HEALTHCARE INFRASTRUCTURE
Former Health Secretary, Alan Johnson, pictured with Dr Bushra Ali, GP and Partner at Modality Partnership and member of the NHS Hull CCG Board, at the opening of the West Hull Health Hub. He said: “We know how to build iconic healthcare facilities in LIFT, and maintain them in ‘day one condition’, and I believe this experience and expertise can be valuably used in other areas of the NHS.” West Hull Health Hub (right) is Citycare’s fourteenth health centre built in the East Yorkshire city.
“The sub-heading for this inaugural meeting is ‘The role of infrastructure in post-pandemic care’, but the first obvious point to make is that this infrastructure was crucial in pre-pandemic care; it does, however, need to be enhanced in a healthcare world dominated by the NHS Long Term Plan.” There seemed, he noted, to be ‘a welcome return to integration’: “The Government’s ‘command paper’ in February said that ‘instead of working independently, every part of the NHS, public health, and social care system, should continue to seek out ways to connect, communicate, and collaborate, so that the health and care needs of people are met’. We know, however, that these needs won’t be met unless we improve health infrastructure, that there’s a £9.3 bn maintenance backlog, and that a fifth of the acute sector infrastructure was built before the NHS’s creation.”
A ‘lack of focus’ on primary care Alan Johnson said that while the Capital Spending Review settlement, and the commitment to build 40 new hospitals, were ‘good news’, the primary care estate still lacked ‘the focus and funding’ to support community-based care and the integration of the different services. He said: “Primary care is the gateway to the NHS, but is often provided through substandard, crumbling buildings that weren’t fit for purpose even decades ago when they were built.” He noted that Local Improvement Finance Trusts had been established by government 20 years ago, ‘specifically to address this problem, as well as the isolation and dangers of single-handed practice’. He said: “I would argue that LIFT facilities are part of the most successful public infrastructure project nobody has ever heard of. There are 49 LIFT companies countrywide,
36 Health Estate Journal January 2022
which have provided 350 health centres, 90 per cent of them in areas of above average healthcare need.”
Leaflet received by all on the NHS’s creation
Alan Johnson always liked to refer back to the leaflet put through everyone’s door two months before the NHS’s creation in 1948. He said: “Although not old enough to have been around, I know it set out 10 paragraphs on ‘What you can expect from your NHS’, and that paragraph 10 said: ‘Health centres in every district’. The LIFT programme didn’t, of course, just happen. It contains a wealth of experience and expertise on strategic estates planning. We know how to build iconic healthcare facilities in LIFT, and maintain them in ‘day one condition’, and I believe this experience and expertise can be valuably used in other areas of the NHS. There are no ‘water handovers’ in LIFT buildings, and none of the horrendous problems mentioned in some of Nigel and Siva’s anecdotes.”
Attending a ‘health hub’ opening As Chair of Citycare, the LIFT company in Hull. Alan Johnson had the previous Friday attended the opening of the West Hull Health Hub, Citycare’s fourteenth health centre built in the Yorkshire city. He said: “Its story is very much the story of primary care, and the need for infrastructure investment in it.” The former Springhead GP practice that has moved into the West Hull Health Hub was set up in a row of terraced housing in the 1930s, where it had remained ever since, but with a growing patient list, it had expanded into the flats above a row of shops nearby, posing access problems, particularly for women with ‘buggies’ visiting the surgery, and the elderly. Alan Johnson said it was ‘a wonder
Springhead worked at all’. He added: “It was, however, classified by the Care Quality Commission as one of Hull’s best GP practices. Conditions were cramped, unsafe, and unhygienic, and yet it was the gateway to the NHS. A case of great practitioners operating in awful conditions – too often the story of NHS primary care.”
New £8 million facility
The doctors and other clinicians that had worked there were now based in a new £8 million building with 32 practice rooms, and ‘plenty of space and space for integration’. Alan Johnson added: “Philip Hammond’s 2018 Budget nearly destroyed this initiative, but thanks to the flexibility and patience of our NHS, and private sector partners, we adapted a third-party development model into something that looks very much like a traditional LIFT scheme, with the emphasis on the whole-life project, not making a quick buck.”
The speaker said that many of the health centres built under LIFT remained under-utilised, ‘as does much of the NHS estate’. He commented: “We need better data on this, so that as well as providing new buildings, we can make proper use of the existing ones. The NHS capital finance requirements can never be met by the public sector alone; we need a partnership that works, which just happens to have been around since the beginning of the century.” This closed Alan Johnson’s very interesting presentation, and the host then invited questions. The hour-long meeting raised some key issues and highlighted some of the most taxing challenges that those funding, planning, designing, building, operating, and maintaining the NHS estate in the short-to-medium term will have to grapple with.
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©Citycare
©Citycare
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