The 24-hour post-modern society in which the NHS delivers healthcare today in the UK as a business has resulted in purchasers and providers of non clinical/FM services
continuing to face more and more service delivery and operational risks (Payne and Rees, 1999). These business risks are mainly caused by uncertainties in customer supply and demand service chain, limited support resources (human, capital, modern healthcare facilities and information technology) and the dynamic NHS service scape (environment).
This has resulted in non clinical service decisions being reached in an ad-hoc manner and often with no effective business strategy. Furthermore, this approach has led to disastrous business planning and caring consequences, particularly in a highly politicised and consumer-sensitive environment like healthcare service provision (Wagstaff, 1997). These risks are also mainly attributed to the apparent lack of best practice guidelines that are available to assist FM service operators in identifying and managing non-clinical service operations effectively. In addition, there is evidence from NHS literature that clearly indicates the lack of best practice models for managing business risks associated with hotel, estates and site (non-clinical/FM) services delivery (Okoroh et al., 2000; DoH, 1999; CFM, 1993; Smith, 1997; Featherstone, 1999; HFN 17,1998). To date, no research has been carried out in the NHS using FM service operators' (domain experts) knowledge to develop an integrated risk management system for managing non-clinical services using modern business approaches. This thesis presents research findings from healthcare executives and FM experts on business risks faced by service operators (purchasers and providers) when managing non- clinical services effectively in the UK NHS. The research methodology used were, a detailed analysis of a best practice hospital case study, structured interviews with domain healthcare FM experts, pilot and major questionnaire surveys and Repertory Grid interviews. The research has established that in managing non clinical/FM services in the NHS, there are seven major common management-related risk classes identified as critical; customer care; financial and economic; commercial; legal; facility-transmitted; business transfer and corporate. Further research using second factor analysis established that these classical non-clinical risk factors could further be subdivided into forty-eight (48) constructs/sub-attributes highly rated by healthcare facilities executives. Using these risks factors and sub-attributes the research has developed a decision support system for risk management that can be used by FM operators to manage business risks in NHS trust hospitals.