01.04.12
Managing the reformed NHS estate
Source: National Health Executive March/April 2012
Adam Hewitt reports on the formal establishment of NHS Property Services Ltd.
NHS property owned by PCTs and SHAs when they become defunct in April next year, as well as staff relevant to maintaining the estate, are to be transferred to a new body wholly owned by the Department of Health, NHS Property Services Ltd.
The creation of the body was officially confirmed by health secretary Andrew Lansley to Parliament on January 25, when he said: “The arrangements for it will be finalised in the coming months, however its objectives will be to: hold property for use by community and primary care services, including for use by social enterprises; deliver value for money property services; cut costs of administering the estate by consolidating the management of over 150 estates; deliver and develop cost-effective property solutions for community health services; and dispose of property surplus to NHS requirements.”
The process of transferring people and property across could begin in earnest as soon as September this year, and is likely to happen in a number of waves until the formal abolition of PCTs and SHAs in spring 2013 – subject to the successful passage of the Health & Social Care Bill, which seemed inevitable as NHE went to press.
Some PCT property, that assessed as ‘service critical clinical infrastructure’, is being transferred to the acute sector – to acute trusts, foundation trusts and aspirant community foundation trusts – under a process initiated by the DH last year. The deadline for trusts to express an interest in acquiring relevant clinical facilities has now passed, and the final ‘list’, approved by the SHAs, is now being considered by the DH.
According to a DH factsheet, the PCT property portfolio accounts for approximately £6.6bn, of which about £4.6bn is freehold.
Around two thirds of the current estate is expected to transfer to NHS Property Services Ltd, covering things like administrative buildings, operational community care property and buildings in multiple occupation. This will also cover facilities where the NHS provider is a minority occupier, where the community provider is a non-NHS provider, as well as some operational primary care property like GP surgeries and property that is now surplus to the NHS. The factsheet, from January 2012, says: “The aim is to achieve a seamless transfer of the estate and dayto day management of it to the company prior to the abolition of PCTs and SHAs. Over time, the organisation will drive greater efficiency in the management of the estate, with resources freed up to improve properties and invest in other frontline services.”
The exact staffing, structure and location of NHS Property Services Ltd remained unclear as NHE went to press, but is expected to be finalised and announced soon. It is likely to have regional ‘outposts’ in much the same way as the national NHS Commissioning Board. The number of staff the organisation will employ is also not yet confirmed.
When announcing back in January 2011 that aspirant community foundation trusts would get the opportunity to acquire PCTowned estate under the process that has now been finished, the DH explained: “All acquisitions of freehold interests or capitalised leasehold interests will be financed by public dividend capital. They will be subject to an overage provision, which will provide that 50% of any profit made on the future disposal of the asset will be payable to the Secretary of State for Health. There will also be provision for the Secretary of State or a body nominated by him to be allowed to buy back the asset, in the event that the trust is no longer to provide the services.
“All transfers of legal interests agreed by the PCT will be subject to approval by the strategic health authorities. Approval will only be granted where they are taking all of the property interests associated with the services transferring to them. Full guidance relating to the approval process will be available shortly. This is an extension of the assurance and approvals process for PCT community services.”
In its FAQ on the transfers, the DH notes that some administrative buildings are also used for clinical reasons, and says: “Individual sites will have to be considered locally on a case-by-case basis, but as a general principle it is anticipated that areas which fall within the definition of ‘service critical clinical infrastructure’ will be those spaces which are used mainly for patient consultation, diagnosis and treatment.
“Inevitably, this will also include any embedded space that is used for associated administrative and support purposes. The aim is to produce a coherent estates portfolio, in each case.”
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