When I began researching knowledge sharing in NHS Estates and Facilities Management (EFM), it was because during the first wave of COVID-19, I had seen first-hand the intense pressures facing teams responsible for keeping our hospitals running smoothly and safely. EFM might seem invisible to many, but it underpins the very ability to deliver safe, effective healthcare. Today, these teams navigate an increasingly challenging landscape: complex, ageing infrastructure, growing maintenance backlogs, shrinking budgets, and a 300k-strong workforce stretched thin. Given these intense demands, I quickly realised improving collaboration across the NHS wasn't just helpful but essential, as the NHS cannot afford to make the same time-consuming and costly mistakes over and over again.
A staggering maintenance backlog of £13.8 billion has accumulated, with over half tied to buildings at significant risk of failure (1). The consequences aren't abstract. In 2021-22, NHS England reported 5,348 clinical incidents directly linked to estates and infrastructure failures, more than double the number reported in 2016-17 (2), clearly illustrating how poorly maintained and outdated facilities, compounded by a lack of investment, severely affect patient outcomes.
Maintenance backlog and capital investment in the NHS (in £bn) (4)
The dramatic situation is summarised by Sir Julian Hartley, chief executive of NHS Providers:
“The cost of trying to patch up creaking buildings and out-of-date facilities is rocketing. [. . . ] The safety of patients and staff is at stake. To provide first-class care the NHS needs safe, efficient and reliable buildings, facilities and equipment.” (NHS Providers, 2023)
About 34% NHS EFM professionals are approaching retirement age (compared to 19% of overall NHS workforce) and only 5% are under 25 (3). Hence, succession planning is a daunting task, exacerbated by an ageing workforce and challenges in attracting young professionals. During my research, I frequently talked to EFM professionals who had recently joined the NHS, reporting about their steep learning curves and the critical need for transferring tacit knowledge from experienced staff.
Age distribution of NHS EFM workforce shows that 34% of staff are nearing retirement (3)
However, internal knowledge-sharing practices often fall short, fragmented by organisational silos and overwhelmed by daily demands. Effective knowledge sharing isn't just about procedures and best practice documents; it’s about fostering trust, creating incentives, and developing systems that enable smooth information exchange.
The strategic objectives set out in the NHS Long Term Plan 2019 (which is about to be overhauled - watch this space: https://www.longtermplan.nhs.uk/) focus on delivering safer, high-quality patient care and meeting ambitious net-zero sustainability targets (5). Yet, the reality faced by EFM teams makes achieving these goals extraordinarily difficult. Given the scale and complexity of these interlinked issues, the central question I set out to explore four and a half years ago was:
I was certainly not the only one recognising the value of leveraging the collective NHS knowledge in the NHS and formulated the following ambitions:
“[. . . ] opportunity to develop the connections and sharing culture conducive to knowledge sharing, which can support the NHS in its quest to develop as a learning organisation.” (NHS, 2016)
“[. . . ] new arrangements must help overcome the barriers to productive collaboration that organisational and professional self-interest can erect.” (Lord Carter of Coles, 2016)
“[. . . ] organisations within NHS England must find ways to work together across organisational boundaries [since] it may be the only way to deliver a successful NHS” (NHS, 2019)
Previous research studies clearly highlight knowledge sharing as an under-utilised yet powerful solution. It reveals that informal networks, targeted professional development, and structured, context-specific knowledge channels significantly improve organisational resilience and efficiency.
As highlighted by one NHS Estates Manager during the study:
“We often know what we need to do, but finding the right information quickly during a crisis is a whole different matter. We desperately need better ways to tap into collective knowledge.” (Brown, 2023, p. 156)
To address these challenges effectively, knowledge sharing must become a systematic, embedded practice rather than an afterthought. This means not only improving how information is captured and shared but also addressing cultural and organisational barriers such as trust, communication styles, and incentives for collaboration.
At INNEX, we're leveraging this critical insight by creating tools designed specifically for NHS EFM teams. Our platform helps surface, capture, and share institutional knowledge seamlessly. By doing so, we empower professionals—particularly newer staff—to make faster, better-informed decisions that improve compliance and patient safety.
The stakes are high, and the cost of inaction is clear. A strategic investment in knowledge sharing isn't just sensible; it's urgently necessary.
How effectively is your team sharing critical knowledge today? We're working to tackle these exact challenges at INNEX—get in touch and let's discuss solutions that make your daily decisions quicker, safer, and more informed.
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