A recent Health Service Journal article spotlights a number of pressing issues many NHS Trusts are facing; breakdowns in contract management, blurred responsibilities between Trusts and their estates department or their subsidiaries, and escalating estates-related costs. The review of King’s College Hospital Foundation Trust revealed a “culture of blame,” weak contract oversight, and procurement practices risking non-compliance — all within the context of growing financial pressure. This is not an isolated case.
TIAA have been providing specialist business assurance services to the NHS for nearly 30 years and we understand the operational and financial challenges your Estates function may be under — particularly around rising maintenance overspends. We have seen how such issues can erode value for money, create governance risks, and limit a Trust’s ability to deliver efficient, high-quality services.
To help address these challenges, we can offer two distinct but complementary review services, designed to give you actionable insights, restore control, and support better decision-making.
Maintenance Diagnostic Review – High-Level Health Check
A structured, top-down assessment of your estates maintenance governance, controls, and risks. Key areas covered include:
- Governance and Oversight: Clarity of roles and responsibilities between the Estates function or subco, Finance, and Procurement.
- Financial Control: Budget setting, cost tracking, variance analysis, and responsiveness to overspend signals.
- Procurement and Contracting: Effectiveness and compliance with your procurement strategy and overview of the contract management arrangements.
- Value for Money Framework: How VfM is assessed, documented, and monitored.
- Operational Assurance: Post-completion reviews, QA processes, and issue resolution mechanisms.
We present findings in a concise dashboard report identifying key risks, gaps, and opportunities for improvement.
Deep-Dive Investigation – Targeted Cost and Controls Review
A focused, forensic review where particular suppliers, contracts, or cost areas are showing overspend or performance concerns. Areas we can examine include:
- Procurement Compliance and Audit Trail.
- Supplier Vetting and Framework Usage.
- Subcontractor Oversight and Variation Management.
- Authorisation and Payment Controls.
- Contingency Usage and Cost Drift.
- Compliance with contract terms.
- Verification and Quality Control of Completed Works.
- Benchmarking and Value Testing.
Our aim is to uncover root causes, identify control weaknesses, using our data analytics tools and to offer pragmatic recommendations that can deliver savings and assurance.
Whether your Estates Team needs an overarching review, a targeted investigation, or both, we can tailor our support to meet your immediate challenges and align with your strategic objectives.
We would welcome a conversation to explore your needs further and shape the right level of support.
For more information – please contact us
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