Whole life cycle performance measurement re-engineering for the UK National Health Service estate

A. Halim Boussabaine, Richard J. Kirkham

    Research output: Contribution to journalArticlepeer-review


    Purpose - The measurement of the performance of built assets with the UK National Health Service portfolio is based on simple benchmarking techniques such as £/m2. The purpose of this paper is to examine an alternative approach, which could produce a more informed and balanced approach to performance measurement Design/methodology/approach - The existing benchmarking and clustering techniques used within the NHS are examined. These reveal inadequacies in truly representing asset performance. Data envelopment analysis techniques are applied here to map the estate costs against the outputs of the estate (i.e. number of inpatient days). Operational and maintenance cost data was collated from 15 NHS acute teaching trusts outside of London, these were mapped against two outputs (in-patient days and occupied beds per available beds) in order to determine how effectively each NHS Trust translates input resources into inpatient days and occupancy of available beds. Findings - The results from the models generate efficiency improvement scores. The scores disclose that the standard deviation of average efficiency in the cluster was 22.38, thus revealing a significant variance in performance. The efficiency values range between 100 and 33.6 per cent. The results provide useful information on the technical efficiency of building assets and allow NHS Trusts to identify where efficiency improvements are necessary within a continuous efficiency analysis framework. Research limitations/implications - Further work is required on the analysis of other types of hospital buildings within the UK to test the validity of the sample used. Other outputs may also be relevant and should be explored. Practical implications - This paper was presented to NHS Estates as part of a commissioned report which is now being considered as part of a process to re-engineer performance measurement within the estate. Originality/value - The paper adds value in demonstrating the benefits of an established methodology within a new setting, which is the performance of built assets. © Emerald Group Publishing Limited.
    Original languageEnglish
    Pages (from-to)324-342
    Number of pages18
    Issue number9-10
    Publication statusPublished - 2006


    • Data analysis
    • Facilities
    • National Health Services
    • Performance measures
    • United Kingdom


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