Resolving estates challenges in the acute sector

Shared Agenda Associate Director, Nikola Idle, examines some of the challenges facing the acute sector in our latest ‘Shared Insights’ piece…

In January 2023:
• 94% of all hospital beds in England were occupied (up from 87% in 2 years ago)
• 1.9 million people attended A&E, with 28% or 480,000 waiting more than 4 hours for admission, transfer or discharge
• 7 million people were waiting to start treatment for consultant led elective care, and their median average wait time was 14 weeks

The challenges facing our hospitals are well publicised, and against this backdrop acute trusts are having to look ever closer at how they utilise their facilities and make each space work even harder to meet increased demand for services.

Shared Agenda is working with a number of Trusts locally and nationally to undertake a strategic assessment of their estate and suggest changes that could be made to enhance efficiency and deliver additional capacity.

The scope of each review varies according to the specific challenges faced by each Trust, whether that be addressing existing condition issues to unlock capacity, improving operational adjacencies, scoping new development, and/or supporting future service change and transformation including aligning with wider initiatives such as Out of Hospital programmes.

We typically adopt a three-stage process, engaging with relevant stakeholders at each stage, that encompasses:
• Understanding the baseline position – mapping the existing use of the estate and gathering stakeholder views on how well this works
• Defining the future vision – planned or potential service changes, future demand projections, use of digital and remote ways of working
• Identifying how the vision could be achieved – relocation of services on and off site, re-configuration of the existing estate or new developments, enabling alternative ways of working

We can also engage our wider network of health planners, architects, cost and technical advisors to offer a holistic approach to estate planning – diving deeper into the information usually provided in a 6 facet survey, and producing a detailed delivery plan to address current and future challenges.

Our experienced team of Better Business Case Registered Practitioners will also ensure our work aligns with the principles and processes laid out in the HM Treasury Green Book, so that the output can be utilised to support future capital funding bids.

If you’d like to know more please contact Nikola Idle –