For healthcare facility teams, the challenge is increasingly universal: maintain ageing buildings, reduce operational risk, improve energy performance and support changing models of care, all while working within limited budgets and live clinical environments where disruption must be kept to a minimum.
The UK’s National Health Service (NHS) recently reported a maintenance backlog of £15.9bn (approx. CAD$31.8bn) – a cost larger than running the whole NHS estate for a year. To illustrate the scale, the total floor space of trust and primary care trust buildings is estimated at 28.4 million square metres, or about the size of 9 of New York’s Central Park. To help FMs identify where best to channel their limited budgets and resources to make the most difference, NHS Property Services (NHSPS) has released guidance with valuable advice that could apply to all healthcare providers. Data and evidence-based decisions are recurring themes throughout the report, with facility managers urged to ‘challenge assumptions with evidence’.
Maintain according to need and strategic value
To help categorize and identify how to manage large spaces and portfolios, the core, flex and tail approach is recommended. Rather than treat all spaces the same, FMs should identify which are a strategic priority and which are a drain on budget.
- Core spaces have a long-term role in supporting future care delivery and a proactive, lifecycle approach should be taken to optimize their performance.
- Those categorized as flex are acceptable but will require future change, so maintenance should be targeted at safety and operational continuity with a plan or upgrade or reconfiguration.
- Tail buildings are not aligned with future strategy and should just be maintained for compliance and safety, with clear transition / disposal plans.
Prioritization should also extend to how spaces are used day to day. Not all spaces are used the same way and FMs should challenge static service schedules to make sure they align with requirements.
One NHSPS study found rooms formally booked for more than 80% of the week were actually occupied less than 20% of the time. Elsewhere, space reported as fully utilized was operating at only 7% occupancy. To understand how large spaces are actually being used and how to deploy resources to the highest priority areas, simple occupancy sensors are invaluable and can recoup ROI through more efficient schedules.
Replace periodic snapshots with continuous insight
Many maintenance and compliance activities still rely on periodic inspections. Engineers visit sites, take readings and return later to repeat the process. The report recommends modernizing this approach to work smarter and not harder and employ condition-monitoring technology to provide continuous visibility without the need for manual checks. Sensors provide near real-time visibility of asset performance, enabling issues to be identified within hours rather than days or weeks and resolved before failures occur. Combined with utilization data, this strategy can release FM team capacity and avoid unnecessary servicing.
Live data should be combined with forward planning through a strong asset management focus, using condition, maintenance and lifecycle data to plan asset replacement before failure. This creates time to consider a more efficient and sustainable alternative, rather than making an emergency like-for-like purchase, while also allowing work to be budgeted and scheduled to minimize disruption.
This is particularly important for heating, cooling and ventilation systems, which is a high impact starting point for any hospital to reduce operational emissions.
Connect data to reveal the complete operational picture
Healthcare organizations do not necessarily lack FM data, but it is often fragmented across CMMS software, asset registers, condition surveys, building management systems, energy platforms and other sources. Each provides only part of the operational picture.
Maintenance records might reveal that an asset is failing repeatedly, for example, but combining this with BMS, energy and utilization data could help establish why. It may be operating inefficiently, following an outdated control strategy or working harder than necessary for the way the space is now used.
The report therefore recommends mapping key data, understanding where it is held and how it connects, and establishing clear ownership. It also highlights the potential for AI to analyse larger volumes of information, identify patterns and emerging problems, and automate repetitive tasks that take up valuable staff time.
This reflects the approach behind SWG’s Geminus platform, which connects information from existing systems and providers, including CMMS, BIM, BMS and IoT data. Bringing these sources together gives estate teams a clearer view of building performance, while AI helps them interrogate the information and uncover insights more quickly.
Technology cannot compensate for missing or poorly managed information, however. Organizations must still understand what data they need, which decisions it will support and who is responsible for maintaining its quality.
Start with a problem, prove the value and scale
Transforming a large and complex site does not require every system, asset and dataset to be addressed at once. NHSPS recommends a pragmatic “pilot, prove, scale” approach: test technology against a defined operational problem, demonstrate the benefit and then expand with confidence.
This outcome-led approach helps avoid technology being introduced for its own sake. It also provides the evidence needed to build confidence, secure internal support and make a stronger case for further investment.
Better data cannot eliminate the NHS’s problems. What it can do is help FM teams understand risk, question inherited practices and direct every available pound and working hour towards the buildings and assets that matter most.
The objective is not simply to collect more site data. It is to turn that data into evidence – and use the evidence to maintain the right assets, in the right way, at the right time.
