The way in which healthcare is delivered is changing. This is being driven by advances in technology and in medicine, as well as by the constant call to 'do more with less'. There is finite resource in the system, and yet healthcare institutions are being asked to cut costs and reduce spend while expanding their services. The response has to lie in a new way of working. 

An integrated approach
Taking an integrated approach to managing the estates is one solution. An NHS trust developing a five-year strategic plan will need to address a number of questions:
- what services will we offer
- where will they be located
- how will they be accessed
- what buildings and space do we need
- how should technology be used
- what impact will we have on the environment.

Historically, each of these elements has been tackled separately, but there are significant benefits to be gained from taking a more holistic view. Trusts are now beginning to incorporate healthcare and clinical planning technology, property management and capital development, and technology, into the same conversation. This eliminates overlaps and gaps, and capitalises on efficiencies and opportunities. Efficiency has to be about doing things differently, not just cutting costs.  

New ways of working
An integrated approach is at the heart of what we do at Essentia, an organisation which combines commercial focus with public sector values and which provides consultancy services in strategy and estate development. We help organisations, largely but not exclusively in the public sector, to become more efficient and more effective. 

We do this by finding ways to work differently, creating improvements in productivity and efficiencies across the whole estate, leading to a reduction in operating costs. We work with clients to redefine investment strategies and prioritise specific projects, confirming their outline feasibility and assessing likely capital costs. Our approach is to focus on redesign and challenging conventional thinking.

Essentia started life as the in-house Capital, Estates, Facilities and IT Directorate for Guy’s and St Thomas’ NHS Foundation Trust, designing and delivering a comprehensive investment, technology and infrastructure strategy, and providing high quality non-clinical services. The Essentia directorate continues to flourish and alongside it, in 2013, we formed an independent commercial arm, Essentia Trading Limited, a wholly owned subsidiary of Guy’s and St Thomas’ NHS Foundation Trust. Essentia Trading employs close to 50 consultants who advise clients in and outside the NHS on strategic estate development. Our profits are invested back into the NHS.