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Community Healthcare Estate: progress or a missed opportunity?

28 March 2014

With the first anniversary of the official launch of the government's flagship reorganisation of primary healthcare fast approaching what impact has it had on new estate development?

Following the dissolution of the Primary Care Trusts it was deemed unsuitable to transfer the estate to the Clinical Commissioning Groups and as a result NHS Property Services Limited (NHSPS) was created.

NHSPS now exists alongside Community Health Partnerships (CHP) (the wholly owned government company set up to manage the government's investment in the Local Improvement Finance Trust (LIFT) programme). With a few exceptions all properties developed as part of the LIFT framework were transferred to CHP, and all remaining properties were transferred to NHSPS. 

The concept of two national (although the Department of Health has already announced that NHSPS and CHP will be merged in due course) estate holding bodies is a positive step. Such a  move allows the department and those companies to work together to properly plan the primary healthcare estate on a local, regional and national scale.

For too long healthcare estate has been poorly planned. Primary healthcare buildings should be accessible, available when required and flexible.

CHP and NHSPS have a huge opportunity and responsibility to remodel primary estate. The LIFT Framework and independent of it other models of development, have to some extent started this process. However, the process has a long way to go.

Following the changes NHS England introduced a new approvals process for all projects. There is little evidence to date that the new approvals process is helping to speed up the delivery of a lengthening pipeline of new primary healthcare developments. Add to this the remaining budget uncertainty for the organisations involved and delays in delivery of new premises are not being reduced.

Delivery of the pipeline is essential to ensure that primary care services can be delivered properly and cost effectively. More importantly the clinicians and users of the NHS require and deserve the use of a fit for purpose and modern estate.

Now is the time

The cost of borrowing money has never been lower and the fear of many in the industry is that an opportunity is being lost. Interest rates will not remain low forever. New primary healthcare estate is required and now is the time to procure it.

The government is looking to save money within the NHS and reduce the size of its budget and most experts accept that moving some services out of the acute hospitals and into the community will help to achieve this.

However, the Estate has to be fit for purpose in order to do so. It is therefore essential that all interested parties including the Department of Health, NHS England, NHSPS, CHP and their private sector partners work together to speed up the process before the cost of delivering these new premises rises.

Currently the opportunity is being missed however it is not too late. Sometimes money has to be spent to save money in the long term and now is the time. The structures are in place and there are many good people involved who care passionately about the NHS but the Department and politicians need to realise the opportunity. Further delay would be unacceptable.