COMMENT: Is there still life in LIFT?

THE coalition government is seeking to bring about a paradigm shift in the nation’s approach to public services, particularly to the NHS. What we are now witnessing is a once-in-a-lifetime event on a scale that probably could not have been delivered by the Conservatives alone without the support of their coalition partners the Liberal Democrats - the political challenge would possibly have been too big for one political party to act alone

Reform of public services is one side of the coin of the coalition government’s priorities; the other being deficit reduction. Cameron and Clegg, Osborne, Gove, Letwin and Lansley are committed to them both, since they believe that one cannot be delivered without the other. The old way of centrally predicting, providing, controlling and funding can neither deliver the improved services now demanded, nor be afforded in the long term.

The old way of centrally predicting, providing, controlling and funding can neither deliver the improved services now demanded, nor be afforded in the long term

As this caravan of substantial change passes through the nation, private providers and the wider LIFT community have choices to make. They can stand on the sidelines, bedazzled and entertained; they can sweep up behind the parade picking up what they can once it has passed; they can join in, climb aboard the bandwagon and go along for the challenging ride; or they can engage with the policy-making process, and contribute to the direction of travel.

What all businesses, indeed most organisations want, are clarity and certainty. The absence of both undoubtedly makes this a troubling time, since there is clearly much yet to be resolved. But we can, of course, still summarise what we already know with a reasonable degree of confidence, and predict what the future may hold.

First, senior officials within the Department of Health will reach a decision about their recommendation to ministers about the future of primary care estate. Ministers will then consider that advice, make their own policy decision, and make more detailed announcements, probably in March.

But that announcement might still not give the certainty which we crave, and in its uncertainty may be both the opportunities and threats that we face.

The current PCT estate must be kept safe for patients and staff during this transitional period. Irrespective of who is it is owned by, it must be managed effectively and efficiently and this is a job of work that needs to be clearly allocated

The current PCT estate must be kept safe for patients and staff during this transitional period. Irrespective of who is it is owned by, it must be managed effectively and efficiently and this is a job of work that needs to be clearly allocated.

For the PCT’s residual estate we should refresh our memories of what it is that the LIFT Council has been arguing, since I believe that in substantive part it may yet be delivered.

Our contention, consistently deployed since the Government first announced its proposals for change in last summer’s White Paper, remains that successful delivery of the Government’s objectives for the reform of the NHS will be best achieved by placing responsibility for every aspect of decision-making with an expert asset manager who has the requisite knowledge and skills in that area.

We support an approach that places commissioning responsibility in the hands of clinical experts. We believe that to undertake their role as effectively as possible they need the support of an expert asset manager.

Not only through LIFT, but for private sector partners more widely, the changes to the NHS open up huge windows of opportunity

If this support is available it is far more likely that appropriate infrastructure will be provided so that the chosen models of care are actually delivered by an appropriate range of clinical providers; so that estate, when properly managed, becomes a means of delivering service reconfiguration and improvement, not a barrier to change. Reductions in wasted expenditure by focusing on issues such as utilisation levels will also deliver benefits to the NHS and taxpayer alike.

LIFT is already referenced in the Health and Social Care Bill as an option for estate management and ownership, and we are hopeful that ministers will endorse that positioning of LIFT as a vehicle to which the local NHS community should look. We do, however, acknowledge that if the local NHS finds that the local LIFTCo, or neighbouring LIFTCos, are unable or unwilling to take on that role, it will be able to look elsewhere too.

Not only through LIFT, but for private sector partners more widely, the changes to the NHS open up huge windows of opportunity.

Through the turmoil of a General Election, the unprecedented outcome of a coalition government confronting the biggest economic recession in history, and the largest reforms of the NHS since its inception, LIFT has remained a key player.