Senior Consultant Robert Ede has authored a comment piece for HSJ which evaluates the Conservative’s manifesto pledge to “introduce the most ambitious programme of investment in buildings and technology the NHS has ever seen”.
The Prime Minister recently gave public backing to the recommendations of Sir Robert Naylor’s review of NHS Property and Estates, which called for an additional £10bn investment in healthcare premises to deliver NHS England’s Five Year Forward View.
If the Conservatives are to return to government on 9 June, Robert argues that three key challenges will determine whether a transformation in the NHS estate is delivered:
- To legislate or not?
Whilst NHS Chief Executive Simon Stevens have been very effective in navigating around the 2012 Health and Social Care Act, there has been a growing realisation that the system has reached a juncture. New legislation could drive accountability into Sustainability and Transformation Partnerships (STPs), address problems created by the internal market, and create a clear pathway for accountable care organisations. It would also turbo-charge the Naylor Review’s recommendations, creating the right incentive framework for providers to make better use of available land.
The case for legislation is therefore strong. But as we have already seen with the garbled release of the STPs, system reform must be stress-tested to avoid political backlash. A new bill introduced in mid-2019 would avoid the distraction of Brexit negotiations, and allow for sufficient consultation and buy-in with the healthcare community.
- Ensuring the STP process delivers consistent care
Key Conservative figures, such as Ben Gummer within the Cabinet Office, want to reward successful STPs that offer sound financial plans and radical change. But this approach carries risk – given the potential to exacerbate variations in care and patient outcomes across England. Footprints where progress has stalled must not be left behind.
- Putting the power in the new NHS property organisation
The creation of a new NHS property organisation has been disrupted by the general election. This work must recommence in earnest following 9 June, with the new government encouraged to provide clarity over its design and function provided as soon as possible.
Robert concludes by arguing it will be the responsibility of the estates community to ensure that ambitious capital programmes are not de-prioritised after the general election on 8 June, whichever party is victorious.
The Whitehouse Consultancy is a leading communications agency within healthcare estates. To access our in-depth briefing into the Naylor Review here.
