In this article, Simon Taylor, estates strategy director, NHS Property Services is optimising healthcare spaces, unlocking funding, and tackling maintenance challenges to create a more efficient and patient-focused NHS estate

Last December, a number of NHS Trusts declared their buildings unfit for purpose; this is nothing new and has been in and out of the media headlines for years.

The warning from these Trusts came months after the recommendations from Lord Darzi that singled out capital investment as a major area of concern identifying a £37 billion shortfall.

And the National Audit Office recently published their report revealing at least £49 billion maintenance backlog across government buildings. The NAO found that MoD properties, schools, and NHS properties have a backlog totaling more than £10 billion each, making up 88 per cent of the total backlog.

Added to the major financial constraints is the level of confusion around the many capital and revenue funding methods. 

NHS Property Services looks after 10 per cent of the NHS estate – that is around 3,000 buildings.

Funding

In our recent funding report, estates, finance and strategy leaders shared their concerns and told us what the key barriers are to delivering an NHS estate for the future. 

84 per cent of estate leaders surveyed stated that barriers to funding are due to a lack of understanding of the options and these have a real impact on the success of funding applications and total funding pots being leveraged. 

So, we at NHS Property Services welcome that long-term estates funding is under the spotlight once again. We know there are ICBs and Trusts that are missing out right now on funding opportunities, through developer contributions.

Our approach is to provide better access to the funding opportunities on offer and to make informed financial choices to ensure the release of additional capital focuses by deepening NHS leaders’ understanding of their options and sharpening their skills.

As a strategic estates partner, we are helping many ICBs to deliver their estate infrastructure strategies. This includes helping them to make the most of their existing estate and different capital and revenue funding sources available – but we want to help many more. 

We want to ensure our customers use every bit of the support and advice from our experts they can to get their property fully functioning and able to offer the best care to patients. 

And we will do this by: optimising the existing NHS estate through better use of vacant space, improved utilisation and speed of decision making – all to improve pace of delivery of better facilities; introducing a new approach to estate investment decision-making, through a new funding settlement and simplified capital processes; and tackling backlog maintenance and ensuring statutory compliance to improve safety and productivity. We will also be rolling out existing property technology, such as NHS Open Space, property and facilities management CAFM platform and Smarter Building and investing and increasing collaboration between estates resources, keeping skills in-house.

The three shifts

Since the change in Government, more focus has been put on waiting times and how to tackle them. The Prime Minster, Sir Keir Starmer wants three shifts: primary care to community services; analogue to digital; treatment to prevention.

The Institute of Fiscal Studies’ recent report noted the last time the NHS met its target of 92 per cent of patients receiving treatment within 18 weeks was 2015. NHS Property Services is determined to help our customers achieve these three shifts. 

Since our conception in 2013, NHS Property Services has raised £541million from the sale of 596 properties for reinvestment; and we have also delivered surplus land for 8,326 new homes in the past seven years alone, we have cumulatively saved the NHS £364 million.

Healthy places

There are many examples of our work to support the NHS. And our 5,500 colleagues across our organisation continue to work tirelessly to deliver great results.

Our Healthy Places programme was expanded last year to increase focus on Community Diagnostic Centres, we announced our most recent construction in December at St Margaret’s Hospital in Epping.

A further Healthy Places project is the Chiswick Health Centre project, where we were able to rationalise inefficient land use and release latent value. The proceeds of the land sale were recycled back into the new health centre development. This was alongside section 106 planning contributions and a grant from the NHSE towards the temporary relocation costs for suppliers. 

The new health centre will host three GP surgeries, two NHS Trusts, and the Chiswick PCN (Primary Care Network), delivering a range of primary care and out-of-hospital services to more than 60,000 patients locally.

A joint development with Hounslow Council also formed part of the project and will deliver 55 social-rented, affordable new homes on the surplus land. 

Another great example of our work is at St James’ Hospital in Portsmouth. The former asylum was sold in January 2024 and will offer 209 new homes and community facilities in Portsmouth in the future.

Social prescribing

One of our growing areas of support, which is particularly beneficial for GPs and hospitals that find patients coming to see them due to long-term stress affecting their health is social prescribing. GPs have told us that a lot of people visit them when they are feeling lonely or isolated and we have responded to their call to help tackle this problem.

Since 2019 we have been supporting the 47 per cent of our customers who are GPs by using our estate to provide social prescribing and green spaces in communities up and down the country. NHS Property Services has transformed underused indoor and outdoor spaces into wellbeing hubs and green spaces that can be used for gardening groups, cookery classes and other types of therapy.

We now have 100 of these across England that bring people together to improve health and wellbeing. One excellent example of these hubs is the Victoria Central Health Centre in Wallasey, Wirral. It helps people with anything from housing to getting back to work to caring for someone with dementia. It is a non-medical service supporting people with problems that can make us feel unwell and are caused by stress. 

Pushing our role as a social prescribing facilitator alongside our property expertise means we provide better support to our customers to tackle what they see are the areas holding them back from delivering the best treatment for patients. 

As we at NHS Property Services look to the future, we know we have an important role to play in supporting Trusts and GPs; the NHS faces challenging times ahead but working together we can deliver our vision. Because we are part of the NHS, every penny stays within the health system and is reinvested across it so we can continue to focus on delivering brilliant service and building an NHS estate that is fit for the future.

A webinar run by our town planning experts to help our NHS colleagues learn how to speed up access to funding takes place on 25th February for more information click here. Our handbook which gives expert advice on how to draft business cases can also be found here.