24 January 2019

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A healthy estate

Reconfiguring the NHS estate is going to require private sector support, whatever opponents might tell you
A healthy estate

The health sector is probably not the most favourable towards private finance in the UK at the moment. Whether it be issues around firestopping, car parking charges, or even the delays to two new builds caused by the collapse of Carillion, it's fair to say that the sector looks on the notion of privately financed buildings with a rather large dollop of scepticism.

However, that is only one side of the coin. After all, the Lift programme in primary care has been quietly going about its business for 15 years now and has largely proved to be uncontroversial with the general public.

And it is in primary care where the health estate is now increasingly focused, with plenty of attention on moving services out of acute hospitals and into the community. As technology changes, so will the ability for doctors' surgeries to provide more than just a consultation with the GP.

In this context, two roundtables held last week by Partnerships Bulletin, in conjunction with Addleshaw Goddard and gbpartnerships, have highlighted some of the important changes that need to be made within the market if a new vision of locally delivered health infrastructure can be made real.

What was striking about both events was the agreement from all those involved - from both the public and private sectors - that private investment will prove to be a vital piece of the puzzle. While both events - one held in London and one in Manchester - focused on the notion of devolution, it was clear that unlocking opportunities for private sector investment remains a big hurdle within the market.

Equally as clear, from both events, was the belief that one key to unlocking this investment is to improve the leadership within the NHS, so that local health professionals are empowered to make decisions on the future of their estate. Many participants felt that this failure to devolve such powers - or in some cases devolve it in a way that made it easy for people to abdicate responsibility - is something that must be addressed.

However, it is important to note that, during both sessions, there was a feeling that the answer to tackling the health estate is not simply freeing up the private sector to build more buildings. We are no longer in the times of simply building large new acute hospitals across the country, and many trusts are using innovative estates partnerships to consolidate and reconfigure their estate to make it more efficient and effective for modern health investment.

As part of this, it was agreed that utilisation will be a key watchword for the health industry over the years to come, as buildings' potential needs to be maximised. This could even result in a complete revolution in the way health professionals interact with their buildings, making greater use of lease structures and flexible buildings that can be reconfigured quickly to changing needs.

Despite these core themes running through both events, it was also interesting to note that there were some significant variations in the discussions in the two places. That may well be an indicator that devolution is happening across the estate, resulting in different localities finding different issues to tackle.

A write-up of the two roundtable sessions, plus the thoughts of sponsors gbpartnerships and Addleshaw Goddard, will feature in a special 'Big Question' supplement

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A healthy estate

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Reconfiguring the NHS estate is going to require private sector support, whatever opponents might tell you

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