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

TSSA welcomes vote backing HS2 phase 2

17/07/2019TSSA welcomes vote backing HS2 phase 2

The general secretary of the Transport Salaried Staffs' Association (TSSA) has described the decision by MPs to approve the second stage of the H... more >
County council approves £153m link road amid climate change protests

16/07/2019County council approves £153m link road amid climate change protests

Norwich county councillors have formally approved a new link road for the Norwich bypass, despite the environmental group Extinction Rebellion st... more >
Lewisham Council appoint new chief executive from Hackney Council

15/07/2019Lewisham Council appoint new chief executive from Hackney Council

Lewisham LBC is set to appoint Kim Wright, currently a group director at Hackney Council, as its new chief executive. Wright will take up th... more >

comment

Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
How community-led initiatives can help save the housing shortage

19/06/2019How community-led initiatives can help save the housing shortage

Tom Chance, director at the National Community Land Trust Network, argues that community-led initiatives are a productive way of helping to solve... more >
Aberdeen's green transport fleet attracting international attention

19/06/2019Aberdeen's green transport fleet attracting international attention

Aberdeen City Council’s hydrogen spokesperson, councillor Philip Bell, highlights the Granite City’s determination to play a leading ... 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

Digital innovation in the public sector: The future is now

17/12/2018Digital innovation in the public sector: The future is now

One of the public sector’s key technology partners has recently welcomed a new member to its team. Matt Spencer, O2’s head of public ... more >
Artificial intelligence: the devil is in the data

17/12/2018Artificial intelligence: the devil is in the data

It’s no secret that the public sector and its service providers need to invest in technology to help make better use of their resources. Bu... more >
New Dorset Councils CEO on the creation of a new unitary: ‘This is going to be the right decision for Dorset’

05/11/2018New Dorset Councils CEO on the creation of a new unitary: ‘This is going to be the right decision for Dorset’

The new chief executive of one of the new unitary authorities in Dorset has outlined his approach to culture and work with employees, arguing tha... more >

public sector focus

View all News
TSSA welcomes vote backing HS2 phase 2

17/07/2019TSSA welcomes vote backing HS2 phase 2

The general secretary of the Transport Salaried Staffs' Association (TSSA) has described the decision by MPs to approve the second stage of the High Speed Two (HS2) as “wise and welcome&rdq... more >
County council approves £153m link road amid climate change protests

16/07/2019County council approves £153m link road amid climate change protests

Norwich county councillors have formally approved a new link road for the Norwich bypass, despite the environmental group Extinction Rebellion staging protests on the steps of the County Hall. ... more >

the raven's daily blog

New rules to change the future of Social Value

05/06/2019New rules to change the future of Social Value

The government has announced the introduction of new rules to change the future of social value and make the way housing developers stump up the money for infrastructure both simpler and more transparent. These regulatory changes are designed to help achieve its ambition to deliver 300,000 extra homes per year by the mid-2020s.  ... 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 >