Context of our work
The NHS landscape
Challenges and opportunities
The NHS faces unprecedented challenges and opportunities. It has seen the biggest reorganisation for decades and along with other public sector organisations; commissioners, managers and clinicians alike are facing a future of growing demands and static or reducing budgets.
Redesign of service delivery needed
'Estate' or infrastructure, is being increasingly viewed as a strategic commodity which, like other technology assets and human capital, can be 'managed' to achieve better access for patients and better efficiencies for commissioners and providers.
There is also a wide recognition that there needs to be a more fundamental redesign of services and that estate, buildings and infrastructure play a key role in making this redesign a reality.
The NHS: Policy Context
The Five Year Forward View
NHS England’s Five Year Forward View (FYFV) set out a clear vision for a better NHS with a focused direction for wide scale transformation and new ways of working across the NHS and with local government. infrastructure solutions for integrated primary, acute and community care settings.
The announcement of the combined £6bn health and social care budgets in Greater Manchester, and confirmation of the 64 CCG Co-commissioning areas and the 29 Vanguard areas to pilot the ‘new care models’ in March 2015 indicate the need and pace for innovation and change.
Responding to commissioning intentions
Through the delivery of our Strategic Estates Planning Service , we are working closely with the NHS and Local Authorities to provide dedicated expertise and resource to support commissioners to develop and implement Local Estate Strategies that will respond to commissioning intentions and facilitate the a change in the way that services are delivered, driving system improvements and supporting service transformation.
In January 2015, the NHS invited individual organisations and partnerships to apply to become ‘Vanguard’ sites for the new care models programme, one of the first steps towards delivering the Five Year Forward View and supporting improvement and integration of services.
There are currently 50 Vanguards sites, split across five themes (see below). Each Vanguard is taking the lead on the development of new care models which will act as the blueprints for the NHS moving forward and the inspiration to the rest of the health and care system.
- Integrated Primary and Acute Care Systems: joining up GP, hospital, community and mental health services.
- Enhanced Health in Care Homes: offering older people joined up health, care and rehabilitation services.
- Multispecialty Community Providers: moving specialist care out of hospitals and into the local community.
- Urgent and Emergency Care : joining up A&E, GP out of hours, minor injuries clinics, ambulance services and NHS 111.
- Acute Care Collaborations: spreading excellence in hospital services and management, across multiple geographies.
CHP engagement with Vanguards
Across 62% of these vanguard sites, CHP is already actively working with commissioners and local partners to facilitate a change in the way that services are delivered through our Strategic Estate Planning Service.
|Type of Vanguard
|| No of Vanguards
||No of Vanguards in CHP SEP areas
|Integrated primary and acute care systems
|Multispecialty community providers
|Enhanced health in care homes
|Urgent and emergency care
|Acute care collaboration
Devolution is the transfer of certain powers and responsibilities from national government to a particular geographical region - enabling local decision-makers to better meet the needs of the people who live and work in their region.
The Greater Manchester Agreement
In February 2015, the 37 NHS organisations and local authorities in Greater Manchester signed a landmark devolution agreement to take charge of health and social care spending in the region.
Laying foundations for NHS devolution
Led by Local Area Director, Neil Grice, CHP’s Strategic Estate Planning expertise has helped Greater Manchester’s 12 CCGs develop a Strategic Estates Group and is offering a good foundation for conurbation-wide thinking as the area takes on its new responsibilities for health and social care.
We have actively supported the DevoManc Task and Finish Group and Steering Group with the development of the Greater Manchester Estates Strategy and we are also supporting the finalisation of the Governance Structure, including the Development of the Greater Manchester Estates Board, Land Commission and Delivery Team to go live in April 2016.
Getting this work right will make the devolved NHS work better for patients, and help deliver services within budget.
Devolution in Cornwall
In July 2015, Cornwall became the first rural county to reach a devolution agreement. Led by Strategic Estates Adviser, Andrew Collier, CHP is driving the development of a Local Estates Strategy and supporting the health and social care system to identify its estate needs to help inform the devolution business planning process.
One Public Estate
The One Public Estate Programme, is a pioneering initiative run by the Local Government Association (LGA) on behalf of the Cabinet Office.
The programme enables local authorities to work with central government and local agencies to release assets and share land and property information across the public sector.
By doing this, the programme will:
- Deliver more integrated and customer-focused services.
- Create economic growth.
- Reduce running costs.
Generate capital receipts.
As part of our Strategic Estates Planning Service, CHP has well established links with 15 Local Authority participants and we will continue to focus its joint working including established local partnerships in Essex, Nottingham and Southampton.
Primary Care Transformation Fund
The four year £1bn Primary Care Transformation Fund (announced in December 2014) will see the acceleration of improvements in GPs’ premises and infrastructure.
This alongside the New Deal for GPs (January 2015) indicate the scale and timing of future transformation that is relevant to CHP.
CHP is working with the Department of Communities and Local Government and key partners to develop links and opportunities with issues centrally and on local matters including housing growth, S106 and the Community Infrastructure Levy, regeneration and social housing.
The Better Care Fund
The £5.3bn Better Care Fund (June 2013) set out to transform the integration of health and social care across the NHS and local government.
The role of the Health and Wellbeing Boards and the local initiatives to improve service integration will continue to play a key role in determining local priorities and this will in turn need a new approach to how the health, local service and social care estate is configured and how CHP and its partners work alongside local partners to deliver change.