From the ground up: the complexity of the primary care estate challenge

'We hope for a different vision for the NHS estate of the future - one that maintains its position at the heart of the community, and one where the NHS estate positively contributes to improving health, rather than being a place for the treatment of ill health.'

Helen Buckingham, Senior Research Fellow from the Nuffield Trust summarising the findings of their recent research project into the NHS estate.

The think-tank brought together teams from Sustainability and Transformation Partnerships around the country at workshops - supported by government and industry experts, including us at Assura - to explore the unique challenges each faced in trying to make its NHS buildings fit for the future. Primary care estate was one of the top issues - the complexity of building ownership, leases and lack of specialist expertise and capacity within the NHS locally were all difficulties raised by participants.

The Trust's recommendations include:

• 'In prioritising capital investment, STPs should be cautious about dismissing capital developments whose primary purpose is to improve the quality of care or the care environment, and which do not deliver a direct revenue saving. Where such schemes meet the priorities of the STPs, local systems should work in partnership with their strategic estates advisor, who may be able to broker appropriate relationships with third party developers.'
• On sourcing capital: 'STPs should identify a range of alternative sources of funding where the ETTF will be insufficient, and broker relationships with third party funders as required.'
• On involving GPs: 'STPs and local systems should agree locally appropriate mechanisms to ensure GPs are involved in service and estates planning, both from the broad strategic perspective and more directly in relation to planned developments in primary care.'
• The report also includes notes the importance of improving existing GP buildings where possible - a key part of our work, which has included one of the country's biggest extensions to a live surgery.

Read the Nuffield Trust's report in full.