FUTURE ESTATE PLANNING


terms of capital, and where it was most needed, with some of the more deprived communities having some of the worst primary care capital investment. The relationship between the GP contract, and the way GPs are incentivised to participate in funding programmes to get such capital development, thus needed examining. Paul Maulbach added: “Thirdly, the systems need some flexibility around capital. One of the things we had recently – which has now finished – was (NHS England’s) Estates and Technology Transformation Fund (ETTF), which gave flexibility to systems to target small sums of investment into where they felt it was most needed. For example, you could build an extension on a practice, or a community centre. We find those types of investment deliver excellent value; they’re roughly 75% cheaper than other forms of estate investment, because you’re building on existing estate.”


Flexibility to support system locally “My fourth point,” Paul Maulbach said, “relates to linking this into the wider planning agenda. We have flexibility through Section 106 funding arrangements with local authorities – with new housing developments – to secure some of the development funds to support NHS capital investment. Those sums are never enough, which is why systems need flexibility to build on top of that development pot, but a key challenge when working with councils is that the more deprived areas generally have much lower rates of return on those developments. So, the amount of money available to support investments is considerably lower. We need to address how we can generate more flexibility.”


Speaker’s nursing background The next speaker was Professor Jane Perry of the University of East London, where she is Dean of Health, Sport and Bioscience, responsible for over 100 staff and 2,300 students, and manages the school’s strategic academic portfolio. A nurse for over 30 years, with a clinical


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Prof. Jane Perry: “Moving forward, good academia will see practice partners, service- users, academics, and students, all have a very strong voice about what healthcare infrastructure and roles should look like”


background in general practice, she became a Nurse Practitioner, and was an early adopter of prescribing rights and advanced practice. This extended role led to her move into academia. In her role in East London, she has grown the nursing and allied health programmes substantially, forging close relationships with NHS Trust partners for both undergraduate programmes and apprenticeships. Explaining that she would be talking ‘from an educational perspective’, she said the future of how practitioners were educated would need to changed, ‘based on some of the really innovative and transformative learning during the pandemic’, but also the ‘sort of solution-focused approach’ the University had had with its practice partners during a challenging time.


New hospital and primary care training hub Prof. Perry said she had been ‘fascinated to hear discussions about the estate’, because the University was now developing a new hospital and primary care training hub. She explained: “We’re doing this because it’s becoming really apparent that we mustn’t train students in silos; they need a very full and holistic patient journey. But what does that look like in the new digital world? In East London, there are large health inequalities, and providing a sustainable healthcare workforce is vital for us.” She continued: “Producing career-ready practitioners will become even more important, and we want our students to be able to work interprofessionally. Practitioners and professionals do often train in silos, and although we talk about interprofesssional learning, we’re not yet doing it sufficiently


well to produce the kind of strong integrated teams we will need to address some of the challenges we have with workforce crisis.” Prof Perry said that, working for the University’s School of Health, Sport and Bioscience during the pandemic she had seen opportunities ‘where every single one of these practitioners could come in and make a difference’. She added: “The important thing now is for other practitioners to see how this works together – the power of science and sport, alongside other healthcare practitioners.” One of the ‘important things’ she and her team had done during the pandemic was to establish very strong relationships with their practice partners, and to start to ‘co-produce’ how they would manage the student journey. She said: “Moving forward, good academia will see practice partners, service-users, academics, and students, all have a very strong voice about what healthcare infrastructure and roles should look like.”


‘Rediscovering planning’ in the NHS The event’s final speaker was Richard Darch, Chief Executive at healthcare infrastructure specialist, Archus. He began: “Unsurprisingly, I’m going to agree with every point made so far by the previous three speakers. One single point though is that we need to re-discover planning in the NHS – in my view a lost art and science. The NHS historically has led the way in how it planned its services, and indeed its capital allocation across the system. We’ve moved away from that, and although the title of this seminar is around the refresh of the Health Infrastructure Plan, I’m not sure we need such a Plan – rather we need


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May 2022 Health Estate Journal 53


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