Devo Manc leaders seek private investment for NHS

As part of the devolution programme, the region is looking at non-NHS sources of funding because of the constraints on capital funds at the Department of Health and NHS England.

A report to the devolution strategic partnership board said there were “significant capital and estates requirements” in Greater Manchester, not least the £63m needed to implement changes to emergency services under the Healthier Together programme.

The £450m transformation fund allocated to the region cannot be used for capital projects, while capital budgets at a national level are being tightly squeezed as the DH struggles to balance its budget.

The report said: “The funding ask is well beyond the current national affordability envelope… The current system is therefore incapable of enabling the delivery health and social care reform.

“We therefore need to examine other options for delivery our system changes including private/public funding models…

“We are having exploratory discussions with institutional investors to gauge the appetite for creating a fund or partnership to provide investment in new facilities in return for long term revenue streams.”

Typical forms of private investment in primary care have involved local improvement finance trust schemes, while many hospital providers have used private finance initiatives.

Both are likely to be considered, along with borrowing by foundation trusts or local authorities.

The project is being coordinated by the Greater Manchester health and social care devolution team, with support from local authorities and consultancy firm PwC.

As part of the planned estates transformation, hospitals will be “reduced in size through standardisation of clinical support and back office services”, and there will be a reduction in the number of acute beds due to bolstered prevention, primary care and community services.

There will also be requirements for “multi-purpose community based hubs” accommodating integrated primary care, community health and adult social care services, as well as step-down care.

Meanwhile, local leaders are seeking an agreement that “capital generated via asset sales over and above” the Greater Manchester share of the national £2bn target for estates sales can be retained in the region. However, the report said this will be limited given that much of the land likely to be released as surplus will be in areas of low value.