JWL's first four hospitals were built in Edinburgh (two), Glasgow and Stockport. These early projects were for relatively small 60-80 bed sites mainly focused on the care of the elderly and psychiatric patients. But in 2003, the company bid successfully for a project that involved a significant element of refurbishment as well as the usual new build, at Highbury Hospital in Nottingham.
The four-year £25 million project was conceived to further develop the former maternity hospital's modern role as a base for a variety of mental health and learning disabilities services, and entailed the construction of new wards, a Psychiatric Intensive Care Unit and buildings to house support and administration facilities.
A Help Desk had not been part of the PFI requirement for James Walker's earlier contracts, but the scale of the Highbury Hospital project and the Standard Form contractual environment meant that it was a requirement of the Project Agreement.
"In fact, it was a primary requirement as a management tool in relation to maintaining the service levels we are contracted to provide," explains Lorn Smith, Quality Manager at James Walker.
"The whole continuity of our services hangs on it. Using the helpdesk as a management tool prevents us, or one of our contractors, from dropping the baton at any stage and in the unlikely event of that happening, the Help Desk is there to reduce the impact. The overriding issue is service provision, and that makes the Help Desk central to everything. Also, a key element in ISO 9001 and 14001 quality and environmental certifications for the site in terms of continuous improvement, it is essential that all services are in a position to interact via the Help Desk."
The search for a suitable Help Desk solution began in 2003, with Lorn and his colleagues examining the market for appropriate software packages, before taking to the road to see several in action and shortlisting thereafter.
With the shortlist reduced to two contenders, James Walker put them both through their paces, presenting them with a series of likely scenarios based on the types of calls the Help Desk would be likely to receive in the hospital. Finally, Concept™, FSI's Computer Aided Facilities Management (CAFM) system emerged as the closest fit.
"The most challenging aspect of identifying the ideal software was that so many off-the-shelf packages seemed to be geared mainly towards maintenance rather than the proactive management of a full facilities service," says Lorn.
"Nottinghamshire NHS Trust already had a Help Desk facility, purely for maintenance purposes and due for replacement, while another arm of the Trust, the forensic service at Rampton Hospital, was already a Concept™ user and considering upgrading to Concept™ 500. Although that was a positive situation – it meant there was already a culture of having worked within a Help Desk environment and staff were used to the idea of reporting issues and having them dealt with promptly, allowing them to concentrate on administering healthcare – our requirement was for a Help Desk on-site, rather than trust wide, to tackle all the other services, i.e. Soft FM, as well as maintenance."
Lorn says that FSI put a lot of effort into assessing and understanding the specific needs of the PFI Project at Highbury Hospital. "FSI assured us that they could seamlessly integrate the NHS Standard Output Specification within Concept™," he recalls.
"They had obviously done their homework, and ably demonstrated how the 'what if?' scenarios we'd presented them with would translate into the logging, handling and closing-out of calls and tasks. A project scoping study was completed, they educated us on the integration of the CAFM system and together we sculpted the basis for the system. We placed our order in September 2004."
The system was live by the end of the same year. "The setting up of the Highbury Hospital Help Desk presented us with a number of challenges" says Lorn.
"The main challenge was getting the structure right from the outset. In many ways, this was made easier by the PFI Project Agreement itself, which sets everything out very clearly within the standard output specifications and payment mechanism. Each service, each performance parameter has a defined performance value in terms of its relative importance to the hospital."
JWL installed Concept™ 500, with some additional modules including Internet, building management (BMS), Eclipse facilities booking and Workflow Lite™ intended for implementation as the project /development evolves. The system operates on a server at the hospital, with Lorn and other members of the team enabled for remote access as required.
"We need, at all times, to have a robust audit trail that can be followed and can stand up to internal and/or external assessment. Reporting is also critical and is achieved through Concept™, in conjunction with Crystal Reports, i.e. Crystal Connect."
"Introducing a management system as complex as Concept™ requires a planned and systematic approach. We introduced assets and equipment management later, but initially the Help Desk was focused on all the buildings and locations, and tying together all the resources – porters, maintenance crews, domestic and catering staff, security – so that we could reflect the required performance parameters for each service. Each service specification in the PFI contract dictates how much time there is to respond to each call. Allowing unacceptable situations to develop or failing to rectify such a situation would incur a penalty, however, Concept™ gives JWL the tools to avoid this."
Training was a vital part of the implementation process, the first stage of which was to train the three members of JWL's implementation team to work with FSI on this element of the process. The next stage involved training the permanent Help Desk operators who attended a comprehensive course at FSI's headquarters in Upminster. Several other key staff from different services within the hospital received training, ensuring that the Help Desk culture would be established throughout the operation from the start.
Lorn continues: "FSI's training was well-structured and thorough, and whenever they were needed, FSI were always there to help. There were very few initial issues, certainly nothing of a serious nature, but FSI would come right back in and fix it, in the event of anything untoward arising and if there was ever a glitch in a report, they'd help us out via their support network."
"Everything has gone well in general since Concept™ has been up and running," says Lorn. "It has proven to be a robust, stable system which runs well, testament also to our own IT infrastructure. Some of the additional modules have still to be implemented. For example, it is our intention eventually to make the Internet module available to NHS Trust personnel, so that ward managers can log calls from their own desktops. That's for the future, as is the BMS module and Workflow Lite™, although the Eclipse module for facilities booking has been in use since 2005 and that is working well."
Lorn says the ability to develop PPM elements further into the system has been crucial. While most issues surrounding the ongoing construction of new buildings don't directly affect the Help Desk, as they come into use they need to be incorporated into Concept™.
"So far, following completion of the first two phases of the construction programme, we've had five new wards and a main production kitchen, all very straight-forward to add. It takes minutes to bring a whole new building online, and it is an uncomplicated process. This is now handled primarily by the Help Desk operators themselves and it is just a matter of ensuring they are provided with the correct information," he says
The main thing is that the Help Desk is perceived by everyone as the hub for service delivery in the hospital.
"If we were in an environment where the idea of a Help Desk was completely new and alien to the users, there could be a significant cultural hurdle to overcome," he says. "Here, we had a couple of instances where for some people it had become a habit to bypass the system and go direct to a particular service, such as portering, for example. But once they saw how the Help Desk could work for and with them, any negativity and/or resistance was eliminated."
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