ESTATE PLANNING AND STRATEGY
residents and vulnerable people could access the help they needed on their doorstep, avoiding the need to travel too far at a time when long periods of lockdown meant everyone’s mobility was hugely restricted; Thirdly, and finally, as vaccination centres – again by making use of the buildings’ community-based location to offer millions of residents a convenient place to get vaccinated as the COVID fightback began.
‘Business-as-usual’ role In parallel with the three ‘COVID lives’ of NHS LIFT buildings, their role in offering vital day-to-day health services (GPs’ surgeries, dentistry, pharmacies, and social care etc) also continued where it was safe and practical to do so. From the moment the pandemic began to gather pace in the spring of 2020, NHS LIFT buildings (and the estates professionals that manage them) were thrust into an ever-changing journey, where the same four walls had to constantly adapt and evolve to offer a lifeline to local communities, whether it was for testing, treatment, vaccines, or many other health and social care services in between. It was a unique challenge, and probably one that many health estates professionals will not see again in their lifetime. In circumstances like these, it is always tempting to come up with a clever statistic about how many square metres of new clinical space were quickly created, how many miles of temporary partition walls were installed, or how many variation requests were approved at record speed and so on. However, the reality is that the urgent changes to our buildings happened so quickly that it would be impossible to track, and even if numbers were available, it is unlikely they would capture the true scale of the unprecedented changes and challenges that estates professionals faced. Building flexibility into the primary care estate The speed at which these changes happened points to two fundamental strengths of NHS LIFT buildings – which are vital elements to build into any plans or decisions about the primary care estate of the future. Firstly, as modern, innovative buildings, LIFT facilities had the space and flexibility to quickly adapt to the needs emerging from the pandemic – something that simply wouldn’t have been possible with older parts of the NHS estate. LIFT buildings are significantly bigger than traditional primary care buildings so, taking the creation of ‘Hot and Cold Hubs’ as an example, it was much easier to create the separate entry and exits necessary to separate the space. Indeed, this capability is now being built into future variations to space to make LIFT buildings able to deal with what the future has in store. What the pandemic helped to underline is that demand on the NHS (and the
The Tessa Jowell Health Centre in Dulwich, south London, is the newest building to be delivered under the LIFT partnership. It was literally ‘born’ during COVID, opening its doors right at the peak of the pandemic.
primary care sector in particular) is constantly changing, evolving, and generally increasing. There is a clear ‘lesson learned’ – that it is not only vital that we create enough capacity to meet future demand, but also that we make that capacity as flexible as possible, so that it can be quickly adapted to a range of possible future needs.
Partnership working and embracing the private sector It is not only a case of what NHS estates capacity is created in future. Who is involved in delivering it is also a key consideration, and points to the second underlying strength of the NHS LIFT estate that we saw during the pandemic – namely, the important role that the private sector has to play. To briefly recap, the NHS LIFT Programme was designed to bring together private sector investors with Community Health Partnerships (CHP), a key part of the NHS family. As long-term partners and co-investors, CHP and the private sector partners share a common interest in ensuring that LIFT healthcare facilities continue to be well- used, well-maintained, and best serve the local community. It is a partnership that has a 21-year track record in delivering for local communities and the NHS, with over 350 community health buildings now delivered across England under the LIFT programme. The role of the private sector in the NHS is understandably a ‘hot potato’, and one that quite rightly attracts much debate and scrutiny. It’s important, however, that the debate covers all parts of the argument. The financial support offered by the private sector is crucial, especially at such a challenging time for public finances, but we shouldn’t only focus on money – this is also about the expertise, skills, and resources the private sector can
offer to help tackle existing and emerging challenges in the NHS.
Ability to adapt The pandemic was a perfect illustration of this where, as I set out earlier, many of the community health buildings delivered under the NHS LIFT partnership needed to quickly adapt to help the NHS’s fightback against COVID. The vital role of the private sector in the LIFT partnership meant that quick decision making, and additional funds and resources, were more easily available, allowing our buildings to very quickly adapt to emerging health needs – whether it was for testing, treatment, or vaccination. It really was an ‘all hands on deck’ scenario of people working for a greater good, regardless of whether they were from the public or private sector. A good example of this is the Tessa Jowell Health Centre in Dulwich in south London, which is the newest building to be delivered under the LIFT partnership. This was a building that was literally ‘born’ during COVID, opening its doors right at the peak of the pandemic.
A ‘dual challenge’ As the project neared completion, it was faced with a dual challenge where the emerging health crisis meant the delivery of vital healthcare facilities became even more urgent, but where lockdown restrictions made the completion and opening of the building ever more challenging. The public and private sector delivery partners tackled this dual challenge head-on, and were fully committed to tackling whatever hurdles emerged to ensure that the building could be opened as planned. A small anecdotal example shows the considerable lengths the key partners went to in keeping delivery on track: when faced with a construction working area that was too
October 2022 Health Estate Journal 101
© Benedict Luxmoore
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