NHS asset management: when is it time to throw in the towel?

Estates teams face a quandary with NHS assets. Manage them well and you’ll release a much-needed windfall, squander them and you’ll always be short of funds to invest in areas that really make a difference. Now it’s been recognised that “an attractive and well-maintained environment makes an important contribution to the well-being of patients” you might finally have the budget to improve patient-facing areas. 

It’s a dilemma that’s familiar to any car owner who’s faced increasing repair costs: when’s the right time to stop throwing good money after bad and invest in a new set of wheels? Get the timing right and you’ll dodge an expensive repair bill for a replacement gearbox. Get it wrong and you’ll be laying out for a new car prematurely when you could have had another thousand miles of trouble-free motoring. 

To clarify, I’m not just talking about medical equipment here. By ‘assets’ I’m referring to chairs, tables, doors, windows and the very building fabric. Being in control of every aspect of an asset’s lifecycle from predictive planning and maintenance, to delivery and installation, compliance, maintenance and replacement, removal and disposal, NHS facilities managers have a huge opportunity to make considerable cost-savings. 

Instant inaccuracies 

There is a problem with this utopian vision of assets though: typically, an asset survey is a large, expensive undertaking that a trust will outsource every few years. But before the proverbial ink has even dried on this, it will be out of date. 

The solution is to integrate asset management into your existing works management platform, or invest in one if you haven’t already. This allows staff to constantly collect data on your assets as they go about their day, making your asset list responsive and always correct. Having all your data in one place empowers you to start thinking about assets differently, and it will certainly save you money on those redundant surveys.  

Sweat your assets 

Utilisation is key to understanding the value of your assets. If your trust has invested several million pounds in an MRI scanner, it makes sense for it to run 24-hours a day, if feasible, to get the maximum return on your investment. 

“If you don’t understand the utilisation of your assets, you’ll never be able to understand the value – only the cost” 

At the other end of the scale, if you have fifty chairs in the hospital waiting room, only twenty of which are used at any one time, you’re wasting 30 assets. It’s a simple example but it illustrates my point: if you don’t understand your asset utilisation, you’ll never be able to understand their value – only the cost.

This matters because it’s only when you understand the value of each asset that you’re able to identify the sweet spot where the maintenance burden of an asset outweighs the cost of replacing it.  

The skill is in recognising when you’ve reached that point. Fortunately, even without a crystal ball, it’s possible to accurately predict this. All you need is the right data.  

Game-changing 

When you have real-time information on your trust’s assets, it’s a game-changer. You can make informed purchase decisions because you know not just the purchase price of an item but the true lifecycle cost – often known as the total cost of ownership (TCO) - once maintenance, repair costs and lifespan are factored in. 

Here’s a hypothetical example. Say you need to replace a piece of equipment and ‘Model A’ costs £3,000 while ‘Model B’ costs £5,000. On the surface, it looks like a no-brainer to buy the cheaper option.  

But if your data shows they break down more frequently and have higher maintenance costs, it’s clearly more cost-effective to opt for the pricier units that require minimal maintenance and have a 25% longer lifespan. When you take all the data into account, the more expensive machines actually represent better value. But without the data, only a fool would sign off the more expensive model. 

Having the ability to predict when equipment is likely to fail also enables you to take advantage of potential volume discounts, gives you a firm baseline for improvement and allows inter-trust comparisons to be drawn on asset performance. 

But the biggest saving comes from not having to replace a faulty piece of equipment at all. If a chair breaks in the aforementioned under-used waiting room, then there’s no need to replace it, plus you can move the remaining chairs to where they are needed. But a trust would not even be aware that it has spare capacity without having good utilisation data. 

Quick win 

Judging when the time is right to upgrade a piece of equipment, replace it or make-do and mend requires planned maintenance assessments. If the thought of the extra work involved makes you groan, an easy way to alleviate the overhead of these visits is to combine them with your regular compliance checks, and have an intelligent platform maintaining the data. 

An inspection gives you the opportunity to evaluate both the hard and soft data. The factual KPIs such as the number of run hours and whether it has broken down in the period, alongside observational data (Does it sound like it’s running smoothly or as if it’s going to grind to a halt as soon as you leave?) 

Every asset or asset class should be assigned an owner. Research shows that when a named individual is given personal responsibility for an asset, they look after it better. Timely data is critical to the efficient management of estate assets. Furthermore, it should be presented in a format that can be easily understood by non-technical staff to help them make the right decisions. 

However good the intentions, a dusty spreadsheet can never be truly current. The only way to build and maintain an asset register that’s accurate in real-time is with the help of an automated solution such as mpro5 that updates continuously during the estate’s day-to-day operations.  

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