Future looks bright for healthcare construction and design industry with adaptation of NHS LIFT

Despite widespread criticism of PFI over recent months, the scaling down of major hospital schemes, and an increasing lack of capital due to government cutbacks, the industry is still providing opportunities with the continuation and adaptation of NHS LIFT.

Speaking to BBH this week, David Pokora, executive director of The LIFT Council, denied the approach was losing momentum in the current climate, claiming that, in contrast, it could provide the answer to the needs of healthcare trusts in the newly-reformed NHS landscape.

I believe LIFT certainly still has a place in the healthcare marketplace and that there are opportunities for both the NHS and the LIFTCos

NHS LIFT - Local Improvement Finance Trust - was first launched by the Department of Health in 2000 to develop and encourage a new market for investment in primary care and community-based facilities. The buildings are refurbished or built and maintained by a local LIFT company (LIFTCo) - a joint venture between the public and private sectors that has the responsibility for leasing facilities back to the primary care trust and maintaining the premises over the long-term.

Once established, the LIFTCo can be used many times, meaning that the various private sector partners become increasingly adept at working together.

Pokora said: "I believe LIFT certainly still has a place in the healthcare marketplace and that there are opportunities for both the NHS and the LIFTCos.

LIFTCos are perfectly placed because they can access private capital, they are well established, and they are seen by banks as less of a risk than a completely new company

"We know the health service has to start to move patient care out of hospitals into more local settings or people's homes and to do this we are going to need investment in facilities. LIFTCos are perfectly placed because they can access private capital, they are well established, and they are seen by banks as less of a risk than a completely new company. They are there already and I think they have a real role to play in helping the NHS deliver improved care for patients at a lower cost."

While he admitted the pace of development seen in the healthcare industry over the past decade was slowing down considerably, he added that LIFT had the advantage of concentrating on relatively low-cost schemes - up to around £20m - unlike PFI, which has been used to fund developments worth hundreds of millions of pounds.

He said: "In times of financial constraint we do not go out to buy a new house, but we might get a new TV. Life continues, but on a smaller basis, and that is why LIFT is so well placed to help improve the healthcare estate."

He added that, as well as building and adapting infrastructure, LIFT was also likely to evolve in the new landscape, providing even more opportunities for industry.

The first of these is in developing local authority and joint NHS infrastructure. With the NHS reforms providing a more joined-up approach to commissioning health and social care, and with the drive to improve efficiency in the public sector, it is likely there will be more new buildings where councils and health trusts will cohabit.

Pokora said: "People tend to think of LIFT as just a Department of Health thing, but it is not. We are doing quite a few different facilities with local authorities already. The NHS reforms will increase this link between local authority and healthcare as we will have to think more holistically across each geographical area about the totality of community assets and how they can be more inter-related and work together with the aim of reducing the overall cost to the public sector. LIFT will have a real part to play in that."

The NHS reforms will increase this link between local authority and healthcare as we will have to think more holistically across each geographical area about the totality of community assets and how they can be more inter-related and work together with the aim of reducing the overall cost to the public sector. LIFT will have a real part to play in that

The first example of this approach, as BBH reported in May, is the commissioning a new leisure and health facilities in the London borough of Lambeth. Under the umbrella of the Norwood Hall Joint Service Centre, the £16.5m scheme will be delivered by a LIFTCo including Allford Hall Monaghan Morris architects and Building Better Health.

Commenting on the project, a spokesman for Building Better Health said: "With the work taking shape, it demonstrates the ability for the private and public sectors to work together in harmony to deliver a project of huge benefit to the community."

Pokora also hinted there will be opportunities in the future for LIFTCos to get more involved in the provision of medical equipment to the NHS.

He explained: "LIFTCos have a tried and tested supply chain that includes equipment providers. They have worked together in the past to equip the premises they have built and there are cases where they have provided a raft of clinical devices. The future of LIFT will be about flexibility and adapting to meet the demands of the marketplace. "If there is business to come out of the NHS reforms, it will be driving down the overall cost of healthcare and LIFT can definitely help with this."