Every clinical commissioning group in England has been directed to evaluate estate within its area to work out how much capital funding can be released by property sales.
- CCGs to calculate total investment in facilities necessary to introduce Forward View care models
- Commissioners will also determine potential capital receipts from selling surplus properties
- Capital receipts to be pooled nationally and redistributed
Under the major new national estates plan, money raised will be used to support new care models, HSJ has been told.
Each CCG will also calculate the total upfront investment needed to establish new care models in their area, and determine how much running cost cash can be saved by using estates more efficiently.
The work is being coordinated by the Department of Health’s two property companies: NHS Property Services and Community Health Partnerships.In an interview with HSJ, NHS Property Services chief executive Elaine Hewitt revealed that money from the property sales will be pooled nationally and allocated to areas in need of investment.
Each CCG will review all the property within its area which is owned by the two bodies, which usually includes most community services estate, the offices used by commissioners, and some GP practices.
It comes amid growing calls for adequate upfront investment in the Five Year Forward View.
The Health Foundation and the King’s Fund this week jointly proposed a transformation fund worth up at least £1.5bn a year until 2020-21 to properly test and roll out new models of care.
The estates strategy will focus on primary care and community services buildings, as these make up the bulk of CHP and Property Services’ portfolios. However, the exercise will also look at office space, as Property Services owns much of this estate.
A key aim will be for every CCG to ensure there are adequate facilities to enable the establishment of new care models as described in the forward view.
CCGs will identify which properties should be sold, and how those that are kept can be used as much as possible to minimise inefficiency through under-occupancy.
They will also calculate the value of capital receipts that can be generated by selling surplus property, and how much CCGs could save in rent by consolidating the local estate.
A letter from the DH and NHS England to CCG leaders last month said: “You are already meeting the costs of the estate in your area, either directly as occupiers, or indirectly through your commissioning contracts.
“The direct running costs of the NHS owned and occupied estate comprises the third largest cost, after staff costs and medicines. Better use of the estate will enable significant savings for potential investment in patient care.”
In the forward view, the national arm’s length bodies pledged to set up a “pump priming model” to fast track new care models. This could be funded via foundation trust savings, and “could also unlock assets held by NHS Property Services”, the document said.
The forward view also recommends scaling up primary care, and much of the portfolios of Property Services and Community Health Partnerships - worth an estimated £5.5bn combined - are used to provide these services.
NHS Property Services chief executive Elaine Hewitt, who took up the post in February, confirmed that any money from selling its buildings will be pooled nationally, rather than reinvested locally.
Property Services and CHP will be responsible for allocating the money.
Local plans are expected to be finished by the end of 2015. It is intended that figures on the potential income from land receipts, and the cost of investing in new care models, can be aggregated to give national level data, which would inform NHS England’s budget setting for 2016-17.
The local plans could help CCGs make the case for investment from the £1bn primary care infrastructure fund.
Ms Hewitt said she did not yet know whether the total national value of the property sales would cover the amount of investment needed. “But I think there is a real opportunity here to look to unlock significant space, and cost, and value that we can then look to reinvest,” she added.
Property Services will be working with 114 CCGs to produce their local plans, while CHP will work with 96. CHP is working in CCG areas where it has exclusive rights to develop primary care facilities under local improvement finance trust deals.
For Property Services, supporting a national estates programme is a shift in approach, from acting as a landlord to actively helping the NHS system implement the forward view.
“We’re both a landlord and a service provider,” Ms Hewitt said. “I’m driving the organisation to operate professionally in both capacities.
“To date we have been very landlord oriented and my intention is to turn this organisation to face outwards… I see NHS Property Services as having a vital role to play in supporting the NHS.
She said there was “a real opportunity to work the estate harder in terms of efficiency and effectiveness” and make sure that the NHS’s “scarce financial resources are not locked in”.