Public Sector Property

08.09.16

The crown estate of health and care

Source: PSE Aug/Sep 16

Along with optimising land usage and promoting co-location, a radical new report makes the case for rationalising all local NHS estate into one body. PSE’s Luana Salles reports.

As with the rest of the public sector, estate management has been a key focus across the NHS in recent months. Whether that’s in the form of NHS England CEO Simon Stevens developing a plan to build affordable housing for staff on NHS land, or the Department of Health considering accepting land disposal receipts in exchange for lowering trust debt levels, it’s clear that much needs to be done to optimise the health service’s £31bn estate – which, at £7bn yearly management costs, is the third largest NHS expenditure after staffing and drugs. 

Perhaps in part due to this unresolved issue, a recent Localis report pitching a series of practical ideas to reform NHS finance was welcomed by several cross-party heavyweights, including London mayor Sadiq Khan, Lib Dem health spokesperson Norman Lamb MP, and NHS Confederation chair Stephen Dorrell. 

Barriers to transformation 

The report emphasised how the NHS estate is “vast but used inefficiently”, even despite government programmes such as One Public Estate. For example, it said a major East Dulwich Hospital site was granted outline planning permission in 2003, but has been left unused since the hospital closed down 10 years ago. 

This, the report argued, is both expensive and an obstacle to local transformation and new models of care – despite these being the health service’s hallmark ambitions for this Parliament. Better managed land would also create revenue-raising opportunities, either through one-off receipts or long-term income streams in redeveloped areas.

Nationwide rationalisation 

As well as sticking to higher estate management standards, as previously advocated by Lord Carter’s major review of NHS efficiency earlier this year, Localis said areas should consider rationalising all local NHS estates into one body. 

“As in Sweden – and similarly to Crown Estate – this could be transferred to a holding company structure that is arm’s length of the state, which then works alongside local authorities and one or more private sector partners,” the report argued. “Alternatively it could be led by a network of providers and local authorities working across a sub-regional geography, as is the case in north London.” 

Microcosmic examples of this are already cropping up around the country, most notably in London and Greater Manchester, the only two areas to sign up for a health devolution deal so far. Five north London boroughs have already agreed to collaborate in their estate strategy to share buildings. In Greater Manchester, the ongoing £6bn health devo implementation is sponsoring a city-wide reform of estates strategy, with an NHS Estates GM Delivery Team working alongside public sector partners to deliver an ‘One Public Estate approach’ to property management. 

One Public Estate and STPs 

Bruce Mann, the executive director of Government Property Unit, which oversees the nationwide One Public Estate programme, argued that the scheme is one of two possible routes to tackle the NHS estate problem, despite the Localis report arguing it is not delivering change “quickly enough”. 

Speaking to PSE, he said: “The NHS has not historically done as much as central government in terms of rationalisation and utilisation of land and property – although you’ll see from Simon Stevens that he’s got some very significant developments going forward to do more and better. 

“There are two ways of tackling the NHS estate. The first is through the One Public Estate programme, which is about saying to health bodies – and it is starting to happen now really quite well – in a locality: bring your assets to the table and let’s have a conversation. This is especially in the context of integrated health and social care and how we can best serve the citizen between local authority services and health services.” 

But Mann argued this must also accompany a top-down approach by the Department of Health and NHS England through their flagship sustainability and transformation plans (STPs), which bring together health and social care bodies to transform the entire care journey locally. “There’s been a lot of work over the last year within the health family looking at what estate they have got, and how it might be used in the future to meet projected clinical need,” he added, “and that will be brought together inside the STPs.”

Tell us what you think – have your say below or email opinion@publicsectorexecutive.com

Comments

There are no comments. Why not be the first?

Add your comment

 

public sector executive tv

more videos >

latest public sector news

Benefits of blockchain

23/07/2018Benefits of blockchain

Jonny Voon, innovation lead for Internet of Things & distributed ledger at Innovate UK, talks us through the many benefits of blockchain tech... more >
Industrial strategies: taking back control

23/07/2018Industrial strategies: taking back control

The ‘place-based’ focus of the Industrial Strategy will be a significant step towards growing local economies alongside LEPs, writes ... more >
Keeping it simple

23/07/2018Keeping it simple

Jason Waterman, deputy director of disputes & policy implementation at the Crown Commercial Service (CCS), describes the benefits of the stre... more >

comment

Benefits of blockchain

23/07/2018Benefits of blockchain

Jonny Voon, innovation lead for Internet of Things & distributed ledger at Innovate UK, talks us through the many benefits of blockchain tech... more >
Industrial strategies: taking back control

23/07/2018Industrial strategies: taking back control

The ‘place-based’ focus of the Industrial Strategy will be a significant step towards growing local economies alongside LEPs, writes ... more >
Keeping it simple

23/07/2018Keeping it simple

Jason Waterman, deputy director of disputes & policy implementation at the Crown Commercial Service (CCS), describes the benefits of the stre... more >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this... read more >

interviews

Data at the heart of digital transformation

03/04/2018Data at the heart of digital transformation

SPONSORED INTERVIEW Grant Caley, UK & Ireland chief technologist at NetApp, speaks to PSE’s Luana Salles about the benefits of movin... more >
GDPR: The public sector scarecrow

03/04/2018GDPR: The public sector scarecrow

SPONSORED INTERVIEW PSE’s Josh Mines chats to Martin de Martini, CIO of Y Soft, about what the General Data Protection Regulation (GDPR)... more >
Keeping London safe

05/03/2018Keeping London safe

Theo Blackwell, London’s first-ever chief digital officer (CDO), speaks to PSE’s Luana Salles about the role he plays in ensuring the... more >

public sector focus

View all News
Benefits of blockchain

23/07/2018Benefits of blockchain

Jonny Voon, innovation lead for Internet of Things & distributed ledger at Innovate UK, talks us through the many benefits of blockchain technology and its potential to disrupt almost every i... more >
Industrial strategies: taking back control

23/07/2018Industrial strategies: taking back control

The ‘place-based’ focus of the Industrial Strategy will be a significant step towards growing local economies alongside LEPs, writes Cllr Philip Atkins, County Councils Network (CCN) ... more >

the raven's daily blog

One step closer to voter IDs at elections

19/07/2018One step closer to voter IDs at elections

Chloe Smith MP, Minister for the Constitution, evaluates the outcomes of the voter ID pilots conducted at the last local elections. We are one step closer to strengthening the integrity of our electoral system through requiring electors to confirm their identity before they vote, building on the government’s commitment to safeguard ... more >
read more blog posts from 'the raven' >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the o... more > more last word articles >