News - April 2013

NHS Property Issues Briefing

Earth Regeneration Limited (EARTH) have prepared this brief to highlight the health service and real estate issues in London.

EARTH has provided strategic advice to health and social care commissioners and providers on how to make a more creative use of the NHS estate to help provide the services that the public need. Our approach is to work in a collaborative relationship with the NHS, recognising local expertise and knowledge, whilst helping to develop a more holistic overview of the potential to work more closely with local communities, provide better integrated, community based services, and to release funds from better use of the property portfolio.  By brokering relationships with both private and social housing developers such as housing associations to lever in new sources of investment and to to make use of local assets. An overview of the current challenges would include:

Health Issues:

  • New commissioning arrangements and the drive to transform services
  • Moving services out of hospital into a community settings
  • Developing contracts that better meet patient needs
  • Integrated clinical, social care and housing services
  • Better use of expert patients
  • The quality / finance challenge
  • Delivering health and wellbeing interventions to reduce demand and improve lives.

Estates Issues:

  • Opportunity to provide new integrated and flexible spaces
  • The liabilities and opportunities in high value estates
  • The challenge of maintaining and utilising ‘landmark’ Victorian listed hospitals
  • High costs of acquisition
  • Inflexible PFI funding
  • Need to release surplus estate for housing
  • The challenge of moving hospital services into community settings
  • NHS property services company now responsible for estate

There is, we believe, considerable opportunity within London and elsewhere to create service efficiencies and enhancements through funding from surplus estates receipts, and new partnerships with housing associations, local authorities and high end developers.  Such approaches can deliver jobs, housing, meets the needs of vulnerable groups and delivers a return that can be invested into services.

In London and elsewhere we see an opportunity to reposition the NHS integrated services and to significantly fund the costs through enhanced use of the estate, in some cases using enabling development finance.

Enabling Development Finance

Given the current economic climate, there is a need to look at new ways to fund the redevelopment of public assets. In our views this is about using commercial skills for public benefit.

EARTH has worked with a number of health Trusts in order to cross fund the public asset with the release of value.

Our expertise also lies in working with local communities, developing the “story” of new facilities, and building support for a different approach.

There is an emerging need to recognise that new and regenerated buildings have a long life, whereas the service needs are ever changing.  The redevelopment of these buildings needs flexibility of space and fit out with an ownership structure that retains the core assets for the public sector.

EARTH ( and CCC ( have the skills and expertise to provide this strategic advice in combining health service need with real estate expertise.