04.05.12
The next steps for NHS property
Source: National Health Executive March/April 2012
David Pokora, executive director of the LIFT Council, gives NHE his thoughts on the establishment of NHS Property Services Ltd and how LIFTCos, as expert asset managers, can be involved.
The nature of the NHS estate is changing rapidly, as the organisational structure of the health service changes in advance of the formal changes coming under the Health & Social Care Bill.
With the abolition of the PCTs, there is a vast swathe of NHS property that needs to be accounted for. Under a process established by the Department of Health last year, some of it is being transferred to acute, foundation and community foundation trusts, but the rest, the residual estate, will pass into the ownership of a body called NHS Property Services Ltd.
David Pokora, who spent 26 years in the NHS, including 11 as chief executive of an acute trust, is now executive director of the LIFT Council, which represents 95% of the private sector companies involved in LIFTCos around the country.
He said the proposal for the residual estate to pass into the control of NHS Property Services Ltd “makes eminent sense, for a whole raft of reasons.”
He said: “Something has to happen to PCT residual estate with effect from April 1, 2013. That’s simply a function of the health bill, given that it becomes the health act.
“The LIFT companies that are in existence already up and down the country are an ideal vehicle to use to support the management of that estate, for the good of both the local community, and the public purse, given that if one can improve the value for money usage of property, then that’s no bad thing for the NHS as a whole, and for all of us as taxpayers.”
He said that for obvious reasons he currently has “no idea” what the LIFT Cos’ relationship with the NHS Property Services Ltd will look like yet, until more is known about exactly how it will operate.
But he said: “My view is, and our view generally as an industry is, that you can’t manage PCT primary community care properties up and down the country from a single address, wherever it is, and therefore there needs to be local understanding of the health economy, and what the local needs are.
“LIFT Cos, where they already exist, actually have that range of skills and in many respects already provide that service to PCTs, so if they’re providing the service or are capable of doing so, and those properties transfer to the PropCo, then it seems to me self-evident that the LiftCo would continue to provide that service to the PropCo. How that would be structured and covered and dealt with – that is not yet known.”
It is also not yet clear how much responsibility NHS Property Services Ltd will have for ‘managing down’ the existing estate when it takes ownership of it, and how much of its role will be reconfiguring that estate for new purposes.
Pokora said: “If we have a group of people who have expertise as asset managers, why not use them to ensure that premises are exactly what patients and staff need, and we only have enough property, not too much of it. The NHS is facing, as all public services are, a need to find cash. Why leave money locked into buildings that aren’t delivering what they need to deliver?
“It doesn’t matter to me whether it’s NHS Property Services Ltd, PCTs, acute trusts, foundation trusts; it wouldn’t matter what the organisation was, it behoves everyone to make sure money isn’t tied up in assets and properties that aren’t delivering what they need to. That’s an ongoing requirement, because health services change, and therefore buildings have to change to make sense, and be able to be used to deliver the kinds of services people need.”
Asked for his view on the shape and structure of NHS property more generally in the future – on new build versus refurbishment, for example – Pokora told us: “There needs to be new development, there needs to be refurbishment, and there needs to be rationalisation of what exists at the moment. My focus in all of this, and the industry’s focus in all of this, is purely patient-led. The buildings serve patients, and serve patient care. If we’ve got patients who cannot be moved out of hospital because there are inappropriate facilities in the community, that’s daft. That’s just a waste of very expensive hospital resources, and therefore, there ought to be a move to create or adapt where buildings already exist, in order to deliver the kind of services that are needed.
“By looking critically at the facilities that professionals have to use, you start to see ways those facilities can be adapted to deliver a more local health service, which means that patients don’t have to rely upon having to go into hospital.”
Tell us what you think – have your say below, or email us directly at [email protected]