foundations of the UK will benefit all our clients in their transformation journey as to all our stakeholders.”

Jemma Gillson

Stuart Keyden

Alison Martin