Without well-maintained buildings, clinical services cannot be delivered safely and effectively and the environment becomes an inhibitor to patient recovery.

NHS buildings continue to deteriorate at an alarming rate, and the issue of backlog maintenance spiralling out of control has long been in the headlines. In October 2017, The Guardian published that the “crumbling state of hospitals is putting staff and patients at risk and could lead to health and safety prosecutions.”

There have also been stories of NHS Trusts being put in to special measures by NHS Improvement because buildings are unsafe, poorly maintained, not fit-for-purpose and falling in to disrepair.

Since 2013/14, Trusts have been transferring capital budgets to resource budgets to deal with day-to-day financial pressures, drastically reducing funds intended for long-term investments such as buildings, maintenance and equipment. The Health Foundation states that “£1.2bn was transferred from capital to day-to-day spending this year” and “capital spending in the NHS has fallen by more than 20% in real terms over the last three years”.

The Carter Review of NHS Productivity published in February 2016 provided recommendations for achieving £1bn of efficiency savings from hospital estates and facilities. Furthermore, the Naylor Report on NHS Property and Estates published in March 2017 states that “without investment in the NHS estate the [NHS England] Five Year Forward View (5YFV) cannot be delivered, the NHS estate will remain unfit for purpose and will continue to deteriorate”.  

Trusts estate and facilities departments are doing what they can with an ever reducing pot of money, as demand for clinical services continues to increase. Many Trusts are turning to the private sector for investment and strategic planning to help then do more with less. 

Traditionally, capital schemes had been delivered via Public Finance Initiatives (PFI), but these have fallen out of favour in recent times due to their perceived inflexibility and high annual unitary charges. Ryhurst developed the Strategic Estate Partnership (SEP) model in 2010 as feedback from the NHS had highlighted a lack of value for money options for the delivery of capital schemes.

The SEP model is becoming increasingly popular within the NHS. It looks at an NHS estate holistically and strategically and can be used as a vehicle to deliver not only capital schemes, but also as a way of realising estates and facilities efficiencies.

The SEP model is completely flexible, and does not have to be used as the vehicle to take forward projects. It’s a 50:50 joint venture, meaning that decisions within the SEP are agreed on an equal basis between the partners. The SEP provides the capacity and range of capabilities by introducing the right skills at the right time and ensures value for money by testing the market for each specific project.

Ryhurst is in partnership with Lancashire Care NHS Foundation Trust, Cheshire & Wirral Partnership NHS Foundation Trust, the Isle of Wight NHS Trust, North West Anglia NHS Foundation Trust, and has been selected as preferred bidder for Whittington Health NHS Trust. The following savings and achievements have been realised through our SEPs:

  • £5m revenue savings on Hard and Soft FM and increasing quality of services provided through outsourcing
  • Up to 50% reduction in consultancy costs on capital projects
  • Saved over £20m capital costs by renegotiating the ProCure21+ project, The Harbour
  • Increased the use of existing corporate and clinical facilities by 39% through a space utilisation programme
  • Delivery of £40m+ of minor capital projects
  • £300k savings through market testing of the a PFI FM contract
  • Managed the procurement and development of £14.4m CAMHS unit, Ancora House, and through savings, enabled the inclusion of a four bed specialist unit as an addition to the project scope
  • Won two Design in Mental Health awards for ‘Project of the Year’ and ‘Service User Engagement’ for Ancora House

Find out more about SEPs and the success of our joint ventures to date here.