How do we get the NHS from no CAFM to BIM?
G&T’s strategic healthcare team recently met to discuss what issues may be faced by NHS Trusts, STPs and CCGs in working towards BIM. G&T director Joanne de la Porte shared her experience over the past 10 years as a Capital Programme Manager for a large Trust and the benefits reaped from implementing a CAFM system.
Here Joanne discusses her experience, lessons learnt and advice on the first steps towards BIM for existing estates.
BIM – where do we begin?
The Building Information Modelling (BIM) process is now seen as mandatory for public sector procured projects.
“Building Information Modelling (BIM) is a collaborative way of working, underpinned by the digital technologies which unlock more efficient methods of designing, creating and maintaining our assets. BIM embeds key product and asset data and a 3-dimensional computer model that can be used for effective management of information throughout a project lifecycle – from earliest concept through to operation.”
All NHS Trusts that are developing business cases for the New Hospital Programme (HIP1 and HIP2 Schemes) will no doubt now be familiar with the acronyms EIRs, AIRs, OIRs, BEP, PIM, AIM to name a few. They will have had many conversations focusing on the questions, ‘what information do we know and what do we want?’ There will have also been a great deal of discussion relating to the creation of a CDE (Common Data Environment) and possibly a COBie (Construction Operations Building Information Exchange), or they will be on a fast-track learning journey to understand what these things mean and how they will impact their organisations.
The BIM model considers all assets in the building and ensures co-ordination of individual components and installation conflict avoidance during construction. Post construction commissioning, the data generated should facilitate vastly improved building management over the life cycle of the assets.
But what about existing Healthcare Estates?
Let us be honest, how many Trusts have adequate CAFM/EFM (Computer Aided and Estates Facility Management) systems in place, let alone software compatible with 3D scanned models and the data information required to move forward for BIM? We can all see the many benefits of applying BIM to a new building, but what about our aged stock and existing estates? How many organisations have taken the leap to scanning their buildings ahead of major refurbishments? Furthermore, how many Trusts have commenced dialogue to establish their EIRs (Employer’s Information Requirements), AIRs (Asset Information Requirements) and OIRs (Organisational Information Requirements)?
Many Trusts continue to store their existing record information as individual stand-alone CAD 2D Floor and Site Plan files. Additionally, O&Ms are often saved in project zip folders (or on old CDs and memory sticks), Medical Gas As-built drawings are likely to be in another folder, Asbestos registers and Property Appraisal data are saved in cumbersome Excel documents in another folder and Capital Project information saved in another department Shared Drive. This is just naming a few of the data storage scenarios! True, the information all exists, but how accessible is it and how are the interdependencies captured and used in terms of making the right decisions and bringing the building to life?
When the Premises Assurance Model (PAM) or Estates Return Information Collection (ERIC) deadline looms, multiple members of various teams in each Trust must trawl through extensive document folders for evidence and information. By way of example let us consider Backlog Maintenance reporting. In simple terms, the Estates Operation Managers responsible for reporting have to consider the following:
- What did the property appraisal say that we had to address this year?
- What did our Capital funding Allocation allow us to address and what is the funding gap and building Asset upgrade/replacement/ refurbishment to transfer to a future year?
- What works did we undertake that require an update to the property appraisal data? Capital Backlog investment this year + Capital Project Backlog investment this year + emergency backlog projects?
- Where does that leave us?
To undertake this exercise, as a minimum, a Trust without a CAFM or an EFM system would have to review the following data:
- Trust Property Appraisal
- In year Capital Backlog Plan or PPM schedule
- Maintenance records by location – for any reactive replacements
- Capital Project Operations and Maintenance Manuals
- Backlog Operations and Maintenance Manuals
This is a huge undertaking and it is impossible to report accurately without the appropriate systems in place. We must also factor in that the Property Appraisal may have only been a 20% extrapolated sample that has not captured the many updates that could have been digitally reported each time a member of the team went out onto site or managed a repair or replacement with visual access to the asset or building component. BIM certainly can feel very overwhelming and a long way off – but CAFM shouldn’t.
Dipping our toe into BIM ahead of the dive!
I am not a ‘tech’ expert and I do not represent any of the CAFM/EFM software providers. I speak as a construction professional with over ten years spent in NHS Capital Project and Estates teams and 20 years in the industry. In terms of CAFM/EFM and Computer Management systems, we have come an exceptionally long way in the past 20 years.
Way back in 2001 I was a trainee building surveyor for a Local Authority Planned Maintenance Team. The Decent Homes Standard was a few years off and the Government was faced with meeting a tough new set of public housing standard targets by 2004. One member of my team had never even turned on his PC – it had been on his desk for two years. The typing pool sat next door. This team member managed me as his trainee and as someone who could type 80 words a minute, he had hit the typing/PC jackpot, so his PC remained unplugged. Our office was a sea of drawing boards. Only I had CAD on my PC (at my request) and I was mocked for using it – which was ok as I loved drafting! Up the corridor was a room, say 64m², full of A1 ink drawn record drawings in plan folders.
