13 May - non-executive directors - in conversation about NHS estates with Oliver Judge

This week’s session opened with a conversation about NHS Estates with Oliver Judge, NED and senior independent director at Cambridgeshire Community Services (CCS) NHS Trust, who also works on health estates strategy at Surrey Heartlands ICS.

Oliver said: “Everything should come back to a simple way of working. When we talk about property it gets very complex and that complexity stymies innovation. It should be about outcomes, what people’s needs are and how we can meet those needs at a community level but also as systems coming together.

“Looking at children’s mental health services, for example, we need to be thinking beyond the NHS estate into the wider public sector estate – from schools and youth clubs to voluntary services organisations. All of these parts contribute to the wider determinants of health and most of them have their own buildings. By looking at what we have already in the system we can look at how we can deliver services – by sharing buildings and by providing care at home as well.

“A lot of schools are struggling with mental health and with understanding how to take things forward. I’ve spoken to mental health services and they say some schools have vacant space. We could locate some services within schools. That way those services would be located at the same place that the children go to already. There’s no need for them to go to another scary building somewhere that’s specifically about mental health – it’s taking the service to them. The same applies to youth centres.

“We’ve really got to build into our thinking the way services will be accessed in the future. We’ve got smart watches that will monitor what we’re doing. Things like triaging could be done using AI technology. When we look at buildings and what we need, we might be investing in them for 20, 30 or 40 years from now. We need to make sure we’re investing in the right places with the right buildings with flexibility for things that we don’t really fully understand yet.

“We’re talking a lot at the moment about how we get the governance in place and how we make sure we’re doing the right thing. What’s the right thing to do? How do we think this could work? And then what are the barriers? We know that the culture at the moment is more ‘we know in the NHS that this is how it works and it won’t happen any other way’. We’ve got to move people through to help drive and support and give permission for people to be really innovative but also find out what key policy changes are needed to make it happen.

Also overheard:

“We need to ensure that there are adequate facilities for those without technology devices or unable to use them – i.e. more deprived communities with greater health needs.”

“My concern is that there are quite a few people in the community in deprived and rural areas who don’t have access to the technology or to bandwidth – this is not just a problem for health but also for education, where there are large numbers of pupils who couldn’t get access to online teaching, who are also more likely to be those in receipt of free school meals. It’s great to encourage technology but we still need some facilities – and they need to be local and small, and co-locating seems like a good idea.”

“Patients’ perspectives need to be at the core of this and communities and how they work must also be at the core of it. Neighbourhoods are key – that’s where we’ve got to engage.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk