News - November 2012

NHS

These are difficult times for the public sector. We have a coalition government in power, with a radical agenda in challenging financial times; savings are being sought across the public sector. These budget reductions are set to continue for a number of years, with an inevitable impact on public services.  New solutions are going to have to be explored, at the same time as continuing to run services and find reductions.  It is apparent that whilst the NHS, in particular, holds a large property estate - this is seldom managed or commercially exploited with a view to helping to cross-subsidise and enhance service delivery. This is hardly surprising since the primary job of the NHS is to deliver high quality health care and not to demonstrate property expertise. Nonetheless, there are many examples where the NHS estate has been sold, and the site lost for ever to the local community, with many subsequent regrets. The alternative has been to try to continue to use them within insufficient capital funding to convert them into adequate facilities for a 21st century NHS.

The new Property Company will come into reality next April, and will be interesting to see if there is a step change in approach.

At EARTH, we understand that location is everything with service delivery; services need to be easily accessible and convenient. We do not advocate simply selling the estate (except where clearly redundant) – but rather, taking the opportunity to use it better. This can be through co-location with other providers (police, mental health local authority, schools); bringing in complimentary tenants  (cafes, health providers, sports, retail, pharmacies, charities and the voluntary sector); and where possible providing additional facilities - elderly peoples housing, a library, a leisure facilities, gardens and cafes.  Health Centres have high footfall, they are a key part of a local community and could provide a central focus for new forms of service delivery and co-location of services.

Until now the options tend to have been - try to make out of date buildings work to deliver 21st century services; give them to the voluntary sector, who often can't afford to maintain them or adequately heat them; or sell them. House builders have been keen to take redundant stock; but this loses sites for ever as potential hubs of delivery. We are advocating an approach which is both more commercial but, where viable, retains the estate within the public domain.  We achieve this through appropriate lease terms – short, medium and long – realising long term values and, at the same time, achieving integrated services.

EARTH has brought together a team of associates with a wide variety of experiences from across the private, public and 3rd sector – to work with clients to find better, value for money solutions – using their property portfolio to fund and create new service models.

EARTH have commissioned a new kind of Health and Well Being Centre based on delivering outstanding clinical practice with new “social value” services. The aim is to create a range of services that address some of the social reasons for ill health – unemployment; loneliness; chronic unmanaged conditions; isolation; poor language skills.  In addition to working on the appointment of a consortium to deliver the services, we have also worked with the NHS on the building – trying to create a welcoming, accessible and beautifully designed new space.

We are working on a major project to scope out a different future for a semi-redundant hospital. The aim is to bring in private capital to create better public facilities – and to retain the site as loved asset for the local community.

We worked with a Mental Health Trust to successfully achieve a planning consent, which will in turn, bring in private sector skills and capital, but with the aim of providing new state of the art mental health facilities within a new mixed use development.

We are working with a developer to deliver their community programme in a difficult planning environment. This will deliver a new mixed scheme of high quality design in an area of disadvantage and challenging economic circumstances.

We have just completed a commission to find a solution for a site where the community and the NHS were at logger heads with each other. By working with everyone involved we have come up with a solution that delivers a new health centre, at no capital cost to the NHS.

We are also working on the creation of specialist medical facilities for the homeless in London which will free up current A&E beds and provide real value for money to the NHS and specialist support for the homeless.