Space equivalent to the entire footprint of Sainsbury’s stores in the UK, or 263 Premier League football pitches, is going to waste in the NHS, a survey has revealed.
While clinical change remains the biggest challenge and cost opportunity to the reform agenda, radical and concerted action is also needed to unlock latent capacity from its estate
The latest review of underused or wasted space within the NHS estate reveals that, although it reduced by 210,000sq m in 2010/11, there is still more than 1.9million sq m lying idle.
The figures come from the annual report by built asset consultancy, EC Harris, which estimates that by disposing of 50% of this unused space, the NHS could unlock £1billion in capital. A further £1billion could be saved through better procurement, improved third and fourth quartile FM performance, and efficiencies associated with land disposal. By simply decommissioning all FM services from 50% of the disused space, the NHS could save £228m alone, the report claims.
The majority of remaining unused space is owned by foundation trusts and is therefore not accessible to the Treasury to dispose of or seek savings through leveraging procurement scale
Author, Connor Ellis, said: “Progress on the health estate for the second year running is to be welcomed, but further improvements will be more difficult. While clinical change remains the biggest challenge and cost opportunity to the reform agenda, radical and concerted action is also needed to unlock latent capacity from its estate.”
Entitled, Shaping for the Future: Reforming the NHS Estate , this is EC Harris’s third annual report into the efficiency of the NHS estate and it highlights the need for local collaboration between foundation trusts.
Ellis said: “The majority of remaining unused space is owned by foundation trusts and is therefore not accessible to the Treasury to dispose of or seek savings through leveraging procurement scale. This means that local collaboration is more important than ever, with neighbouring trusts needing to work together to maximise the opportunities available to them.”
The report adds: “The NHS’s rainy day has come. We recognise that clinical change remains the biggest challenge and cost opportunity to the reform agenda, but radical and concerted action is also needed to unlock latent capacity from its estate and assets in order to keep improving healthcare outcomes with the limited funds available. Overall tariff reductions are here to stay, possibly for much of the next decade, so there remains little choice.”
Local collaboration is more important than ever, with neighbouring trusts needing to work together to maximise the opportunities available to them
The document highlights four key measures that will help to generate better health outcomes and financial savings. They are:
- Efficient asset management to unlock capital receipts: Based on NHS asset values, the NHS could conservatively provide a £1billion capital sum through selling off unused land
- Make savings by reducing the performance variation of NHS trusts: Savings of more than £1billion a year are possible across the NHS through standardising the cost of facilities management delivery between the best-performing and worst-performing trusts, the removal of FM services from disposed land and better procurement
- Encouraging greater collaboration between trusts and GP consortia: With policy changes on the horizon, and the need for efficiency of unused space likely to grow again, trusts and GP consortia in the same locality need to work together around the use of their property assets to realise the potential savings
- Improve clinical care and governance: There are hundreds of good providers in the NHS, but attention understandably focuses on the handful of really failing ones. There needs to be stronger and better governance to ensure standards of care and public value are achieved
It states: “Those trusts that do dispose of land can maximise the value by looking carefully at future clinical usage and being more radical on performance outcomes than in previous years. Such action will benefit all stakeholders and provide tariff compliance and minimise overheads, providing much-needed efficiency savings and/or re-aligning to clinical priorities for the NHS.
Surplus land costs money to maintain which is better used to directly provide healthcare services and contribute to the £20billion savings the NHS will deliver before 2015
This streamlined approach to estates management is supported by the Department of Health publication, Disposal Strategy - Land for Housing , which indicates the potential areas already considered by the NHS as 'no longer required’. This has been identified for disposal for housing over the next four years.
The report states: “Surplus land costs money to maintain which is better used to directly provide healthcare services and contribute to the £20billion savings the NHS will deliver before 2015. Identifying and disposing of surplus land in the NHS is therefore a win-win proposition for everybody.”
In total, the current NHS estate covers 7,461 hectares and if trusts want to sell off land they are expected to put this on the electronic Property Information Mapping Service (e-PIMS). There are currently more than 300 separate entries from NHS trusts on the register.
The DH report states: “The majority of the surplus properties identified by NHS trusts are likely to be used for housing, but there is a significant number that are likely to be used for other purposes eg commercial and community".
Click here for the EC Harris report
Click here for the Department of Health report