NHS reforms force estates bosses to rethink plans for six new health centres in Bolton

Published: 28-Sep-2011

A LACK of cash and the introduction of GP-led commissioning have resulted in NHS Bolton announcing plans to scrap at least a third of its proposed estates improvement works.


In June 2008, the primary care trust published its strategic service delivery plan, Building Better Health for Bolton, which set out proposals for 10 new health centres in the area. However, just three years later, the coalition government’s planned NHS reforms mean the strategy is being scrapped, with six of the buildings yet to be delivered.

It is clear the PCT will cease and staff numbers can be expected to diminish more or less gradually over this period. The requirement for office space will be significantly reduced

The agenda for an estates meeting held at the trust’s headquarters stated: “When the UK economy entered a substantial downturn in 2008, our pragmatic response was to lengthen the timescales for our plans, making them more compatible with slower funding growth, but not to alter our fundamental direction.

“Now, however, on top of changed financial circumstances we have a fundamental reform of NHS organisations, with the demise of the PCT in 2013 and the beginning of a transfer of community health buildings. GP-led clinical commissioning groups will take over commissioning over the next year or so and they will inevitably want to develop their own views and priorities for the community estates. The PCT will therefore call a halt to its published estates strategy.”

Overall four of the 10 buildings are already operating or about to open, delivered through the NHS LIFT procurement route with construction partner, Eric Wright Group. These represent 16,000sq m from a planned total floorspace of around 24,000sq m - or two thirds of the buildings originally proposed. If today’s committee agrees to scrap the plan, the PCT will begin an estates utilisation review, considering how well it uses other buildings in its portfolio.

GP-led clinical commissioning groups will take over commissioning over the next year or so and they will inevitably want to develop their own views and priorities for the community estates. The PCT will therefore call a halt to its published estates strategy

The agenda stated: “The local health economy faces tough challenges if it is to meet the system reform and savings required of it under the NHS White Paper. A key part of the strategy to meet these challenges is to review the utilisation and suitability of the current and future estate and our ability to maximise the utility of this valuable asset while retaining the flexibility required to meet changes in service need and delivery.

“This work needs to look further than just the utilisation of space; it needs to look at the estate holistically to ensure it is not just well used, but is fit for purpose, located as close as possible to the population it serves, and has the flexibility to cope with changes in demand or changes to care pathways and service delivery.”

The review will be completed by the end of February 2012, after which the PCT will draw up an outline business case reviewing its options and testing the affordability and deliverability of any schemes highlighted as being critical to future services.

This business case is expected to clarify the trust’s position in relation to plans for health centres in Avondale and Farnworth, which were due to be the next buildings commissioned. Decisions will also need to be made on what will happen to the PCT headquarters when the organisation is dissolved in 2013. The agenda stated: “It is clear the PCT will cease and staff numbers can be expected to diminish more or less gradually over this period. The requirement for office space will be significantly reduced.

“There is an immediate opportunity to reduce the headquarters estate, which must be seized. There may also be other ‘quick wins’ to contribute to challenging QIPP targets for the organisation.”

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