This report shares some novel and exciting ideas for raising capital, and locally effective and accountable ways of using it, that take into account future, as well as present, need.
Here we highlight a number of important points from the report:
The NHS is asset-rich in terms of land and property, so it should emulate the successful property empires such as the Duke of Westminster's Grosvenor Estate or even the Crown Estate, to leverage steady and significant revenue streams, rather than simply selling off the family silver. Estate management and other joint ventures can help leverage revenue and provide cheaper and efficient alternatives to PFI managed estates.
A larger capital allocation – perhaps as much as £10 billion per year – is needed to match European averages. This could be derived from a range of sources, including bonds, the Treasury, leveraging NHS property and private partnerships.
There is evidence of innovation, but it requires a commitment from all sides and needs local joint working and planning, free from too much centralised control with an emphasis on taking into account future need. A steely approach to project prioritisation could provide greater clarity and focus.
There needs to be more and better training for NHS staff in capital and estate development and management, and less bureaucracy. This will enable the NHS to enter into novel partnerships with private sector investors, local authority partners and even housing providers in schemes that will provide a fitting environment in which to provide a world-class 21st century health service.
There need to be longer-term rental streams on NHSPS properties once they transfer to local NHS control. If NHS commissioners or trusts could guarantee rent for 20-25 years, this could provide an opening for more investment in clinical space.
And finally, doing nothing is not an option if we are to achieve a fit-for-purpose NHS estate and deliver on the Long Term Plan. Access to capital has to be prioritised to ensure delivery of what is needed: the key to this is change, not a continuation of the status quo.
Click here to download 'NHS Estates: Innovation and a sustainable future' in full.
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