Part 1: Authorising Engineers
The NHS doesn’t just run on doctors and nurses. Behind the wards, there is a 300k strong Estates and Facilities Management (EFM) workforce team making sure the lights stay on, lifts are reliable, medical gases are safe, and buildings comply with increasingly complex regulations. These teams are often invisible, but their knowledge and decisions directly affect patient safety.
Yet how these teams actually share their knowledge - what they pass on, what gets lost, and how experience is embedded - hasn’t been studied in detail. That’s where my PhD research came in. To cut through organisational charts and job descriptions, I built persona profiles: evidence-based but fictional characters that capture how different types of EFM staff work, communicate, and share what they know.
Over the next five posts, I’ll be sharing these personas - Directors, Heads of EFM, Managers, Technicians, and Authorising Engineers - to show how knowledge really moves through NHS infrastructure.
Figure 1: Overview of the create persona profiles across 5 managerial levels
The personas are grounded in two years of research. First, I ran case studies in 7 NHS Trusts, interviewing staff at every level of EFM. These conversations gave me the day-to-day stories: how someone trains a junior colleague, where bottlenecks appear in compliance, how people improvise when official channels fall short.
Then I conducted a Delphi study with 165 NHS staff, a structured survey process where experts respond over several rounds until a shared picture of reality emerges. This added weight and consensus to the case study stories, showing what was common across sites and what was unique.
By combining these two strands, I built ten personas across five managerial levels. Each is based on data about knowledge-sharing styles, barriers, and demographics. To keep them relatable, I gave them names like Chris Collaborator or Sarah Solitary to capture their dominant knowledge-sharing style. Photos were AI-generated to match demographic distributions from my research, with gender randomised to avoid stereotyping.
These are not caricatures; they’re grounded in lived experience, designed to make the invisible parts of EFM work more visible.
We start with one of the most distinctive roles in the system: the Authorising Engineer (AE).
As HTM-00 makes clear, the AE provides impartial advice on system design and safety, audits compliance, and assesses whether staff are competent to act as Authorised Persons. In other words, they’re the external conscience of the system: independent, experienced, and not afraid to say when something doesn’t meet the mark, although there are challenges, as highlighted by the HSSIB in the COVID-19 investigation on oxygen issues:
"The investigation was told that authorising engineers are also frequently private providers that must tender to trusts for their work. This may create challenges in authorising engineers challenging organisations or seeking assurance that issues highlighted in their reviews are actioned if they fear this may jeopardise their ability to secure further work with the organisation."
Figure 2: INNEX chat explaining AE role
In my research, AEs formed one of the most consistent groups. Unlike other levels, where knowledge behaviours varied widely, the AEs I interviewed were strikingly similar: long careers, deep technical expertise, and strong ties to professional bodies. To reflect this, I created the persona Michael Mentor.
Authorising Engineers typically bring decades of experience across design, installation, maintenance, and management. Many specialise in areas like medical gas pipeline systems, electrical safety, or ventilation. Most are fellows of professional bodies such as IHEEM, and many play an active role in updating HTMs and HBNs.
Their knowledge-sharing habits are shaped by their position:
But their independence also creates problems. AEs often can’t access core NHS platforms. The NHS Futures Collaboration Hub, for example, is closed to anyone without an NHS email address. That means the very experts tasked with keeping systems safe are locked out of official knowledge-sharing spaces. Instead, they depend on personal contacts, phone calls, and conference side conversations to stay in the loop.
Figure 3: Persona profile of Michael Mentor (numbers in brackets show anonymised interviewee codes)
Authorising Engineers act as knowledge bridges: linking Trusts, mentoring Authorised Persons, and providing impartial oversight. Without them, the NHS would struggle to keep pace with evolving compliance standards.
The challenge is demographic. In my Delphi study, 80% of AEs were over 55, with few successors coming through. That means decades of expertise could disappear in a short space of time.
AEs also face structural barriers. They’re excluded from NHS collaboration hubs that require an NHS email, cutting them off from official knowledge-sharing spaces. From their vantage point across multiple Trusts, they see recurring problems but lack a formal way to feed lessons back into the system.
Several of the AEs I interviewed were clear about the gaps they see in the current system. One recurring idea was the creation of a national skills register. At present, training records and competencies are held locally by individual Trusts, making it difficult to see who is qualified to advise on a particular technical issue. A central register, they argued, would allow expertise to be identified quickly - whether it’s for a compliance review, a major incident, or simply to mentor less experienced staff.
Another strong theme was the need for a shared platform where lessons and near misses could be exchanged across Trusts. At the moment, those insights often stay within local teams, passed informally or buried in internal systems. Because AEs are external, they have an unusual vantage point: they see patterns repeating across multiple organisations but have few formal channels to share those lessons back into the system. Current NHS collaboration hubs, such as the NHS Futures platform, are closed to them because access requires an NHS email address. As a result, the very people tasked with safeguarding compliance are excluded from the official knowledge-sharing spaces.
The Authorising Engineer may sit outside the Trust hierarchy, but the system cannot function without them. Their independence is what gives them value, yet it also leaves them excluded from official channels of knowledge exchange. Bridging that gap is urgent.
If the NHS wants resilient estates and facilities, it needs to capture the knowledge of today’s AEs before it disappears, and invest in platforms that let internal and external experts collaborate.
At INNEX, we’re working with both Trusts and AEs to build tools that make regulatory knowledge easier to access, audit, and share - closing the gaps that AEs themselves have been flagging for years.
Next week, I’ll move inside the Trust to explore the Directors of EFM: the people balancing national strategy, local budgets, and the daily realities of keeping the NHS running.
If you're interested in exploring how we can help transform your compliance workflows from bureaucratic burden to strategic advantage, reach out directly at carl@innex.ai.
Want to dig into the details? Read the full thesis here.