With more than 150 NHS PFI contracts expiring by 2051 – most by 2036 – early handback preparation is essential. Anisha Mayor, WSP’s UK head of healthcare, examines how trusts can protect their estates, reduce clinical and financial risks, and transform handback from liability to long-term asset
Many of the private finance initiative transactions that were initiated in the 90s and the noughties were a first for NHS executives; in much the same way, the handback process is also new territory. So finding the right advice is crucial; advice that is objective, cost-effective, safeguards your future clinical and estates risks, and, importantly, as best as possible, adheres to your future models of care.
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For those PFIs that have seven years on the clock ahead of handback, there is comprehensive expiry guidance created by the National Infrastructure and Service Transformation Authority (NISTA). And NISTA support continues at the five and three-year points ahead of handback. But what can trusts and boards do to make this process even easier, way before the NISTA expiry process kicks off?
Understanding the current state of the asset
Together with the Institute of Healthcare Engineering and Estate Management (IHEEM) and Citation, WSP has supported the development of a digitised PFI question set that creates an initial deep dive for NHS execs and estates directors to have within their grasp a live central repository for understanding the condition of the asset. It is based on six key areas of a structured asset management system, including strategy and planning, asset management and decision-making, lifecycle delivery through to asset information, organisation and people, and risk and review. Serving as a temperature check and a way to interrogate the asset to ensure it is operationally compliant, it is an essential first step to minimising clinical and estates risk and backlog in the future.
Complying with the latest legislation
And indeed, there is a difference between operational compliance against safety-critical legislation and compliance against the PFI project agreement and schedules. As an NHS exec and senior responsible officer, it will be vitally important to ensure that a baseline operational compliance of the asset is achieved against the latest legislation, such as fire safety standards, as a first step. This is because preparing for compliance with the Premises Assurance Model when the asset is within the NHS estate will be essential.
Reducing revenue spend post-handback
However, it is also critical that there is a complete understanding of how to exercise your rights and obligations under the PFI contract. Decisions need to be taken in collaboration with your PFI provider on issues such as lifecycle spend that ensure, at five-year life cycle reviews, investment is made into critical systems. Where required, availability will need to be created within the NHS estate to decant clinical services out of the PFI so that the necessary lifecycle works can take place, particularly if the asset is to be handed back in the contractually prescribed Condition B.
The main driver ought also to be the longer-term horizon of mitigating NHS revenue spend and the ever-increasing backlog maintenance bill when the asset is back into NHS ownership, especially as it remains uncertain how much of the existing annual unitary payments given to NHS trusts and boards will continue.
Preparing early for handback will protect clinical services and reduce future backlog risk. Collaborative, cross-discipline approaches – and clear, accessible asset data – give trusts and boards the best chance of turning handback from a liability into a long-term asset.
