From blind spots to smart spaces: How data and IoT are transforming NHS estate efficiency

Authored by Becky Allen, Healthcare Solutions Lead at MRI Software

The NHS is under growing pressure to deliver more with less. Yet, a recent investigation revealed that £4 million in property taxes has been spent on 77 unused NHS buildings over the past three years – including hospitals, GP surgeries, and office blocks. These sites represent not only a financial drain, but a missed opportunity to improve care delivery and operational efficiency. The total value of the neglected estate is estimated at £40 million.

This challenge highlights a critical issue: lack of visibility into how NHS estates can be utilised efficiently. Without accurate, real-time data, NHS organisations struggle to identify underused assets, take timely action, and optimise space to meet growing clinical demand. Fortunately, the tools to address this are already available.

Data-driven decisions: The role of IoT in estate optimisation

MRI Software work with over 150 NHS Trusts every day to support estate transformation through IoT-enabled analytics. By deploying discreet sensors across facilities, Trusts can monitor occupancy, footfall, and usage patterns in real time. This data enables estate teams to:

• Identify void space in real-time, allowing Trusts to consolidate services, sublease additional areas, or repurpose underused zones for clinical delivery before they become financial liabilities. For example, administrative offices or storage rooms with consistently low occupancy can be repurposed into consultation rooms, treatment spaces, or diagnostic suites helping Trusts meet estate optimisation targets while improving patient access and flow.
• Optimise patient flow by detecting bottlenecks in high-traffic zones such as outpatient corridors and A&E.
• Align staffing and cleaning schedules with actual usage, improving operational efficiency and infection control.
• Support sustainability goals by linking occupancy data with energy consumption to reduce waste.

The cost of inaction

A recent freedom of information request uncovered that £40milion was spent on property tax for neglected buildings, which could pay for around 120 junior doctors or 140 newly-qualified nurses. While some of the 77 buildings are earmarked for sale, others remain in limbo costing the NHS thousands each month in rates, maintenance, and energy.

This is not an isolated issue. A 2022 report estimated £1 billion per year is lost to wasted NHS estate space, including leased buildings later found to be unnecessary. With non-clinical areas occupying over 33% of NHS space, well above the 30% target, highlighting that Trusts must act decisively to optimise their estates.

Strategic repurposing and smarter space use

MRI’s estate optimisation tools support NHS organisations in repurposing underused space for clinical delivery, staff accommodation, or revenue generation. Strategies include:

• Hybrid working models that reduce the need for fixed desks and offices.
• Digitisation of records to free up storage areas for clinical use.
• Subleasing surplus space to medical students or community partners.

These approaches not only reduce operating costs but also improve patient experience and staff wellbeing.

Energy efficiency and net zero alignment

Empty rooms don’t just waste space, they also waste energy. Heating, lighting, and ventilating areas not in use contributes to avoidable carbon emissions and inflated utility bills. By integrating visitor data and behaviour trends with energy management software, Trusts can align energy use with actual demand.

For example, pairing footfall analytics with energy data allows Trusts to identify patterns such as high overnight energy consumption in low-use zones, prompting targeted interventions that reduced costs without compromising care.

Next steps for NHS leaders

With Green Plans submitted and expectations rising, the healthcare sector is entering a new era of accountability. Key steps include:

• Capturing accurate utilisation data using IoT sensors and analytics platforms.
• Setting evidence-based targets aligned with NHS benchmarks.
• Engaging stakeholders with clear visualisations and business cases.
• Leveraging external expertise through MRI’s managed services.

MRI Software already works with leading NHS Trusts, including King’s College Hospital, to deliver these solutions combining live demonstrations, training, and real-world case studies to show tangible impact.

Smarter estates, better care

The £4 million spent on empty buildings is a symptom of a deeper issue: a lack of visibility. But with the right data, tools, and mindset, NHS estates can be transformed from a financial liability into a strategic asset supporting better care, lower costs, and a more sustainable future.