Estate solutions to deliver the Five Year Forward View

28-Aug-2015

How Community Health Partnerships is working with the NHS to make better use of the healthcare estate

Community Health Partnerships’ executive director and strategic estate planning lead, Antek Lejk, looks at the problem of underused space, its work in this area, and the challenges and opportunities it presents for the NHS

The NHS Five Year Forward View (FYFV) set out an ambitious plan for service transformation, with greater integration of primary and acute services and emphasising the need to offer patients a greater range of treatment and diagnosis in community hubs closer to home.

Building on this, NHS England announced a £1billion investment in primary care infrastructure at the start of the year to improve premises, help GP practices harness technology, and provide more space for improved care for the elderly.

NHS devolution, co-commissioning and the Vanguard projects are, in particular, demanding rapid estates responses. Add to that the need to respond to the biggest financial challenge in a generation, and you can see why the momentum is building.

Smart and innovative use of the public sector estate will be key to success.

Ancoats Primary Care Centre is among the new facilities developed to enhance services in Manchester

Ancoats Primary Care Centre is among the new facilities developed to enhance services in Manchester

Having the right estate in place is critical to improving services and responding to the challenges the health sector is facing. That estate needs to be well planned, well utilised and efficiently run in order to offer good value for money and to be able to deliver the changing models of care to respond to the challenges set out by the FYFV.

Having the right estate in place is critical to improving services and responding to the challenges the health sector is facing

Community Health Partnerships (CHP), an independent company wholly owned by the Department of Health, has worked with the NHS, central and local government, and private investors over the last 11 years to improve the health of local communities through better estate. Targeting investment and resource, CHP works to generate lasting improvements that have a wide-reaching impact on wellbeing in an area.

In line with the FYFV, CHP’s Strategic Estate Planning (SEP) Programme delivers strategic estate solutions, savings, service improvements, new models of delivery, and greater integration, with a focus on:

  • Making better use of buildings, including driving out voids and rationalising occupation
  • Refurbishing buildings to improve conditions and accommodate change of use
  • Developing high-quality new facilities offering value for money
  • Disposing of un-needed estate

Transforming services in this way involves many partners, so CHP uses Local Estate Forums as part of the commissioning redesign process. These forums bring all the key players together, including CCGs, service providers, trusts, local authorities, and community stakeholders, to:

  • Understand the existing estate
  • Understand the estate needs that fall out from commissioning plans
  • Put together deliverable implementation plans to create the new fit-for-purpose estate

The benefits of Strategic Estate Planning spread far and wide beyond cost savings. For example, better rationalisation of the estate can free up areas of land for much needed housing. New or refurbished buildings can also offer flexible space suitable for a range of leisure and wellbeing services, alongside healthcare, improving local connections and cross-referral opportunities, as is happening at many of the 300-plus buildings in CHP’s portfolio.

Case Study: Making the best use of NHS buildings

CHP has helped Greater Manchester’s 12 CCGs each develop a Strategic Estates Group (SEG), the area’s version of a Local Estates Forum (LEF).

In North Manchester CCG, for example, CHP joint funded utilisation studies showing that modern primary care centres have considerable scope for accommodating additional services – utilisation rates averaged 59% for clinical space. Under utilisation was costing the public sector over £900,000 annually in wasted space.

The work has highlighted a fantastic opportunity to move services out of ageing infrastructure into up-to-date facilities while saving money. For example, it’s now clear where the CCG could locate four bases for district nursing teams plus palliative care services in community settings closer to patients’ homes. This groundwork in strategic estate planning across the 12 CCGs offers a good foundation for conurbation-wide thinking as Greater Manchester takes on its devolved responsibilities for health and social care.

Studying estate utilisation in North Manchester is highlighting numerous buildings – many underused – that could provide bases for these closer-to-home services

Simon Wootton, CCG estates lead for Greater Manchester NHS and chief operating officer ar North Manchester CCG, said: “Studying estate utilisation in North Manchester is highlighting numerous buildings – many underused – that could provide bases for these closer-to-home services.

“In the longer term, I want to examine utilisation across all of Greater Manchester’s public sector, including the NHS, libraries, leisure centres, schools, police and the fire service. We could develop the public sector equivalent of LateRooms.com, with centralised booking facilities for meeting rooms, thus maximising use of the Greater Manchester estate.”

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CHP’s Strategic Estates Planning service aims to address the considerable opportunities for the NHS to:

  • Use the existing estate more effectively
  • Reduce running and holding costs
  • Extend opening hours across the week
  • Reconfigure the estate to better meet commissioning needs
  • Share property (particularly with social care and other public sector partners)
  • Dispose of surplus estate to generate capital receipts for reinvestment
  • Ensure effective future investment

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