Conor Burke
Former NHS leader now supporting health and care systems to gain insight, integrate services and improve performance.
www.cpbconsulting.co.uk
7 comments By Conor Burke
I assume there is a typo and SoC is planned for end of March 2021?
Does the recent policy announced by DHSC to potentially transfer and repatriate over £5billion capital assets held by CHP/NHSPS back to local providers create an opportunity for systems to think creatively about how to dispose of unfit property and develop more affordable and efficient solutions?
This is potentially very important and transformative - there are over 3,500 properties currently held by both NHS Property Services and Community Health Partnerships which local systems and have been unable to make major changes to for years. The ownership model, payment methods and incentives in the current system have made it extremely difficult for local providers to work effectively together to deliver benefit for local people.
The primary and community estate is a key enabler of an integrated model of care and there is an urgent need to invest in and develop fit for purpose premises.
This change potentially enables local stakeholders to use existing infrastructure in new ways and also develop new facilities to provide a full range of services with flexible capacity.
Where will the capital funding come from? New routes to capital are emerging - In Newham, ELFT, the Council and the GP Federation have formed a new jointly owned finance organisation and raised considerable capital from the Public Sector Loans Board (Treasury) at public sector borrowing rates enabling the implementation of a long term and affordable place based estates strategy through the acquisition, improvement and leaseback of local properties.
https://www.elft.nhs.uk/News/State-of-the-Art-Health-Centre-Is-Coming-to-Newham
Aside from the critical maintenance backlog issues the primary and community estate will be a fundamental enabler of integrated care and primary care networks and there is an urgent need to invest in and develop fit for purpose premises given the poor quality, limited capacity/size, lack of spatial flexibility and rising costs of the existing buildings as pointed out by Sir Robert.
The existing financing models used by NHSPS, CHP and private investors etc add significant costs and are unaffordable for commissioners and only generate a return for the private sector or Treasury.
However there are some very interesting locally owned, innovative and affordable models emerging that could be the solution, such as the Newham Health and Care Space - a tenant (local authority and NHS) owned alternative finance organisation that has raised over £60m and has a 40 year plan to acquire and re-develop local health care properties and build new integrated care hubs....its worth a look -
https://www.newham.gov.uk/Pages/News/Green-light-for-new-multi-million-pound-health-and-care-facilities.aspxAs always some great insights and wisdom from Alwen on how she approached and has succeeded in delivering what must be one of the toughest NHS leadership jobs. I have been lucky enough to have worked with and for her and she has a blend of leadership qualities rarely seen in others - humble, approachable, empathetic, highly intelligent, visionary, analytical, articulate and decisive but incredibly politically astute - these are all wrapped in a core commitment to NHS values. Wishing her every success with the next stage - not that she needs it..
Although not common a number of former OTs have been NHS CEOs over the years including myself, Health Mullin (O'Meara) and Pam Court to name but a few. There are also quite a few former Physios currently CEOs. I think a therapist professional background does bring something different and is particularly relevant as we move towards great care integration and collaborative working which as therapists you have to do well to be successful. I think the headline is a little odd as im sure Liz has achieved much as a leader and manager since she practised clinically but I wish her every success in her new role.
Until recently I was a commissioning leader in the BHR system and provided my views to GT as part of their work. It appears that the investigation process is still ongoing but I do hope that if there has been a serious governance failure, as it appears from their report, that this is not repeated by relevant regulators and that those involved are held accountable and that appropriate action is taken.
More important is what this all means for the local system, for patients and for the population.
With both the acute provider and local CCGs now in significant deficit and with population growth exceeding 7% over the next 5 years the system and its leaders need to come and work together with regulators to agree how they recover while sustaining priority services.
Very difficult decisions will undoubtedly need to be made and implemented that minimise impact on patients which will require all stakeholders to work constructively together to address a common and very significant challenge. I know they can do this.
It would be helpful if as much support and focus was now given to this and to the very committed and capable people that remain in the BHR system who have to deal with the challenge of what others have left behind - I include myself in this group.
Commented on: 23 November 2020
Integrated trusts aim for first-of-its-kind merger