When NHS Greater Glasgow and the Clyde area of NHS Argyll and Clyde combined in 2006, the Board became one of the largest health providers in Western Europe providing healthcare services to over 1.2 million people and employing more than 40,000 staff.
By 2008 it was apparent that the existence of a large number of legacy CAFM systems and multiple estates packages were no longer sustainable. The newly formed board, NHS Greater Glasgow and Clyde (GG&C) was using seven different CAFM Estates Management Systems, all of which were heavily paper-based.
Following a full system review, it was recommended that these seven systems were consolidated into one centralised system to standardise data and provide a smarter, faster, more efficient service to clients. The aim was to provide benefits in both maintenance time and operational costs by eliminating operating system incompatibilities and conflicting legacy data that were creating inefficiencies and high operational costs.
The Board required the new system to perform some essential functions:
- Remote notification of faults by users
- Access to live status updates of task completion by users
- Mobile functionality for managers and tradesmen to improve site-wide control and data management
Essentially, the Board required a highly responsive, flexible CAFM system that could bring together all key estates and facilities tasks. It was important that the system selected was reliable, web-enabled and secure with controlled user access.
The review took into consideration an existing longstanding relationship with the Board and CAFM software developers Asckey Data Services Ltd and their estates management package fmfirst® Estates (formerly known as Eclipse-fm). The fmfirst® product suite had already been in operation at Glasgow Royal Infirmary (GRI) and part of the Southern General Hospital (SGH), since early 2011. It was decided to expand the use of fmfirst® across the whole of the newly formed Health Board came about due to the systems targeted functionality, reputation for reliability and robust user and system support.
The logistics of mobilising such a large scale user-base needed careful consideration. The migration of all legacy data from eleven separate installations over to fmfirst® was the next stage of the process. The migration exercise, successfully managed in conjunction with the Board and Asckey, involved extensive data cleansing to ensure the accuracy of all information in the database. This included over 100 locations, over 6,000 staff records and the import of over 70,000 assets into the system.
System installation of this size required a carefully coordinated, bespoke training programme for new users. Asckey’s training team arranged a series of training sessions with staff across all locations. The training covered all key areas such as Helpdesk functionality, right through to full supervisor and administration training including Mobile Task Management (MTM).
Phil Wright, Account Manager at Asckey said: “Representatives from all locations attended to learn the system basics including Help Desk, Staff Management, Asset Management and Mobile Task Management. The majority of attendees found the course allayed any fears about learning new technology. They could see first-hand how simple and intuitive fmfirst® was to use. The session allowed trainees to interact with the software and ask questions.”
“The delegates’ hard work paid off with all delegates successfully completing the course which covered all essential functionality. A stand-alone training system was made available to all users for practice before moving to the live system”.
Each sector within the Board was allocated a superuser who represented the users and could be contacted with any concerns or queries.
User group system development
After the initial system merger and staff training, Asckey monitored user experience and system performance via regular user feedback groups. This was an important part of the customer relationship management process.
An internal GG&C working group made up of department heads and senior estate staff was established. The group allowed Asckey to actively seek user opinion and for users to share experiences and best practice. User feedback is always invaluable and feedback is used proactively in the development of further system enhancements.
The group met regularly with Philip to discuss system usage, any further training requirements and future enhancement plans. Ongoing user feedback is used by Asckey to support the continued development of fmfirst® to ensure maximum system efficiency and staff productivity. This collaboration ensures that the fmfirst® system grows in-line with the changing needs of GG&C users and its wider statutory obligations. A wider NHS Scotland user group has now been established with NHS GG&C taking a lead role.
Process innovation and system integration
Alan Gallacher, General Manager for Estates stated: “fmfirst® provides us with clear task progress visibility with improved communications using one single, centralised task management system. All defects from wards and clinical areas are now reported through a one-click `icon’ located on the desktop screen of a PC located in each ward/clinical area. Estates staff can action these tasks directly via mobile devices (over 300 across the GG&C). Several statutory planned preventative maintenance tasks for Theatre Areas and High-Risk Clinical Areas have been standardised and are also on the system.”
“We are currently working with a 3rd party to investigate an interface between fmfirst® and Condition Based Monitoring as part of our PPM regime to try and reduce the number of PPMs being carried out. Also, a QR code (similar to a Bar Code) system is being developed which will also be delivered as part of fmfirst®. This will help identify the correct asset when we carry out planned maintenance tasks and assist with tagging assets onto a reactive job. Workplace health and safety surveys and Fire Audits are being developed through fmfirst® via PDA’s, eliminating the need for manual paperwork.”
