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Infrastructure challenges faced by the NHS

Infrastructure challenges faced by the NHS

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Almost one year on from the publication of the Naylor review, Simon Bourke, Healthcare Sector Lead, reflects on what this has meant for the industry and the move to transform the NHS estate.

It is no secret that the NHS is under great pressure and this winter we have seen reports yet again that the service is in crisis as bed shortages, makeshift wards and the cancellation of non-time-critical operations hit the headlines.

Solving the problems and reducing the strain on the NHS therefore remains high on the political agenda.

In March 2017, building on the 2016 Lord Carter review, Sir Robert Naylor published his independent review undertaken for the Department of Health. This focused on NHS property and estates and more specifically how to make the best use of the buildings and land, including raising money by selling underused space and premises.

So, as we approach the one year mark following publication, it seems a good time to reflect on the implications for the industry as a result.

The Government’s, official, response to the Naylor review was to agree that infrastructure investment is needed (Boris Johnson also having said the same thing in his unofficial response).

Whilst there is commitment to increased capital funding, little of this is new money with much expected to come from asset receipts and private equity. One of the ways of trying to achieve this was by tasking the Community Health Partnerships (CHP) with finding ways to address the infrastructure challenges faced by the NHS. They concluded that a new estates model is required that can deliver at speed, be flexible and uncomplicated, and meet service needs.

A new Public Private Partnership (PPP) has therefore been proposed. Project Phoenix will consist of six locally driven Joint Venture companies with national coverage to provide a transformational view of estates; not just new build but to provide expert end-to-end advice and to incorporate development, disposal, investment and asset management.

The model will aim to deliver Sustainability and Transformation Plans (STPs) and the CHP will be looking for expert skills that bring innovation and commercial knowledge to complement skills in the health sector and support the transformation of health estates.

However, there is a feeling in the industry that the planned terms and conditions of Project Phoenix are not amenable to the private sector and in addition Trusts may not necessarily welcome PFI by another name.

With the reticence of the Government to provide any significant increase in infrastructure funding, many Trusts will have to consider innovative ways of delivering the STPs by developing wider system improvements and efficiencies to support the delivery of health and well-being. This will include optimising their available assets and land through partnering with businesses that can bring complimentary skills and funding mechanisms to instigate the much needed improvements.

Image: courtesy of VINCI Facilities

Infrastructure challenges faced by the NHS