FACILITIES MANAGEMENT
Outsourced FM can help deliver community care
Owen Ransford Rowe, director of business development at CBRE Global Workplace Solutions, offers a practical reflection on where outsourced hard FM genuinely supports the community healthcare agenda, where it can create risk, and what needs to be in place if it is to play a constructive role over the next decade.
The direction of travel for the NHS is no longer in question. The ten-year strategy Fit for the Future: 10 Year Health Plan for England is explicit in its ambition to move care away from hospitals and closer to people’s homes. For those of us involved in the operational delivery of estates and facilities, that ambition is not abstract policy; it translates into very real questions about buildings, assets, compliance, and resilience. The challenge is no longer whether the system wants to move care into the community, but whether the estates and infrastructure that underpin it are ready to do so safely, consistently, and at pace. From the perspective of a hard facilities management
provider, it would be easy to present outsourcing as a straightforward solution, the silver bullet. In practice, the reality is far more nuanced. Outsourced hard FM can be a powerful enabler of the hospital to community shift, but it can just as easily become complex if it is poorly designed or insufficiently governed. The difference lies not in whether services are outsourced, but in how they are structured, managed, and aligned to clinical priorities.
A shift that fundamentally changes the estate The move from hospital centric care to community based models represents a profound change in the shape of the NHS estate. Acute hospitals, for all their complexity, are typically large, consolidated sites with relatively well understood engineering systems, established compliance regimes, and dedicated estates teams. Community estates look very different. They are more numerous, more geographically dispersed, and often housed in buildings that were never designed to deliver modern healthcare at scale. As community health services expand, estates teams are being asked to support care delivery in refurbished retail units, shared civic buildings, converted offices, and older community health centres, alongside new diagnostic hubs and integrated neighbourhood facilities. Each of these settings brings different risks, constraints, and operational demands. The requirement is not simply to maintain more buildings, but to do so in a way that reassures clinicians, patients, and the public that care delivered outside hospital walls is just as safe and reliable. This is where the estates conversation becomes
inseparable from public confidence. Engagement I have had around the ten year plan consistently shows that while people broadly support the idea of care closer to home, they worry about safety, fragmentation, and the quality of facilities.
Those concerns land squarely in the territory of estates and facilities management.
Why outsourcing enters the conversation Hard FM sits at the heart of that reassurance. Planned building maintenance, statutory compliance, critical plant resilience, and rapid response are not optional extras; they are fundamental to safe patient care. As community provision expands, many trusts are asking whether they have the internal capacity to scale those functions across a much larger and more varied portfolio. From an operator’s point of view, the case for outsourcing is often less about cost and more about capability. Mobilising new sites quickly, establishing consistent compliance regimes, and maintaining visibility across dozens or hundreds of smaller locations requires systems, specialist skills, and surge capacity that can be difficult to sustain entirely in-house, particularly in a tight labour market. One of the clearest advantages of an outsourced hard FM model is the ability to mobilise at pace without destabilising the acute service. In practical terms, this means bringing new community facilities into use without pulling scarce engineering expertise away from theatres, critical care plant, or high risk hospital infrastructure. When a community diagnostic centre needs to open within months rather than years, having access to additional surveying, compliance, and mobilisation capacity can make the difference between progress and delay. There is also a consistency argument. Community estates have historically developed unevenly, with variable approaches to maintenance,
Maintaining compliance across multiple sites can be difficult to sustain in- house.
September 2026 Health Estate Journal 41
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