Thirty years of experience, walking out the door.

“You’ve got a person that’s leaving after 30 years, and we normally don’t even get somebody in […] to shadow them for even a couple of weeks. So you’ve got 30 years worth of experience walking out the door.”

That is a Director of EFM with over 20 years in the NHS describing not a failure, not an incident, and not a worst case. He is describing normal practice.

Everyone in NHS Estates and Facilities Management already suspects this is happening. What has been missing is evidence. So we went looking for it. In cooperation with the University of Cambridge, we interviewed 19 experts across NHS Trusts, NHS England and the independent sector, with between 7 and 42 years of experience each. The question was simple: what actually happens to knowledge when people leave?

It is not a theory. It is a lived reality. Across 19 interviews, there was no dissenting voice. Not one participant argued that knowledge loss in the NHS is overstated.

One Director of EFM described departing staff taking “a phenomenal amount of information with them” that is “very difficult to capture.” An Assistant Director of Innovation put it more bluntly: “you’re going to lose a ton of information.” Senior exits were seen as especially costly, as a Project Director reflected: “I can think of a whole load of senior managers that have left the organisation and take so much out the door with them.”

Another Director of EFM summarised the consensus in a sentence: “I think undoubtedly people do leave with a lot of knowledge. I wouldn’t question that.”

When nineteen experienced professionals independently describe the same problem in the same terms, that is no longer anecdote. It is a finding.

The demographics are not on our side

Blog #1 in this series set out the numbers: 34% of the NHS EFM workforce is approaching retirement age, against 19% across the NHS overall, and only 5% are under 25. Our interviews show what those percentages feel like from the inside.

“Demographics is an industry wide challenge,” one independent consultant noted. A Procurement Specialist described an “aging workforce” with many colleagues “at the upper end of 50, even into their mid 60s.” A Director of EFM with 35 years in the sector observed that “the pool of people who hold that knowledge is forever diminishing,” and a consultant with 42 years put the arithmetic plainly: “There’s more people that got the knowledge and are about to walk away than there are people coming in to take it on.”

The intake is thinning at the same time. As an HR Specialist at NHS England explained: “We used to have really great schemes that were like apprenticeship […]. They don’t necessarily exist anymore, so we’re not filling the pipeline bottom in.”

As one Knowledge Specialist concluded, “it isn’t just for people who are stepping away through retirement.” That matters, because it removes the one comfort the retirement framing offers: predictability. You cannot plan a handover you did not see coming.

What it actually costs

Knowledge loss is not just an abstraction that shows up in a workforce strategy document. It shows up in budgets, in project timelines, and in the resilience of the estate.

One independent consultant was direct: “I’ve seen firsthand the cost, not just financially, but then just in terms of adding value, of getting that kind of knowledge capture wrong, and how that affects day to day resilience.” Others described “the impact of losing knowledge can be quite profound in some circumstances” and, more wearily, “we do suffer a bit from that kind of brain drain.”

The most consistently cited cost is rework. A Knowledge Specialist described “a risk of that reinvention of the wheel type activity”, while a consultant explained the mechanism: “you end up with a lot of inefficiency, because you’re almost redoing things and re-reviewing stuff that’s already been reviewed.” Bringing a successor up to speed compounds it: “if you’ve got someone that comes in new, I mean, it takes you months, if not years, to build up that knowledge.”

The same loss happens at the boundary between capital projects and operations. As one consultant explained: “in the NHS particularly, there is very limited digital handover. And if you don’t get the digital handover right, they reckon you’re losing about 30-40% of the life cycle information value at that point in time, at the beginning.” A building is handed over, and with it a third of what is known about how it works.

But the clearest evidence that this knowledge has real value is what Trusts are willing to pay to get it back. As one consultant observed: “people retire from estates departments, and they come back as a consultant for two or three days a week, and they’re probably being paid now more than they were when they worked there.”

The NHS is already paying for this knowledge, but at a premium, by the day, after the fact.

In healthcare, the stakes have a different shape

Every organisation loses knowledge when people leave. What makes NHS EFM different is what sits at the end of the decision chain. As one expert put it, the guiding principle is not complicated: “at the end of the day, we all want the best for the patient.” One consultant noted the difference this makes, “particularly when people’s lives are at the end of the decision.”

Decisions about ventilation, water safety, medical gas infrastructure and fire compliance sit inside a chain of accountability that can end in a courtroom. A Director of EFM with 35 years of experience acknowledged it openly: “ultimately, I could be called to court to justify the decisions that were made […] and I’d be remiss not to acknowledge that that influences my decision making.”

Another Director of EFM connected legal defensibility directly to knowledge capture: “If something happens on the estate and it causes a harm, then that’s me in court defending where we are. And the only way you can defend it is by having that absolute data in a system where you can go back to it black and white.”

Note what he is describing. Not a nice-to-have knowledge collection. A reliable repository.

Everyone knows. Nobody has the answer.

Here is the part of the research we did not expect. The problem is not that NHS EFM professionals are unaware of knowledge loss, or unconvinced it matters. They are acutely aware, and they are frustrated that awareness has not translated into anything that works.

A Head of Capital Projects captured it exactly: “It would be ideal to be able to have some way to sort of share all this information, but how to do it? I have no idea.” A Projects Manager agreed that “it’s really difficult to get that knowledge out.”

And a Director of EFM with 35 years in the NHS said the thing that stayed with us longest: “How do we capture it? And it frustrates the hell out of me because I can’t come up with an answer.”

That is not ignorance. That is a senior professional who understands the problem completely, cares about it deeply, and has no mechanism available to act on it. Which is a very different problem and a far more solvable one.

The bigger picture

Four things emerge from this evidence. Knowledge loss when experienced staff leave is real and broadly recognised across NHS EFM. It carries tangible operational and financial consequences, from rework to re-hired retirees. Those consequences are amplified by a healthcare setting where mistakes can be life-critical and decisions must be defendable years later. And despite all of this, no adequate solution has yet emerged.

The gap is not motivation. The gap is methodology and tools.

In the next post, we get more specific about what is actually being lost. “Historical knowledge” was the phrase almost every interviewee reached for first, and it turns out to be far too vague to build anything on. Underneath it sit three distinct types of knowledge, each requiring a very different response.

At CompliMind, we are working to close that gap — connecting people, knowledge, and systems so critical insights reach the right hands at the right time. Because the person with thirty years of answers is already halfway out the door.

Want to dig into the details? Read pages 38–40 in the full thesis here.