Our Head of Service realised that with our baseline, we were facing an information gathering nightmare. We were at risk of failure – failure to perform and failure to the people and community that we served. To meet the targets, every property had to be surveyed as soon as possible. Every condition survey result had to be modelled and prioritised over a five-year PPM programme in line with the Decent Home targets. I recall the manager standing in the record drawing room. Dust was covering the top of many of the plan units. He asked me, post-survey, how long it would take me to manually update the results of every Condition survey to an excel spreadsheet. I recall saying – ‘around retirement, and it is likely to crash’. I meant my retirement and not his!
The following week we were in Kingston on the start of my journey into CAFM. Resistance from the team was huge and as the most junior member of the department I felt hugely out of my depth but nonetheless excited by the challenge. Within a year, we had enough data stored in the CAFM system to generate programmes of work based on priorities and the targets. We were also able to update the system with completed works to allow us to model replacement programmes up to 40 years. The technology was basic by today’s standards but the information that was gathered and stored in one place led to great improvements. The team accepted the change over time, especially once they were trained and realised the benefits and the ease of the system and reporting.
So why do I tell this story? I appreciate that most Trusts are now far more advanced in terms of their information gathering and that the quality of information gathered is far superior to that which was collected by the organisation I mentioned back in 2001. I share this with you as the line in the sand. Every Trust has their own line in the sand - their own base point.
The BIM Roadmap
The Government has recognised the BIM roadmap for existing buildings and estates may take some time and has defined that process as follows:
Level 0 BIM: Effectively meaning no collaboration. 2D CAD drafting only. Likely to be via paper of saved in individual folders. This back to the drawing record room that I described in 2001.
Level 1 BIM: Likely to comprise a mixture of 3D CAD work and 2D for drafting of statutory approvals with set CAD standards and electronic sharing of data in a common data environment (CDE).
Level 2 BIM: Collaborative working, an ‘information exchange process’ specific to the project. Any CAD software to be capable of exporting to one of the common file formats or COBie. This is the minimum BIM Target set by the UK Government of all new public sector procured work.
Level 3 BIM: Yet to be defined in real terms, but the vision includes a set of key measures to be secured with further funding.
So, what should Trusts do that are not part of the New Hospital Programme? Or, what should those NHP Trusts that are at SOC/OBC in the process and recognise that their Digital roadmap is far steeper than it should be do next?
I would advise that in the short term, Trusts should be aiming for Level 1 BIM as a minimum standard for their existing estates – with a longer-term road map to Level 2 BIM.
On behalf of a Trust, I worked closely with a software developer over a 10-year period to build upon an existing CAFM system. The system capabilities grew with numerous modules added over time to meet the Trust’s needs. Having a system of this type in place led to both resource and financial savings, but also hugely improved the quality of the data being modelled – allowing the Trust to have confidence in the information being shared and the work being planned and undertaken to its stock.
I would advise taking some time to assess your baseline. Catalogue your existing systems. Do you have multiple stand-alone systems? Who are the key stakeholders and staff using these systems – and for what?
Trusts need to be focusing on bringing their existing estates to life by digitising their data onto a single platform – step one towards a CDE or Common Data Environment. This will become a platform that will then be constantly updated and fed as the estate is managed. The more information that you feed it, the more it will give you back. Establishing Employers and Asset Information Requirements at this level will set a new baseline. The staff resources are already available to manage this and team members will no longer be duplicating work on multiple spreadsheets and the like thus re-balancing how they allocate their time.
As a minimum, 2D drawings should have the capability of being layered to show clashes in the existing estate. For example, record drawings of MEP installations should be stored in a way that makes them capable of being viewed as an overlay against the Trust Asbestos Register, drainage plans, security installations or similar. Trusts should be able to locate GIA data, lease information, building user types at floor and room level at the click of a button. Energy data should be modelled against buildings and floors and should not just be scanned PDFs taken from a BMS system and energy provider bills that have been saved in a folder. Completed repairs and PPM works should be recorded against the property appraisal data at room level on a drawing. Assets registers should be aligned to site locations.
The opportunities for efficiencies and improvements are endless in CAFM and EFM systems and they have existed for years.
These systems have improved immeasurably over recent years and I have only outlined a few examples of their capabilities, but what I can assure you is that if your drawings or estates-based information and data is sitting anywhere outside of a CAFM or EFM system, or you are only using your chosen system as a drawing repository, then you need to act – and soon!