ESTATE PLANNING
A ‘blueprint’ approach to tackle healthcare challenges
Smriti Singh, Associate Partner at The PSC, discusses the business management consultancy’s recent co- development – with Plymouth Local Care Partnership – of a so-called ‘Blueprint’ approach to designing estates which the two organisations says both meets population needs, and enables integration of care. The approach taken strongly aligns with the New Hospital Programme principle that models of care in the acute setting cannot be developed in isolation.
The biggest healthcare challenges we face today are ageing, multiple long-term conditions, and lifestyle factors. However, our healthcare estates are not set up to address these challenges; rather they were designed to deliver interventions when people need immediate ‘help’. Most of our healthcare estates are large acute hospital sites designed to deliver interventions when people are already ill. Unfortunately, these estates leave us ill- equipped to tackle the modern challenges of supporting people in managing chronic conditions, preventing illness, and reducing health inequalities. To address this issue, The PSC has – in partnership with the Plymouth Local Care Partnership – co-developed a ‘Blueprint’ approach to designing estates which both meet population needs and enable integration of care.
The Blueprint approach The Blueprint approach comprises four key steps: 1 Identifying the population need: Understanding the health, care, and wellbeing needs within a population, including segmenting the population and prioritising key population cohorts.
2 Agreeing common principles for models of care: Building on existing organisational clinical strategies and national policy to establish common principles for models of care that meet the needs of prioritised population cohorts.
3 Developing an estates masterplan for key population cohorts: Conducting a gap analysis between the current estate and a fit-for-future estate that supports the desired models of care for key population cohorts.
4 Identifying projects, business cases, and funding: Detailed planning to convert the vision for estates into action, including selecting priority projects and securing funding.
Importantly, these steps should be
The Blueprint approach comprises four key steps – the first being to identify the population need.
delivered collaboratively with key stakeholders in the local health and care system. In Plymouth, this has meant working with stakeholders from University Hospitals Plymouth, the community health provider, Plymouth City Council, and primary care providers. The key healthcare challenges found globally are evident in Plymouth. By 2034, over 20% of the population will be aged over 65. Meanwhile, 9.7% of the population reports long-term health problems or disabilities, and there is higher-than- average prevalence of most chronic conditions – including asthma, coronary heart disease, and diabetes. Moreover, Plymouth faces high rates of smoking, drug and alcohol dependency, and obesity, alongside significant health inequalities between the most and least deprived areas. These challenges have created a
mismatch between Plymouth’s health and care estates and the needs of the population. Most notably, there is a shortage of flexible spaces that enable seamless, efficient care and collaboration, and a lack of community infrastructure
to offer services to people with chronic conditions and preventative services. These factors, among others, have
created significant pressure on University Hospitals Plymouth NHS Trust’s (UHP) acute services, exceeding current capacity. UHP has been allocated funding under the New Hospital Programme (NHP) for redevelopment of its main Derriford Hospital site, but plans for the hospital could not be developed in isolation; new hospitals must be right-sized for future demand, and reserved for the acutely unwell. Assumptions for how preventative, proactive models of care can reduce acute pressure must be supported by concrete plans enabled by the wider health and care estate. UHP saw a critical need to develop a shared, system view of the acute site’s future role in the provision of health and care in Plymouth, meeting the long-term needs of the population.
A focus on sub-localities To address these issues, we focused on sub-localities within Plymouth, instead of looking at needs across the entire city. This approach allowed us to recognise
January 2024 Health Estate Journal 77
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