PFI and PF2

This briefing from the National Audit Office looks at the rationale, costs and benefits of the Private Finance Initiative; the use of and impact of PFI, and ability to make savings from operational contracts; and the introduction of PF2.

Capital planning and property in the NHS: lost opportunities

This long read from Nigel Edwards, and published by the Nuffield Trust, explores why investment in and reform of NHS property requires more expertise within the NHS. It is the first in a series of pieces about the NHS estate, running alongside our Restate programme of work over the coming months.

The innovative use of assets and flexible infrastructure in the world of STPs

The paper from the Good Governance Institute examines, in particular, the innovative use of assets and flexible infrastructure, and how these can accelerate the implementation of plans within a context of limited capital.

Charging policy 2017-18 / Vacant Space Handback

NHS Property Services’ (NHSPS), in conjunction with NHS England and the Department of Health, has published a refreshed charging policy for 2017-18.

Commissioners can hand back vacant space under a new scheme run by NHS Property Services (NHSPS).

Capital collaborations between the NHS and local authorities

CIPFA and the HFMA have worked together to produce this briefing as an initial output from a joint workshop on capital funding in the NHS.

The briefing provides background on the local authority and NHS funding mechanisms, including the prudential code under which local authority treasury management and borrowing is determined. It sets out the problems that NHS bodies currently face in relation to capital funding and identifies some opportunities for working together on capital projects.

Microbiological problems and biofilms associated with Mycobacterium chimaera in heater-cooler units used for cardiopulmonary bypass

J Hosp Infect. 2017 Apr 26. pii: S0195-6701(17)30228-1. doi: 10.1016/j.jhin.2017.04.014. [Epub ahead of print]

The role of heater-cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognized since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of micro-organisms, including M. chimaera and complex biofilms. Whole genome sequencing of M. chimaera isolates recovered from one manufacturer's HCUs, worldwide, has demonstrated a high level of genetic similarity, for which the most plausible hypothesis is a point source contamination of the devices. Dissemination of bioaerosols through breaches in the HCU water tanks is the most likely route of transmission and airborne bacteria have been shown to have reached the surgical field even with the use of ultraclean theatre ventilation. Controlling the microbiological quality of the water circulating in HCUs and reducing biofilm formation has been a major challenge for many hospitals. However, enhanced decontamination strategies have been recommended by manufacturers, and, although they are not always effective in eradicating M. chimaera from HCUs, UK hospitals have not reported any new cases of M. chimaera infection since implementing these mitigation strategies. Water safety groups in hospitals should be aware that water in medical devices such as HCUs may act as a vector in the transmission of potentially fatal water-borne infections.

UHCW Research: L. Dawkin

NHS estates. Review of the evidence

The government considers the NHS estates to have a key role in delivering efficiency, and in supporting the transformation of services set out in the NHS five year forward view. To enable the estates to fulfil this role, the government is intending to develop a long-term strategy for their use. As a first step, it has commissioned Sir Robert Naylor to undertake an independent review of NHS estates and property.

NHS Property and Estates: Why the estate matters for patients

Sir Robert Naylor was commissioned to carry out an independent review of NHS property and estates and how to make the best use of the NHS estate. It highlights the opportunities available to support sustainability and transformation plans and optimise the use of NHS land and buildings.

Electrical services supply and distribution (HTM 06-01)

Guidance from the Department of Health on the design, installation and testing of all fixed wiring and integral electrical equipment used for electrical services.

NHS property and estates: Naylor review

The report examines how the NHS can make the best use of its estate to support NHS England’s Five Year Forward View.

It highlights the opportunities available to support sustainability and transformation plans (STPs) and optimise the use of NHS land and buildings.

The government is already acting on some of the recommendations by:

• creating a new NHS property body
• making a £325 million capital investment over the next 3 years to develop local STPs - as announced in this year’s Budget
• developing an incentive scheme to guarantee that proceeds of sales are available for reinvestment

The government will consider a further multi-year capital programme in the autumn.
The government welcomes the review and will consider the recommendations carefully and respond in due course.

New figures reveal running cost of NHS estate

NHS Digital has released figures detailing the costs of building, maintaining and servicing parts of the NHS estate - from how much is spent on feeding patients, to how many car parking spaces hospitals have.