It is widely recognised that much of the healthcare estate is ageing, faces a challenge to stay for fit for purpose, and we can no longer rely on direct public funding or PFI for capital investment to address this.
According to the Naylor Report over 18% of the NHS estate pre-dates the NHS, and the annual estate maintenance bill in 2016 alone exceeded £5bn. However, the biggest opportunities are in adapting and/or leveraging the NHS estate to support integrated health and social care and to, improve public health.
Immediate opportunities for optimising the NHS Estate include:
The NHS does not need to do this all itself. Investors, developers, charities, social enterprise organisations and private providers all stand ready to work with the NHS on these opportunities to create fit for purpose estate and recognise clear mutual benefits.
These parties can help the NHS create compelling business cases, aligning with business and enterprise outside the traditional bounds of public healthcare to mutual benefit. And they generate parallel activity which can play an important role in improving the general population’s health and wellbeing.
Funding and financing and the design and delivery of new buildings are actually the easy bits! Complications arise as the NHS moves to an integrated care system model, where lining up multiple bodies across primary, acute, and social care as well as commissioners.
To enable this, NHS organizations will need to provide clarity of governance, clear clinical strategies and service plans and above all demonstrate an openness to new approaches and new partners. This will require new systems, leadership skills and recognition of the investment of time required.
We have been fortunate at Arup to work with the NHS on many exciting projects. Our design expertise is currently playing a major role in the completion of the Christie Proton Beam Therapy Centre, and I am have been personally involved in developing the business case for a proposed new National facility at the Defence and National Rehabilitation Centre in Loughborough, UK.
Our experience working alongside the NHS as well as similar work in other countries around the world suggests that this is a wholly achievable vision. I am looking forward to making the case for this collaboration at the Health Show and meeting with colleagues in and outside the NHS discuss how we can all make this change possible.
Katie Wood, Director, Operations Consulting, Arup