System Estate Strategies - it's what the NHS should be talking about

It’s hard not to feel despondent when you hear the word “capital” in the NHS. Having worked in this space for more years than I care to remember, I feel the same; a never-ending race from one capital pot to another, each the latest sticking plaster for the NHS’s worn-out estate.

With the creation of Integrated Care Boards (ICBs) comes an opportunity to rethink this approach to capital.? ICBs can consider estates across the system and truly align with a future clinical model that is inevitably community led and digitally enabled.?

Estates Strategy – that’s what we should be discussing!

ICBs have the ability to direct capital but if they are to make a difference, they need to deploy capital where it is most needed, not to who shouts loudest.

To do this, ICBs need to take a step back from the ever-growing lists of capital projects that are proposed by providers and determine what the health system needs for the future, alongside system partners.?

Value comes through the development of longer-term plans, estate strategies that can inform future needs.??

Approaching a system wide estates strategy should be done collaboratively and systematically by:

• Developing an ICB wide understanding of what estate even exists within the health system, with a clear view of future backlog maintenance and Net Zero Carbon investment requirements;
• Agreeing a collective view as to how the estate is best used and optimising key clinical adjacencies;
• Taking into account “contracted events” such as the impact of impending expiry of PFI and LIFT; and
• A realistic consideration as to the opportunity for generating local value through disposals.

This initial approach to a system estate strategy will enable ICBs to make informed decisions and break down the provider silos that currently exist. By answering these questions, ICBs will be able to create a framework for prioritisation that they can use with providers to ensure future capital schemes will not only address clinical need but also make best use of existing and often underutilised estate. With Black Friday in mind, it makes me think of the phrase “buy cheap, buy twice”...only built to last solutions will do!

Nicholas Lane John Stewart David Morris Kerry Dale Jonathan Clapton Beth Evans

#NHS #NHScapital #estatestrategies #nhsestate