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Naylor review calls for swift action to accelerate change

  • STP capital requirements estimated at £10 billion
  • Conservative estimate of backlog maintenance at £5 billion
  • Property receipts figure could exceed £5 billion in the longer term
  • Secretary of State for Health takes action on new NHS Property Board
  • 5,000sqm reduction in NHS estate is possible, leading to more FM savings
  • Better data infrastructure is essential
  • Robust capital investment plan for the NHS to be in place by summer 2017

An independent report by Sir Robert Naylor for the Secretary of State for Health - 'NHS Property and Estates: Why the estate matters for patients' - published at the end of March 2017, calls for the NHS to take rapid action to develop robust capital plans, aligned with clinical strategies and to maximise value for money - including land sales - and address backlog maintenance.

As stated in the Executive Summary, the review "set out to develop a new NHS estate strategy, which supports the delivery of specific Department of Health (DH) targets to release £2bn of assets for reinvestment and to deliver land for 26,000 new homes."

The Naylor review investigated the opportunities presented by releasing inefficiently used or unused NHS land for purposes other than healthcare, in particular for residential development. It sets out recommendations across three categories: improving capability and capacity, supporting action at local level and developing a robust and sustainable strategy to enable the estate to support transformation in the NHS. The capital investment necessary to deliver service transformation through Sustainability and Transformation Plans (STPs), estimated to be in the region of £10bn, would be met by contributions from such property disposals, private capital (for primary care) and from the Treasury, but with the allocation of additional public funds being proportional to the amount received from property disposals.

The review recommends the creation of a powerful new NHS Property Board to address the challenges inherent in developing an effective estates strategy for the NHS. These challenges include the lack of an existing over-arching estates strategy and clarity over where leadership for NHS estates strategy lies, as well as insufficient skills and capacity in estates strategy and management.

The new NHS Property Board will provide leadership and should be a strategic organisation, at arms-length from the DH and structured to empower speedy executive action and professional credibility. It should be aligned with NHS England and NHS Improvement and bring together functions of NHS Property Services, Community Health Partnerships and other fragmented NHS property capabilities into a single organisation.
The NHS Property Board should be established in shadow form immediately and substantively by April 2018.

The Naylor review also recommends the incentivisation of local action. "At a minimum, the DH and HM Treasury (HMT) should provide robust assurances to STPs that any sale receipts from locally owned assets will not be recovered centrally provided the disposal is in agreement with STP plans. This report recommends that HMT should provide additional funding to incentivise land disposals through a '2 for 1 offer' in which public funds match disposal receipts."

It is also recommended that any land released by the NHS should be prioritised for the development of homes for NHS staff, where there is a need and the NHS Property Board should support this.

A further deadline recommends all national bodies should work together, sharing intelligence, to develop a robust capital investment plan for the NHS by summer 2017.

There will be more detail of the Naylor review in the May/June 2017 issue of HEFMA Pulse Magazine