Accelerating estate solutions for neighbourhood health centre delivery

The government’s NHS 10 Year Health Plan sets out an ambitious vision to deliver neighbourhood health, enabled by neighbourhood health centres (NHCs).

The government has set out that estates and infrastructure strategy and management should be delegated from integrated care boards, with NHS England regions and local providers to have a stronger role to play in estates planning, but several conditions need to be in place to make this happen.

Void space remains a major financial and operational challenge. More directive commissioning, shared budgets, and using void space for neighbourhood services can reduce waste and improve access.

Co-location can support integration, but without a robust culture of collaboration, and reduction in complex cross charging, it only delivers proximity, rather than also being a joined-up experience for staff or patients.

Exploring different funding and ownership models allows healthcare providers and local partners to pool resources and tap into local planning funds.

Health-led regeneration presents opportunities for healthcare access and
economic benefits to local authorities but requires partnership working and
streamlined access to planning processes and development funds.

• To support local delivery of NHCs, the Department of Health and Social Care (DHSC) should:

  • allow systems to best plan and fund strategic estate to remove barriers caused by fragmented ownership and complex cross-charging

  • streamline the notional rent reimbursement process in the General Medical Services (GMS) Contract in order to support general practice to co-locate with other providers and partners beyond health

  • allow systems to retain and reinvest funds into NHC development from releasing unused estate

  • continue to remove restrictions on recycling capital from NHS asset disposals and eliminate double counting of NHS funds that currently trigger Capital Departmental Expenditure Limit penalties

  • give areas demonstrating strong partnership working the flexibility to move funding between providers to support NHC development

  • enable cross-departmental coordination, for example DHSC and the Ministry of Housing, Communities and Local Government MHCLG to link NHC funding with other national programmes such as the New Hospital Programme and community diagnostic centres.

  • Optimising existing space will accelerate the delivery of many NHCs but in the long term, some will be new builds, delivered under a variety of models explored in this guidance, including leveraging primary care autonomy and a new public-private partnership model.