The NHS approach to the digital management of its estates

by John Millar | April 2, 2021 |  5 min read

The NHS approach to the digital management of its estates
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The National Health Service (NHS) is one of the UK’s most cherished institutions. It has been described in the past as both “the UK’s greatest achievement” and “the envy of the world” and has been affectionately voted as the ‘Pride of Britain’ on multiple occasions.

In 2017, almost 600,000 Hospital and Community Healthcare Services (HCHS) staff treated almost 245,000,000 patients in England alone (NHS Confederation, 2017), making it no surprise that it is recognised as one of the most impressive healthcare systems operating in the world today.

At the heart of the NHS are the estates that it operates – its built assets are the very life-blood of its operations. Although the primary focus of the healthcare provider is (as it should be) on the quality of the services it provides, the NHS also recognises the critical importance of its buildings, fully aware that these serve as the venue for the delivery of the healthcare service that it provides (Støre-Valen and Lohne, 2016; Thomson et al., 2019).

The NHS also recognises the importance of innovative socio-technical interventions in satisfying the growing demand for more effective healthcare estate management nationwide (Hamilton et al, 2008) and, as a result, the NHS has consistently been quick to embrace new, digitalised methods of managing these facilities.

For instance, in 2014 (three years prior to Scotland’s national BIM mandate), NHS Scotland led the way for BIM implementation in the healthcare sector with the deployment of an original Level 2 BIM strategy, which included a suite of bespoke Level 2 documents and templates, as well as a comprehensive BIM training programme and a series of region-specific workshops to harmonise its roll-out across each of NHS Scotland’s 14 regional boards (Knutt, 2015). This strategy focused on BIM implementation in the capital delivery of all new projects with a value of over £2m.

Only a few years later, work began on developing this strategy further, aspiring towards a digital estates approach to asset/estates management underpinned by ISO 19650. These efforts sought to improve the operations and service delivery of NHS Scotland via the digitalisation and centralisation of all legacy information (in its various forms) relating to its highly-varied property portfolio, with some newer investments also set to benefit from the implementation of digital twins.

These efforts demonstrate a sensible solution to a complex problem; in developing the digital estate, each facility’s level of informational need was considered individually, with an appropriate level of data capture assigned accordingly. The triaging of facilities – by spatial, functional or technical characteristics – allowed for a smooth and logical roll-out, with ample opportunity for learning (and recording) valuable lessons along the way via a bespoke Government Soft Landings (GSL) framework (Philp, 2020).

The resultant solution enables more effective decision-making at a portfolio level, with the global oversight that a digital estate provides enabling deeper (and more dynamic) insights and better investment planning, playing a key role in ensuring that NHS Scotland makes the most effective use of both its existing stock and future capital investments. Centralised asset information also minimises the disruption of service provision often associated with inefficient maintenance activities, yielding additional savings in both cost and time.

NHS England have been similarly ambitious with regards to digitalisation. In January 2019, the UK Government announced the Health Infrastructure Plan (HIP), promising substantial investments not only in new facilities, but also in the provision of support for its existing stock and accompanying infrastructure.

This plan can be viewed as the NHS’ digital manifesto. Digitality presents a societal paradigm shift, and the means of healthcare provision must evolve with society if it is to continue to meet its needs. The HIP, recognising this, aims to equip the NHS to address the UK’s rising demand for effective care, reform the system underpinning the allocation of capital and provide a greater level of digitally-assisted autonomy for patients.

Embedded in this plan is an acknowledgement of the substantial value that BIM offers, as well as the power of digital twins and Artificial Intelligence (AI) as applied in a healthcare context. Putting words to action, the NHS is currently involved in the exploitation of such digital technologies in a number of projects, with further digital innovation implied for the future. In developing these approaches, the NHS has demonstrated a full, holistic understanding of what digital transformation fully entails for an organisation. It is not merely the organisation-wide deployment of upgraded IT systems and software; it is about re-thinking the entire philosophy, culture and modus operandi of the organisation in the context of the digital economy.

The NHS has prided itself on an open, data-centric approach based on getting the basics right, recognising that over-reliance on proprietary systems and solutions can limit management power and negatively impact upon the ‘future-proofing’ of long-term digital strategies.

There is still a long way to go before the NHS can be hailed as technology pioneers, but its digital transformation journey has most certainly begun. Now we need to follow it closely to see where it leads and indeed can the UK government’s ambitious plans for digital change within the NHS be truly realised in the near future.

The outbreak of the coronavirus pandemic most certainly slammed on the breaks for the roll-out of digital estates management as the NHS became focused on channelling its energy into patient care. However, it has presented many lessons learned that the NHS can be dynamic with its estate management and adapt to change quickly, a positive which will be taken to the next level of technological development of healthcare infrastructure.

For more information, please contact John Millar.

  1. NHS Confederation (2017). NHS statistics, facts and figures. [online]
    Available at:
  2. [Accessed 9 May 2019].
  3. Hamilton, D. K., Diane, R. and Raboin, W. E. (2008). Organizational transformation: a model for joint optimization of culture change and evidence-based design. Herd, Vol. 1, No. 3, p.40.
  4. Støre-Valen, M. and Lohne, J. (2016). Analysis of assessment methodologies suitable for building performance. Facilities, 34, p.726-747.
  5. Thomson, G., Lindahl, G., Shemery, A., Roupé, M., Hampson, K., & Johansson, M. (2019). BIM Related Innovation in Healthcare Precinct Design and Facilities Management.
  6. Knutt, E., 2015. David Philp promises ‘value to the people of Scotland’ in new BIM secondment | BIM+. [online]
    Available at: [Accessed 28 March 2021].
  7. Philp, D., 2020. Blog: The benefits the Government Soft Landings – David Philp | Centre for Digital Built Britain. [online]
    Available at: [Accessed 28 March 2021].