The foggy future of the NHS primary care estate: NHS Property Services is predicted to be packaged up for a private sale – where does that leave public sector land?
The abolition of Primary Care Trusts from 1 April saw a huge swath of public sector land transferred to a new central government agency: NHS Property Services.
But the new organisation may be only a stopgap in the life of the health estate, according to Peter Coates, commerical director at the Department of Health. "NHS Property Services will last around three years, by which time we will have catalogued the estate and the future liabilities; and the chances to rationalise the estate," he says. "Decisions can then be made about whether we need a separate company operating in this area."
At that point, he says, NHS Property Services is likely to be merged with Community Health Partnerships (CHP), the agency in charge of Lift companies – private sector-led public/private partnerships building new primary facilities.
The new organisation might be packaged up for a private sector sale. "It would be unnatural for the government not to consider making money out of its property in current times," says Coates. However, he says that nothing has been decided yet, adding: "It would be quite difficult to sell it."
This raises the question of why NHS Property Services was created at all, when CHP was already doing a similar job in the areas of the country where Lift companies exist. Coates argues that it was important to insulate CHP from changes taking place elsewhere in the health sector, and the uncertainties these create. "It could get sucked down to the same level of uncertainty as the current infrastructure market otherwise," he says.
The government is currently undertaking two reviews of its estate. The first is focused on agreeing an appropriate cost of running with the occupants of the 4,000 properties that are within NHS Property Services' portfolio. The second looks at how the estate can be rationalised, beginning with 10 target sites.
Once these reviews are completed, the opportunities for reconfiguring the estate will become much clearer. "I suspect there will probably be new strategic reviews of the estate coming through, in much the same way as the Education Funding Agency has been doing with schools," says Robert Marr, director at technical consultancy Appleyards Groupe Artelia. "It may inspire funding from central government."
However, while a spokesperson for NHS Property Services says a capital programme is being developed, Coates warns that a comprehensive investment programme similar to the Priority School Building Programme in education is not on the cards.
"The devolution strategy within the Department of Health means it is not tenable to do a centrally driven procurement," he says. "Instead, we will be empowering local people."
Experts agree that work at a more local level is likely. "In the months during which the PCTs have been winding down, projects have been put on the backburner, so opportunities will emerge," says David Hare at the Lift council.
But it remains unclear who will give the approval for any new project. "If the approvals process is handled centrally, the National Commissioning Board will have a significant amount of work, which will in all likelihood have an impact on how quickly we can deliver schemes," warns Matthew Newing, a partner at law firm Speechly Bircham.
"The people who are best placed to determine what they need are the clinical commissioning groups [the GP consortia taking over commissioning responsibilities from the PCTs]," says Coates. "But it's not yet clear what the relationship will be between approval and sponsorship of projects."
It is unlikely to go via the department itself, though. "The Department of Health only looks at £75m-plus projects, or novel or contentious stuff." The vast majority of new primary care projects will be below that figure. Paul Jarvis is editor at Partnerships Bulletin The Guardian
The abolition of Primary Care Trusts from 1 April saw a huge swath of public sector land transferred to a new central government agency: NHS Property Services.
But the new organisation may be only a stopgap in the life of the health estate, according to Peter Coates, commerical director at the Department of Health. "NHS Property Services will last around three years, by which time we will have catalogued the estate and the future liabilities; and the chances to rationalise the estate," he says. "Decisions can then be made about whether we need a separate company operating in this area."
At that point, he says, NHS Property Services is likely to be merged with Community Health Partnerships (CHP), the agency in charge of Lift companies – private sector-led public/private partnerships building new primary facilities.
The new organisation might be packaged up for a private sector sale. "It would be unnatural for the government not to consider making money out of its property in current times," says Coates. However, he says that nothing has been decided yet, adding: "It would be quite difficult to sell it."
This raises the question of why NHS Property Services was created at all, when CHP was already doing a similar job in the areas of the country where Lift companies exist. Coates argues that it was important to insulate CHP from changes taking place elsewhere in the health sector, and the uncertainties these create. "It could get sucked down to the same level of uncertainty as the current infrastructure market otherwise," he says.
The government is currently undertaking two reviews of its estate. The first is focused on agreeing an appropriate cost of running with the occupants of the 4,000 properties that are within NHS Property Services' portfolio. The second looks at how the estate can be rationalised, beginning with 10 target sites.
Once these reviews are completed, the opportunities for reconfiguring the estate will become much clearer. "I suspect there will probably be new strategic reviews of the estate coming through, in much the same way as the Education Funding Agency has been doing with schools," says Robert Marr, director at technical consultancy Appleyards Groupe Artelia. "It may inspire funding from central government."
However, while a spokesperson for NHS Property Services says a capital programme is being developed, Coates warns that a comprehensive investment programme similar to the Priority School Building Programme in education is not on the cards.
"The devolution strategy within the Department of Health means it is not tenable to do a centrally driven procurement," he says. "Instead, we will be empowering local people."
Experts agree that work at a more local level is likely. "In the months during which the PCTs have been winding down, projects have been put on the backburner, so opportunities will emerge," says David Hare at the Lift council.
But it remains unclear who will give the approval for any new project. "If the approvals process is handled centrally, the National Commissioning Board will have a significant amount of work, which will in all likelihood have an impact on how quickly we can deliver schemes," warns Matthew Newing, a partner at law firm Speechly Bircham.
"The people who are best placed to determine what they need are the clinical commissioning groups [the GP consortia taking over commissioning responsibilities from the PCTs]," says Coates. "But it's not yet clear what the relationship will be between approval and sponsorship of projects."
It is unlikely to go via the department itself, though. "The Department of Health only looks at £75m-plus projects, or novel or contentious stuff." The vast majority of new primary care projects will be below that figure. Paul Jarvis is editor at Partnerships Bulletin The Guardian
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