Plans to transfer NHS properties to community service providers have stalled amid an ongoing dispute between trusts and the Department of Health, and claims of irrational behaviour by commissioners.
HSJ has heard that a reluctance to allow aspirant community foundation trusts to take ownership of the buildings they use is also putting the future of some organisations at risk.
DH guidance issued last year said aspirant CFTs could acquire primary care trust properties where they occupy most of the building, and where the asset is deemed to be “service critical clinical infrastructure”.
According to the DH timetable, all transfers should have been agreed by CFTs, PCTs, strategic health authorities and the DH by 15 December. But the final list of transfers has yet to be signed off and discussions are continuing.
Foundation Trust Network chief executive Sue Slipman said “quite a few PCTs” are hiding behind the formal guidance. She added this meant the commissioners were not taking “a case by case, sensible, rational approach to transfers”.
“It is about how reasonable the PCTs are being in how they see the delivery of the services – and therefore the resources that ought to be transferring in order for a service of any kind to be run.”
Ms Slipman said aspirant CFTs were being denied the opportunity to acquire premises used as hubs by teams of community nurses and to store medicine, equipment, and patient records.
Bridgewater Community Healthcare Trust chief executive Kate Fallon said the issue could affect trusts’ ability to reach foundation status. “Not owning our own estate makes it harder to hit the financial targets we need to reach for Monitor,” she explained. Although “Maybe the DH is under the misapprehension that because staff are out and about they don’t need a lot of property.”
She added that key figures in the DH were aware of the issues facing CFTs, and said she did not believe there was any conspiracy over the issue.
But, Ms Fallon said, her trust had still only been offered 30 per cent of the assets it had expected, after “ridiculous conversations about square metres, corridors, and the toilets”.
Assets not acquired by CFTs will be transferred to the newly created NHS Property Services and leased or rented to providers. However, the resulting effect of extra revenue costs and a smaller capital base could be “make or break” for some CFTs, Ms Fallon said.
Primary Care Trust Network head of commissioning policy Elizabeth Wade said there had been a “lack of clarity” from the DH about the estate transfer. However, “this is a very complex task so it is wrong to blame just one set of organisations”.
A DH spokeswoman said it was expected property transfers would be finished “in coming weeks”.