Following the 2017 Naylor Report into NHS estates, it has been estimated that estate upkeep costs have reached approximately £10bn in annual funding for 2019/2020.  Paul Fitzpatrick, Director of Estates and Facilities at Liverpool University Hospital, despite this, Fitzpatrick told audience members at the recent Healthcare Property and Development Conference that “there’s not much evidence of that being spent.”

Aintree Hospital, Fitzpatrick’s previous employer, have been trying to generate capital by redeveloping disused parts of its estate with help from One Public Estate, Fitzpatrick explained: “We’ve been working quite close with the programme and we’ve had a £200,000 grant to redevelop part of our campus, which covers 6.5ha.” [emaillocker id=”71749″]

Aintree Hospital is looking to develop key worker accommodation or extra care facilities as part of the redevelopment.

Shawbrook Bank is a major privately-owned bank that has a “bank balance sheet of about £6.5bn of which a large portion of which is in the NHS” according to Dasos Kirtsides, their Head of Healthcare. Kirtsides told delegates that the bank “works with more than 70 NHS trusts, either through tender process or directly with some of the independents.”The bank has expanded further into the health sector recently, as Kirtsides alluded to: “We started this year on commercial lending into care homes, pharmacy, dentistry.” 

They have also financed their first building within the service, a modular cancer centre in Northampton. Kirtsides described that project: “It was new for us when you’ve gone from 25 years of funding kit, and someone comes up with something different, the builder actually approached us first.”

Assura, a real estate investment trust are an extensive builder of NHS estate, with a “portfolio of 560 buildings, over 5m people receive their primary care from one of our buildings,” according to Simon Gould, Head of Development at the trust.

The firm are trying to modernise the model of the NHS estate, Gould explained: “The NHS estate plan cannot succeed without investment beyond your traditional hospital boundaries.”

Instead they are focusing on creating community healthcare hubs, to create broader well-being spaces.

Integrated Healthcare Properties has been facilitating a new form of financing for NHS estates, the Alternative Finance Organisation (AFO). Andrew Bulloch Managing Director for the firm, described how “it is owned by the NHS and local government on 50-50 basis so there is no private sector involvement.”

In the London Borough of Newham there has been a radical increase in population, necessitating the building of new NHS facilities. Integrated Healthcare Properties has facilitated the creation of an AFO to create 11 new NHS builds in the area, “the first of which should be operational between February and May 2020” according to Bulloch.

The model has the possibility to change the way NHS estates are funded, Bulloch said: “Cited in the Mayor’s vision for London as one of the possible ways forward for community and primary estate.”

The importance of location of estates was raised by Imelda Redmond CBE, National Director of Healthwatch, a charity that is dedicated to being “an independent champion of those who use the health services.” The Charity is helping NHS England in the development of their long term plan.

Redmond urged the importance of making sure sites were accessible, she said “NHS England have announced they’re doing a review of transport to NHS facilities, you are not building in just places you are in communities.”  Access to the latest health technology was also singled out as an area of importance to patients with regard to estates.

NHS estates have a rapidly increasing maintenance cost, yet if the necessary estate works are funded it provides a strong pipeline for the construction industry and can lead to a high-tech renewal. [/emaillocker]