Naylor: Single body should oversee NHS estates

The University College London Hospitals Foundation Trust chief executive was appointed as government adviser on NHS property and estates in February.

He is developing a national strategy for the use of NHS property, which is due to be released before the end of September.

Sir Robert told HSJ there was a “misunderstanding about who manages property in the NHS”.

Two existing bodies – NHS Property Services and Community Health Partnerships – are often thought to own most NHS assets but actually only oversee 15 per cent of them, he said.

“What we need to do is to create a stronger national organisation that oversees the implementation and development of estates strategies over the medium to long term,” he said.

Sir Robert’s report will look at whether this should be a new organisation, or be added to the role of an existing body, he said.

He has been tasked with looking at ways to achieve the Treasury’s target of raising £2bn from surplus land in the health service, to make way for 26,000 houses.

He said: “That doesn’t mean we’re going to sell £2bn of land. What it means is we have to develop £2bn of land.”

The money does not have to come in the form of cash savings, he explained, adding that it would take account of redevelopments that reduce backlog maintenance costs or save money elsewhere in the NHS – such as by moving care out of hospital.

NHS Improvement chief executive Jim Mackey said last week that plans are being drawn up to build 22,000 affordable homes on NHS land.

Sir Robert is also considering whether trusts should have access to a central “advisory function” when redeveloping sites.

He said: “If we go back 20 to 30 years, health authorities used to have very senior estates advisory functions.

“But over the years, that position has been eroded and the infrastructure that used to be available to provide advice on estates, and estates needs, has disappeared.”

A central advisory function would prevent trusts from having to seek advice from external sources which may be “seeking to develop and acquire their property”, he said.

He referred to UCLH’s sale of Middlesex Hospital, which raised £175m, despite developers offering £32m. “We need to take a more commercial view of our property”, he said.

Sir Robert is also developing another piece of work looking at ways to help trusts in London with capital developments that have got “stuck in the system”.

This will focus on “half a dozen” trusts where plans have stalled due to their complexity or because the organisations lack technical expertise.

He gave the example of Moorfields Eye Hospital Foundation Trust, which has a major redevelopment plan that cuts across several organisations.

Sir Robert is putting together an advisory board for the national strategy, and expects it to meet for the first time in three or four weeks.

He plans to write to NHS chief executives in the next couple of weeks asking for their opinions.