An estate strategy; now there's a capital idea

Unlocking capital to invest in healthcare’s physical environment has never been more important, yet many Trusts fail to develop an effective estate strategy which is essential to access funding.

Estates strategies are frequently overlooked and may now be the key to launching a successful bid for funding. It’s therefore vital that Trusts take a closer look. These uncelebrated documents have recently taken a larger role on the healthcare stage, because of the New Hospital Program. Where previously considered optional, they now play a critical role in securing a much-coveted place on the ‘Go’ list.

An estate strategy is the first step towards producing a strategic outline case or outline business case for any investment scheme. Despite the ambiguity of the document’s status, there are recent examples of schemes being rejected from the New Hospital Program due to a lack of an estate strategy.

It is important to remember that an estate strategy contains several key elements. These include, a description of all the accommodation and buildings owned by a Trust, accompanied by a review of the activities the Trust undertakes in those buildings and whether the amount and quality of the accommodation suit the Trust’s existing requirements, as well as future plans. This then enables a conclusion to be drawn as to:

  • whether the accommodation can be reallocated more efficiently,
  • whether services are unnecessarily duplicated, and
  • where there are gaps in the service.

Since the publication of the NHS Operational Planning and Contracting Guidance in January 2020, the NHS requires all new buildings and refurbishments to meet net-zero carbon standards, and business cases must include net-zero ambitions and planning or risk push back from NHSE/I.

There is much that can be done now to prepare for net-zero carbon, including the identification of significant opportunities for decarbonisation and rationalisation of buildings and space. Key opportunities for NHS sites include:

  • Shifting from steam systems to low-temperature hot water to enable heat pump technology
  • Reducing office space in favour of agile working
  • LED lighting upgrade opportunities
  • Ensuring contracted partners are also committed to net zero through tendering processes
  • Consideration of energy and resource requirements from clinical interventions, such as MRI scanners
  • Enabling access to public transportation and integrating electric vehicle charging infrastructure

Planning for net-zero as part of the estate strategy is critical, and must be anticipated, designed, and costed in at the earliest stages of estate and project planning. ETL is supporting several NHS clients to prepare for net-zero and has developed design briefs key interventions required aligned to each RIBA stage to support the delivery of net-zero.

As we move through 2021 the NHS will face some of its toughest challenges and strategic estate planning is essential in the wake of Coronavirus as well as securing all-important capital funding to ensure a fit for purpose healthcare service for generations to come.