Domestic Monitoring Tool* (DMT) integration (now known as the Facilities Monitoring Tool* (FMT))
Part of the national framework agreement to supply Scotland with a central Facilities Monitoring Tool (FMT) included a requirement for the FMT to integrate with the estates packages being used by Health Boards.
In partnership with Asckey, NHS GG&C took a lead role in helping NSS to complete the first FMT estates integration of its kind. The integration process was designed to bridge the gap between a domestic-related failure being found during an audit and this being passed to estates to manage feedback to the domestic team. The successful fmfirst®/FMT integration project completed in 2013, now means that when a failure is raised in the FMT for an estate-related issue, a task is automatically raised for Estates. During the lifecycle of the task, fmfirst® sends updates back to the FMT with progress updates of the work until its completion, greatly improving task communication and efficiency for all FMT users.
fmfirst® integration with existing systems has greatly improved internal FM communications. Now when HEI ward inspections take place, staff can show evidence of all work requested and work in progress as a means of measuring accountability. As a result of this joint work between IT, Estates, Domestic Services and HFS, the integration between FMT and fmfirst® allows the electronic transfer of task requests and status monitoring, reducing manual input of tasks by domestic services and providing a full audit process in both systems.
In-line with ongoing advances in mobile technology, the Board decided that an essential next step for productivity improvements should be the introduction of mobile working. The use of hand-held technology was expanded across the Board. The move not only reduced paper usage but also significantly improved traceability of job locations and their current status, essential in a Health Board of this magnitude.
Mobile working allows for faster task resolution with tasks allocated directly to remote worker mobile devices on location. Each member of staff who carries out tasks for the Estates department has an Android handheld device (PDA). The system uses NHS GG&C WiFi to communicate between the device and the server. Staff can see jobs allocated to them while moving around the estate as the system is functional on or off-line, with a connection only required to download and upload tasks. Jobs are updated dynamically giving the end-user real-time status updates on their jobs.
Mobile devices allow staff to download as many jobs as they wish and store all details of work carried out along with job status eg. on hold, awaiting parts, complete, etc. Using devices compatible with 3/4G networks means that jobs can be sent to trade staff whilst they are out on a job at remote locations. The number of mobile users within the GG&C has been steadily increasing with additional plans to introduce mobile across the whole of the New Southern General Hospital.
The use of mobile has given the GG&C greater flexibility, allowing tasks to be allocated directly to trades staff without them having to report into a base to be issued work instructions. Tasks appear on a mobile device with full instructions, priority and associated documentation. Trades staff are then able to report back on the status of tasks to the central help desk to ensure that all activity is recorded and supervisors are aware of the exact status of any job at any given time. Task duration can be recorded accurately for labour cost estimations as well as being able to keep track of staff location.
The system now provides NHS GG&C supervisors and heads of estates with a unified centralised system with the ability to control large numbers of scheduled tasks from a single template, regardless of location.
Pat McGorry, Health Information & Technology Facilities Application Service Delivery Manager at NHS GG&C stated she felt the whole project would be transferable to other parts of the NHS, she commented:
“The GG&C has seen hugely positive outcomes as a result of the integration project. Tangible benefits including reduced paper costs, a move to a paper-light environment, reduction in the number of help desk telephone calls and staff making use of the web portal have helped save costs”.
“Additionally, the live status updates we are now getting from mobile users has meant faster availability and access to `live’ management information. With quicker task resolution and increased levels of PPM’s being completed, reduced downtime means that the data supplied is more accurate for use on Benchmarking reports and shows improved use of IT technology by estates staff.”
“Having a single system has meant better overall user familiarity and as a result, a reduction in support and maintenance costs. Integration with other systems has helped reduce duplication and closes the loop in key facilities areas including reduced reporting errors. We have seen enhanced supervisory and management capability through live updates from the field – no waiting for manual data entry or lost paper tickets!! All changes have helped us to meet the challenges and principles of the National eHealth Strategy”.
This groundbreaking project concluded in July 2015 with the official opening of the New Queen Elizabeth University Hospital, the Royal Hospital for Children and the Teaching and Learning Centre (including the New Administration Block), all based on the Southern General Campus.
Asckey Data Services Ltd and fmfirst® continue to support the NHS GG&C. In conjunction with NHS GG&C Facilities IT Team, Asckey actively manages all system upgrades and continue to provide full system support and maintenance.
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