We are UHB: Nick Rudge, Associate Director of Estates

University Hospitals Birmingham NHS Foundation Trust runs Good Hope, Heartlands, Solihull hospitals, Queen Elizabeth Hospital Birmingham, the Birmingham Chest Clinic, and Solihull community services.

I started out in a very different world to estates. After studying exercise physiology at university, I had dreams of working with elite sports teams. But when I graduated in 1999, opportunities in that field were scarce. So, I pivoted, landing on a graduate programme in banking and financial services in Bristol. I spent seven or eight years in that sector, eventually running my own business before selling it.

That’s when my career took a bit of a turn. My father-in-law, who worked in health and safety, offered me a role. I got qualified and worked with him for about 18 months before the recession hit the construction industry hard. That’s when I started looking for something new; anything different. By chance, I landed a role through an agency in the NHS in Wolverhampton. It wasn’t planned. In fact, it was Office Angels who got me in the door! That was 2009, and I’ve never looked back.

I spent two years in Wolverhampton before a role came up at what was then Heart of England NHS Foundation Trust, which was much closer to home. I started as a Health and Safety Manager within the estates department, then moved up to Compliance Manager, taking on responsibilities like fire safety and environmental management systems. Over time, I studied for a postgraduate diploma and MSc, both supported by the Trust, which really helped me grow professionally.

In 2021, I stepped into the role of Head of Health and Safety on secondment, which was my first trust-wide leadership post. It was a leap, but it gave me the experience and confidence to return to estates in a senior capacity as Associate Director. My current role brings together governance, business, and strategy; essentially all the pieces of the puzzle I’ve picked up along the way.

There’s no such thing as a “typical day,” but I try to strike a balance between being visible on-site and working from the desk. I split my time across sites like Heartlands, Solihull and Good Hope hospitals, and the Queen Elizabeth Hospital Birmingham. My work spans operations, capital projects, infrastructure, and decarbonisation efforts, all while ensuring compliance and performance meet Trust and legal standards.

It’s a role with a wide lens. I act as a connector between specialist leads, whether they’re responsible for operations, capital, or sustainability. There’s a lot of collaborative working, plenty of meetings, and even more report writing. But whenever I can, I get out on site to see the work in action. That boots-on-the-ground insight is invaluable. What I enjoy most is the variety. No two days are the same, and I get to work with a broad range of people. Whether I’m supporting a new capital project, discussing long-term strategy, or working through a governance issue, there’s always something new to learn or contribute to.

That said, the scale of the role is challenging. My remit covers workforce, finance, compliance, a lot of things. Keeping tabs on all the moving parts in a constantly evolving landscape isn’t easy. There’s also the strain of operating under financial pressure while trying to deliver safe, effective environments for patients and staff. And with ageing estates infrastructure, things like leaks and outdated facilities come up regularly.

We’ve also got new legislation like the Building Safety Act to contend with, which emerged following the Grenfell inquiry. It brings major changes to fire safety and building compliance, which we must now embed across all sites.

Currently, I’m leading a service transformation programme that I’m very excited about. It’s focused on filling long-standing vacancies, especially at Band 4 level, by upskilling our existing workforce and shifting roles to Band 5. We’re piloting it at Solihull Hospital, and already we’re seeing improved staff engagement and morale, even before any financial changes come into play.

The goal is simple: grow our own talent, retain a high-quality in-house team, and reduce our reliance on costly contractors. If we can get it right, the financial savings and cultural benefits for the Trust will be huge. And if it works in Solihull, we’ll roll it out to Heartlands and Good Hope hospitals, too. It’s about investing in people, and I think that’s where the future lies.

There’s a lot I still want to achieve. The decarbonisation agenda is a massive, morally driven mission, and with the NHS target of net zero by 2040, the work is both urgent and deeply meaningful. We’re seeing progress, especially in the decarbonisation project at Good Hope Hospital, and the A&E redevelopment at Heartlands Hospital, but there’s so much more to come.

If I could go back, I’d probably have joined the NHS sooner. But maybe everything lined up just as it should. What I do know is that I’m exactly where I want to be, helping shape spaces that support care, safety, and sustainability for everyone who walks through our doors.

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