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Rapid Covid-19 response sees healthcare facilities transformed

19 April 2021

‘Can do’ attitude sees large-scale improvements delivered to NHS facilities in record time, led by Ed Macfarlane in his former role as director of property.

The last 12 months have proved to be remarkable in many ways as FMs and their service provider partners have shown the true value of their wide-ranging skills and working responsibilities in assisting facilities to adapt to the measures required to meet the requirements within Coronavirus compliance.

One of the highly positive examples that have emerged is that of the efforts of those serving the Buckinghamshire Healthcare NHS Trust earlier this year.

These were led by its then director of property services Ed Macfarlane, who has since progressed further in his career as interim divisional director for women’s health, maternity, children, young people and sexual health for the trust.

The efforts of his team were highlighted by a recent interview with the Worshipful Company of Pattenmakers, of which Mr Macfarlane is a fellow, including the rapid transformation of a car park into a new entrance and triage facility for the accident and emergency (A&E) centre of one of its main hospitals in just 96 hours.

This provided a highly relevant end note to the many achievements celebrated by the trust’s property services department under the stewardship of Mr Macfarlane since 2017.

“After leaving the armed services I’m now on my third career and really wanted to work somewhere that I felt I could make a difference and working for the NHS provides me with the opportunity for this,” he says.

“It feels like we’re helping someone every day, from hospital patients to colleagues, partners and others.

“It’s also very encouraging to be involved with organisations such as the Pattenmakers and seeing the level of support for armed service veterans. This is another aspect that’s being encouraged within our trust and it’s very rewarding to see the results of these efforts.”

He provides the example of a 90-year-old dementia patient who attended one of the trust’s hospitals and was found to be an armed services veteran. He was then visited by a member of staff who is also a veteran, resulting in a warm conversation and the sharing of memories that provided the patient with reassurance and comfort at a difficult time.

Project delivery

There have been numerous comments describing Covid-19 as an accelerator and this can be seen within the various projects delivered by Mr Macfarlane and his team this year.

“It’s served to cut through a lot of the red tape and shorten committee discussions and we’ve delivered projects in much shorter time scales than would previously have been the case to deliver improvements and keep everyone as safe as possible,” he says.

In addition to the building of a new A&E entrance on the site of a former car park in 96 hours – hugely impressive in itself – the Buckinghamshire Healthcare NHS Trust has also benefited from a new gas pipeline installed in just two weeks and increasing oxygen supply by 200l/sec, an upgraded power supply project brought forward and delivered by SSE engineers, the design and building of temporary wards completed within eight weeks in total and a three-stage lockdown plan implemented across three hospitals.

These and other projects completed this year could easily provide standalone case studies on an individual basis.

While the above are superb examples of the highly professional response to the pandemic, it should also be recognised that they were completed alongside the various creation and installation of wide ranging initiatives such as the implementation of one-way travel, improved processing of patients and a long list of safety measures established to keep staff and patients as safe as possible.

Mr Macfarlane provides yet another example of the design and build of an assessment pod that was completed in six weeks, which saw the initial design chalked out on former car parking space.

“This allowed NHS staff to test how it would work to make sure everything was in the right place. It was built in six weeks and is now one of the best ambulance response units in the country.

“This was a great defining moment in proving how the quick response to Covid-19 was completed, not only in our trust but across the country, often with the benefit of military training.

"While the situation itself was very difficult to deal with for many people for obvious reasons, I actually enjoyed the challenge and it was very satisfying to see these projects completed so effectively,” he says.

Perhaps unsurprisingly, there have been other major successes within Mr Macfarlane’s tenure that will continue to deliver benefits to the trust in the future.

One of the best examples of these is improving the trust’s use of its space, which is measured by the weighted average unit (WAU) metric.

At the start of his property director role in 2017, Mr Macfarlane states that the WAU rating for the trust was £770 per sq m and regarded as too high.

“One of the issues was the storing of records, which takes up a lot of space, but we solved this by purchasing a local warehouse that allowed us to store everything in a central location, and the costs were covered by renting out one of our car parks,” he explains.

“Not only is this more accessible and efficient, but it’s allowed us to use a lot of space within the estate far more effectively, with the initial investment of £750,000 saving £4m so far. Within two years our WAU rating fell to £610 per sq m and further improvements will see the rating fall to £550 per sq m, which is when we’ll be at the ‘green’ level where our space is used in a highly efficient way.”

Improved use of space can also be seen to be having beneficial financial effect, Mr Macfarlane continues. With the 1.9m sq ft estate including a large number of ageing facilities, there is a £100m backlog of maintenance work.

“The changes we’ve made has also allowed the trust to generate more income. One of the benefits of this is that we can look to invest in the estate and reduce the maintenance backlog and aligning all these with further improvements has further improved our CQC rating,” he says.

Profound experience

While these examples serve as a brief outline of the many positive developments achieved by Mr Macfarlane, his team and their service delivery partners, the need to for personal support can also be seen as an important area of consideration. He provides the example of the HorseHeard charity and the “profoundly moving” experiences resulting from this.

“I’ve attended a few days with teams of colleagues and veterans, where everyone is encouraged to bond with a horse. One former veteran was terrified of horses and also suffered from PTSD, but was persuaded to come along.

“As they approached, the horse just leaned toward them and you could see them both instantly relax.

"The benefits are massive and we’re looking to repeat this with some NHS colleagues, many of whom operate in stressful conditions and I’m sure they’ll benefit greatly. We even brought a horse into one of the children’s wards with some wonderful results,” says Mr Macfarlane.

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