There has been an increasing pressure on NHS services in recent years, further exacerbated by the significant and irrevocable disruption of the pandemic. This puts pressure on NHS property, land, and buildings (collectively referred to as 'estates') — much of which is cramped and outdated. Yet estates are an essential part of the service's ongoing transformation project, and crucial in realising the benefits of Integrated Care Systems (ICSs).
Good estate management ensures buildings and infrastructure are properly maintained and can cope with the demands placed upon them. It also helps deliver efficient, effective services while providing value for money. The government's focus on ICSs presents a unique opportunity for NHS estates to work more closely with local communities, and play a greater role in the overall delivery of healthcare through their management.
NHS estates must ensure adequate clinical space for primary medical care and primary care networks, ensuring infrastructure is fit for purpose. In secondary care, there is the increased need for space and flexibility in hospitals, presenting another challenge due to the age of By improving timely access to primary care and actively addressing health inequalities, and by collaborating with local partners within ICSs, NHS estates can help the the overall service meet its goals.
ICSs enable NHS organisations to work more collaboratively in the achievement of these goals while maintaining their properties. Achieving said goals requires NHS estates to adapt quickly, something which is often complicated by a lack of resources and capital.
Political priorities play a significant role in the amount of funding NHS estates receive. The New Hospital Programme will result in additional funding for the NHS organisations selected to participate, but local priorities may take precedence in regions where there are competing demands on health care resources. Capital funding can therefore not be counted on as a consistent source of income, making it more important for NHS estates to form a strong business case when seeking funding.
There has been an increasing focus on making strategic changes to estates, driven by the need to improve quality of care, the implementation of new models and the changing demographic of the population. Making these changes can be a complex and challenging process, requiring estate professionals to have a clear understanding of the issues involved.
Continuous education, peer reviews and insights from case studies can be useful, helping NHS estates understand how infrastructure is planned and managed from a strategic perspective, as well as how the built environment can influence approaches to procurement and service delivery alike.
To ensure that the NHS continues to provide high-quality healthcare, estates must be planned effectively from a strategic perspective. To overcome capital funding challenges that have arisen in recent years, we must find a way to make the most effective use of its resources — with collaboration with local partners through ICSs providing an opportunity to learn and work together.
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