ESTATE PLANNING AND STRATEGY
COVID’s lessons highlight the need for flexible primary care
Sarah Beaumont-Smith, CEO of Fulcrum Infrastructure Group, highlights the impressive way the primary care estate ‘flexed’ and demonstrated its adaptability during, and in the wake of, the COVID-19 pandemic. She believes that ‘what was done at great speed and out of necessity’ has ‘helped to change the mindset’ of how capacity in the primary care estate could be used over the longer term.
It is fair to say that we remain in turbulent times across the healthcare sector. We have all emerged from the pandemic hoping for some much-needed stability, and while there are promising signs of things getting back to some form of normality, it is clear that it will not be ‘business as unusual’ for quite some time yet. Added to this, the structure of the NHS is going through important changes – most notably with the new Integrated Care Systems (ICSs) being established across England – that will help to transform how different organisations plan and deliver joined-up health and social care services in different regions.
It is also a time of huge political change
– at the time of writing, two politicians are battling to become the country’s next Prime Minister, and by the time you are reading this, one will have been selected, and will have started setting out their own vision for the UK, including what the NHS of the future might look like. So, the health estate finds itself in a perfect storm of political uncertainty, a changing NHS landscape, and with the after-effects of the pandemic still being felt.
A track record of resilience As we know, however, the NHS has remarkable track record of being resilient for more than 70 years, never more so than in recent times. While there is understandably a desire to turn the page on the pandemic and start a new chapter, it would be a missed opportunity not to reflect on what worked (and what didn’t) during COVID. Understanding how the NHS survived the challenges of the past two years can offer us invaluable lessons on how we can set up the health estate of the future to deal with whatever might come next – in simple terms, as we look to the future, we must also learn from the past. In writing this article, I therefore wanted to try and capture some of the key ‘lessons learned’ – both from my own experiences, and from those of colleagues and industry partners from across the health estate.
100 Health Estate Journal October 2022
At the Waldron Health Centre in south-east London, large areas of temporary partitioning were used to create a temporary re-routing of patients, and a clear barrier between COVID-related facilities and ‘business as usual’ services.
The primary care estate’s vital role When we think about the role of the health estate during the pandemic, our attention is naturally drawn to major hospitals, the acute sector, and emerging new facilities such as the Nightingale centres. This is completely understandable, of course, given the heroics that these buildings, their staff, and volunteers, performed around the clock; the images on the nightly news of the battle for COVID being lost and won on busy hospital wards made for harrowing, but compelling, viewing. However the primary care estate – and
the estates professionals that manage this vital part of the NHS – also emerged as one of the quiet successes of the UK’s COVID response. I saw this at first-hand in my role as CEO of Fulcrum Infrastructure Group, an investor in more than 40 community health facilities delivered in partnership with key parts of the NHS family under the NHS LIFT programme. As the Chair of The LIFT Council – the representative body of private sector investors in the NHS LIFT Programme –
I also saw the vital role that other NHS LIFT providers, their buildings, and EFM staff, played during the pandemic. In just two years of the pandemic, many of the 350+ primary care buildings across the LIFT estate effectively took on three different ‘COVID lives’, each creating their own changes and challenges from an estates management point of view: Firstly, as ‘Hot and Cold hubs’, with
temporary new layouts created to allow day-to-day services to continue as normal, while other space could be safely created to deal with the emerging pandemic, and the need for diagnosis and treatment space. In several Fulcrum buildings, for example, such as Akerman Health Centre in south-west London, and Waldron Health Centre in south-east London, large areas of temporary partitioning were used to create a temporary re-routing of patients and a clear barrier between COVID-related facilities and ‘business as usual’ services; Secondly, as vital testing facilities – LIFT buildings are located in the heart of the community, so they offered a perfect location for NHS testing services, meaning
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