A cost comparison exercise was conducted by GK Transformation at the University Hospital of North Staffordshire NHS Trust

The review encompassed the Trust’s Hard and Soft FM Services within the PFI development and the Trust’s retained estates.


The University Hospital of North Staffordshire NHS Trust were keen to explore the possibilities for cost improvement with regard to its Estates & Facilities services, as part of a wider programme to balance the Trust’s books. Consequently, the Trust sought some independent cost comparator analysis that would help to inform the Trust as to how its services compare with those of other similar organisations from a financial perspective.

The cost comparison exercise was conducted by GK Transformation in 2015.

The review encompassed the Trust’s Hard and Soft FM Services within the PFI development and the Trust’s retained estates, to include:

• Estate Maintenance – PFI and Retained Estate
• Domestic, Catering, Portering, Linen Services – PFI and Retained Estate

Terms of Reference
The Trust requested GK Transformation to undertake the following:

 To review the costs of the FM services within the scope of this review through undertaking a cost comparison exercise in order to determine how these service costs compare with those of similar services in other Trusts.
 To assess the performance of the FM services within the scope of this review, in overview, thereby enabling an assessment of the value for money provided by these services.
 To review FM services within the scope of this review in detail with a view to identifying any service improvement and/or cost improvement opportunities.
 To review the service specifications/service levels of each FM service within the scope of this review in order to identify any opportunities for service/cost improvement whilst being cognisant of the corporate risk around statutory compliance, backlog maintenance and business continuity.
 In all the areas above, to make recommendations for change or improvement, as appropriate.
Cost Comparison Exercise

GK Transformation undertook a focused cost comparison exercise, using comparative data from:

• 86 Trust wide reviews (Financial Recovery Plans)
• 190 Market testing exercises, 120 Technical Evaluations
• 565 Service Reviews
• a host of assignments of working with commercial service providers in bidding for NHS and Public Sector contracts and scores of value testing reviews.

Our database covers most clinical and non-clinical services and functions. In total our database covers over 160 NHS Trusts, 40 PCTs, 38 Commercial Organisations and 8 Shared Services functions.

Through semi-structured interviews with the key service managers of those services that formed the scope of the review we gained a good understanding of the services being provided. It is vitally important that any comparative analysis is based on like for like comparisons as it is not unusual for the range of service provision to vary significantly from Trust to Trust. Establishing a good understanding of the services in question is therefore imperative if the resultant analysis is to be meaningful.

Comparative Analysis
Having established a suitable understanding of the service provision at the Trust, the levels of service being provided, the costs and quality of these services, our team then undertook comparisons of this performance with that of other Trusts. Details of the comparator Trusts used were provided within our report.

Performance and Service Specification Review
As part of the review our team undertook a review of the current performance of each of the FM services in question.

To establish the compliance status of the Trust our consultants examined all available documentation and undertook a number of direct observations to assess issues such as cleanliness, food quality, response times, workmanship, etc. Through this approach our team undertook a sample audit against the service specification, current regulations and guidance.

Our consultant team sought to compare the performance of the FM services against both the requirements of the current service specification but also against the performance of similar services in other Trusts. In turn, this enabled our consultant team to critically examine the current service performance levels and identify any areas where there might be potential to either improve performance or cost or both.

Recommendations were then made to enable the Trust to address any shortcomings and develop and implement a robust Management Plan that will facilitate a co-ordinated approach with regard to statutory compliance issues.

It should be made clear that this review focused upon the question of value for money and the issues of performance should be viewed in that regard. We would like to make it clear that this review was not intended to be a full review of the Trust’s compliance with its statutory and regulatory obligations. Other inspection regimes will perform that function. In the case of this review, the objective was for our team to understand the current service levels and how the FM teams perform in delivering to these.

Development of Recommendations
Having established a faithful picture of the FM Services provided to the Trust and having completed a cost comparison analysis, our Consultant team then sought to develop a set of constructive recommendations to assist the Trust to achieve both cost and service improvements.

As part of this stage of the review, our team drew on their wide ranging experience of how these services are delivered elsewhere, taking full account of best practice models. The team also, through discussions with both service providers and service recipients, explored the previous experiences within the Trust that have shaped the current service configuration and performance levels.

From the information gained in the examination of the current position, undertaking of the data analysis exercise, discussions with key service heads and the cost comparison exercise, the Consultant Team concentrated on defining and making a judgment on the strengths and weaknesses of each service.

Where our team have identified any shortfalls or opportunities for service improvement we aimed to develop a number of practical recommendations for the Trust to consider.

Report & Findings
Finally our Consultant Team have presented the findings of this review within a detailed report, having been thoroughly validated as part of our ISO9001 accredited quality assurance system. Our report details:

 Analysis of the current position
 Outcome of the Cost Comparison Exercise
 Outcome of the Performance Assessment and Specification Review
 Practical Recommendations for Service and Cost Improvement
 Recommended course of action together with outline implementation programme

The report’s findings provided a detailed level of analysis based on our granular benchmarking methodology, which provided meaningful insights into the relative performance of both the PFI and the retained estate provision.

The report also helpfully provided a range of cost improvement suggestions covering Portering, Car Parking, Waste, Post, Linen, Catering, Domestics, Estate Maintenance and FM Management and Administration.

Our client felt that the GK review had provided an “extensive and detailed review and analysis of the PFI and the retained estates and facilities services”.