Health Service Focus

31.03.17

The shape of estates under STPs

Source: NHE Mar/Apr 17

NHE looks at the early proposals for estates efficiency already starting to emerge from England’s 44 sustainability and transformation plans (STPs).

While money (or a lack thereof) takes up most of the headlines in the national press, anyone who lives and breathes the NHS knows that reforming and upgrading its estates will be a critical step to harnessing significant service transformation. 

Last year, Lord Carter identified significant variation in how efficiently acute trusts make use of space – some have running costs of £105 per square metre, whilst others can be as high as £970 – and, more recently, the Health Select Committee argued that local health areas must assess the infrastructure investment needed to ensure 24-hour A&E departments are fit for purpose. 

The major channel through which to accomplish this will be sustainability and transformation plans (STPs). In fact, proposals for better facilities management will form the cornerstone of any successful plan – and, as chancellor Philip Hammond confirmed in his Spring Budget, any extra capital from central government will take into consideration whether the local NHS area is succeeding in raising proceeds from unused land to be reinvested in the health service. 

So far, STPs haven’t revealed much in the way of financial needs linked to proposed estates changes. When NHE spoke to Jon Rouse, who leads on Greater Manchester’s health and social care integration, in November last year, he told us that their business case was under development, but all that could be shared at that point was that health leaders would need to think “laterally and creatively” about releasing headroom for extra investment. 

When the King’s Fund published its comprehensive round-up of STPs at the end of February, it said these cash details were included in the overall financial template each area submitted to NHS England, which are not in the public domain. But some detail had started to emerge across a handful of footprints, both related to money and strategy. 

Early estate ideas 

According to the think tank, most STPs outlined ideas to make better use of their estate, such as disposing of assets considered to be ‘surplus’ to requirements. Staffordshire and Stoke-on-Trent found that “too much” estate and underutilised inpatient capacity is one of the key drivers of its forecast ‘do-nothing’ deficit. It is now considering several options to use its estate more efficiently and, if successful, could save £22m by the end of this Parliament. 

Importantly, many STPs have listened to widespread concerns about council involvement and have drawn up proposals to work alongside local authorities and the wider public sector on an estates strategy. The King’s Fund listed Leicester, Leicestershire and Rutland as an example: the STP footprint intends to work with councils, ambulance and fire services to identify service co-location opportunities, as well as rationalisation and consolidation of the estate. 

Bedfordshire, Luton and Milton Keynes wants to build on work already carried out by councils as part of the government’s One Public Estates scheme, with an aim to create local centres for health and social care staff alongside other public services, such as housing. 

As recommended by the Health Committee, Bristol, North Somerset and South Gloucestershire STP has looked at areas where the estate can be improved, such as replacing buildings that aren’t fit for purpose with new facilities. Where appropriate, this will be financed by a reduction in the overall estate. Similarly, North West London wants to upgrade the primary care estate by investing up to £100m alongside “minor improvement grants”. 

Cambridgeshire and Peterborough expects to develop new primary care and community facilities when GP practice leases expire, with plans to create “larger, modern, family- and frailty-friendly hubs” that bring together doctors, social care and community staff. 

A BMA investigation cited Cambridgeshire and Peterborough STP as one of a handful of footprints currently quoting capital needs of more than £500m to drive forward plans. Whilst it is still unknown how much of this would be tied to estates, some other areas have given an indication: Lincolnshire, for example, needs around £200m to finance projects including the estates requirements of new care models and service reconfigurations. Given that extra funding is “likely to be limited”, the STP is exploring other sources of money, such as third-party developers, public-private partnerships and county council funding, the King’s Fund explained. 

Others have taken different avenues: Coventry and Warwickshire STP, for instance, has called on the Department of Health to “revisit its overarching policy on capital receipts, allowing local areas to retain them for reinvestment rather than returning them to central government”.

For more information

The King’s Fund ‘Delivering sustainability and transformation plans’ report can be accessed at:

W: www.kingsfund.org.uk

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Our Health Heroes: NHS awards ceremony unveils shortlist

18/10/2017Our Health Heroes: NHS awards ceremony unveils shortlist

With the NHS facing unprecedented demand and difficult working conditions, it’s incredible that the workforce across the country still deli... more >
RCGP launches overseas doctors guide to entice foreign practitioners

18/10/2017RCGP launches overseas doctors guide to entice foreign practitioners

The Royal College of General Practitioners (RCGP) has launched a guide for foreign doctors coming to Britain. The document – launched ... more >
Data scandal worsens as NHS loses further 162,000 key patient files

18/10/2017Data scandal worsens as NHS loses further 162,000 key patient files

Revelations that the NHS lost more than half a million patient files have been deepened with the reveal of a further 162,000 pieces of paperwork ... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

The Refugee Doctor Initiative

The Refugee Doctor Initiative

Terry John, co-chair of the BMA & BDA Refugee Doctors and Dentists Liaison Group and chair of the union’s international committee, talks about a brilliant initiative that is proving mut... more > more last word articles >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Our Health Heroes: NHS awards ceremony unveils shortlist

18/10/2017Our Health Heroes: NHS awards ceremony unveils shortlist

With the NHS facing unprecedented demand and difficult working conditions, it’s incredible that the workforce across the country still delivers great care to patients every single day. Requiring care is never a pleasant experience, but having a brilliant member of staff look after can make a huge difference to a quick recovery. For that reason, it’s important to recognise the support staff who work so hard to give patients p... more >
read more blog posts from 'the scalpel' >

comment

Make doing the right thing easy

11/10/2017Make doing the right thing easy

Kay Currie, professor of Nursing & Applied Healthcare Research, ‘Safeguarding Health through Infection Prevention’ (SHIP) researc... more >
STAR: an innovative app for speech therapy

11/10/2017STAR: an innovative app for speech therapy

Dr Stuart Cunningham, a senior lecturer in Human Communication Sciences at the University of Sheffield, on a new app set to support speech and la... more >
The value of health creation

11/10/2017The value of health creation

Dr Brian Fisher, vice chair of the New NHS Alliance, outlines the many benefits of investing in health creation. We live in one of the riche... more >
Developing a new type of think tank

11/10/2017Developing a new type of think tank

James Roach of the National Collaborative Group explains how the new and unique think tank is moving from rhetoric to action in order to help del... more >
A digital framework that works for the NHS

09/10/2017A digital framework that works for the NHS

In response to the ever-increasing opportunities to use innovative digital technology to carry out essential admin tasks, NHS Shared Business Ser... more >

interviews

Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >
Simon Stevens: A hunger for innovation

25/09/2017Simon Stevens: A hunger for innovation

Simon Stevens, chief executive of NHS England, knows that the health service is already a world leader when it comes to medical advances – ... more >
Improving care at the touch of a screen

08/08/2017Improving care at the touch of a screen

When it comes to dementia, having a calm and safe environment can have a substantial impact on a patient’s quality of life. NHE’s Jos... more >
A new approach to talent management

25/07/2017A new approach to talent management

Martin Hancock, national lead for talent management at NHS Leadership Academy, and Gill Rooke, the organisation’s senior operations manager... more >