Jenny Kay, BA Hons, RGN, RSCN, MBA.
Director of Nursing, Dartford and Gravesham NHS Trust, Darent Valley Hospital, Dartford, KentThe NHS housekeeping initiative was announced as part of The NHS Plan, following extensive consultation with patients, staff and stakeholders (DoH, 2000). The aim is that by 2004 over half of all trusts will have a ward housekeeping service (NHS Estates 2001; 2002).
The staff at Dartford and Gravesham NHS Trust, with its brand new 400-bed Darent Valley Hospital, were keen to bid for funding for pilot status, which would help us work on a strategy that could then be rolled out to the NHS as a whole. We received funding in early 1991.
Our first task was to establish what role the housekeeper would fulfil, and whether it would duplicate or complement existing roles (both in the NHS and Carillion) and, if so, to what extent. Would the housekeeper be an NHS employee, or employed by Carillion Services plc?
In the wards, under the PFI concession agreement, Carillion provides two staff - a 'housekeeper' whose duties are chiefly cleaning, and a 'service team assistant', who takes the main responsibility for serving meals and drinks. The terms of the concession agreement are that all facilities management is provided by Carillion - that is, cleaning, catering, laundry, estates management and so on.
The decision was made to host a series of focus groups with staff and patients. They were co-ordinated by Bill Davidson and Laurie Bryant, external facilitators recommended to us by NHS Estates project management team. The focus group objectives were to:
Key issues were:
The project manager therefore worked up a detailed costed options appraisal. The cost of implementing the NHS housekeeper project throughout the trust is large. The preferred option includes higher rates of pay and more hours. Less expensive options have been considered, but these would tinker at the edges of the present system, rather than provide the radical change desired.
Department of Health. (2000) The NHS Plan: A plan for investment, a plan for reform. London: The Stationery Office.
NHS Estates. (2001) Housekeeping: A first guide to new, modern and dependable ward housekeeping services in the NHS. London: The Stationery Office.
NHS Estates. (2002)Process Mapping the Housekeeping Service: A toolkit for change. London: The Stationery Office.