The new model helping trusts get the most from the NHS estate

Many trusts have inherited estates that are really not “fit for purpose” - they may not be aligned with the optimal model of care, not sufficiently flexible to meet evolving needs, or in some cases, may simply be surplus to requirements. In an age of constrained budgets and evolving models of care, maximising the value of the NHS estate has become a key requirement.

Where trusts are looking to maximise value and align the estate more closely with clinical strategy, a new model is rapidly emerging which I believe offers real opportunities to drive efficiencies. Strategic infrastructure and efficiency partnerships (SIEPs) or strategic estate partnerships (SEPs) involve a trust entering into a strategic partnership with the private sector to provide estate and service transformation solutions to generate value and savings, in line with clinical strategy.

‘The SIEP model is a flexible, 50:50 partnership that requires both partners to agree on strategy and priorities’

The applications of a SIEP (or SEP) can be wide ranging – from new or refurbished facilities to wider service transformation, creating new efficiencies and generating new income streams.

The SIEP model is a flexible, 50:50 partnership that requires both partners to agree on strategy, priorities and outcomes – a “non-exclusive” arrangement underpinned by a partnership plan that can flex over time to reflect changes in clinical strategy and estate priorities. They are quick to implement and the legal documentation is “light touch”.

Some of the advantages of a SIEP could include:

• expertise and innovation to help develop estate and service transformation proposals aligned with clinical strategy;
• access to third party investment to deliver estate transformation including new facilities where required; and
• commercial discipline and resource to develop estate and service transformation proposals from a “whole estate”, strategic perspective.

SIEPs are gathering pace as a model. Five have already been established nationally, with Bevan Brittan advising on all of them. The first such partnership was for Lancashire Care Foundation Trust, with others now including Cheshire and Wirral Partnership FT, University Hospital Southampton FT, Isle of Wight Trust and Yeovil District Hospital FT. Isle of Wight Trust the first non-FT to enter into a SEP, approved by the NHS Trust Development Authority.

Due to increasing interest in the model, we have worked closely with those active in the market to share learning and operational best practice, which has led to the creation of a “SIEP Alliance”, a forum comprising 12 private sector organisations. Watch out for further details on this in due course.

With a growing market of private sector providers, and genuine efficiencies to be gained, I believe that SIEPs are something a wide range of trusts may want to consider.

Rosemary Jago is a partner at Bevan Brittan