Over the past two NLA healthcare expert panel cycles, the focus has been predominantly threefold:
- A cohesive and integrated masterplanning approach to London’s major hospitals in collaboration with local authorities and the GLA.
- Development of NHS primary / community care infrastructure within London to champion better healthcare outcomes in the capital, utilising NHS Property Services, where possible, to adopt an entrepreneurial approach to buying and developing sites.
- In line with decarbonisation, planning policy to drive stronger consideration of retrofit for NHS services. Equally, NHS design guidance is to be revised to consider more strongly building reuse and associated acceptable derogations.
Since the last cycle, an overview was given of changes in the healthcare sector. These included Integrated Care Systems (ICSs) acquiring legal status, the Autumn Statement affecting healthcare funding, the status of the New Hospital Programme and the publication of this year’s Estates Return Information Collection (ERIC) data that uncovered the level of high-risk backlog maintenance in London’s hospitals.
With the introduction of some new panellists, the objective of this year’s cycle was focused on what the expert panel could do to achieve a tangible outcome that would influence the New London Agenda. A compelling discussion centred on three key areas of need: clinical need, estates need and staff retention.
Developing further an integrated approach to master planning of London’s major hospitals is the concept of “looking beyond the red line boundary” of a particular hospital / NHS Trust to create a wider campus of care across each of the five London ICSs, which could be incorporated into a set of more London-centric ICS infrastructure principles. This includes:
- A more concentrated focus on delivering healthcare on the high street through the rollout of a pilot scheme. This could be through, for example, retrofit of existing retail space, meanwhile use space or local authority stock. The resulting benefit is healthcare, which is preventative through social prescribing, elective care and step-down care, can be provided directly in the local community, ultimately driving better healthcare outcomes. In addition, reusing existing building stock aligns with both the GLA’s and the NHS’s decarbonisation agenda.
- As a result of devolving some healthcare outside of major NHS hospitals, each Trust can be rationalised and decompressed and given the opportunity to plan more coherently a sustainable estates strategy that incorporates a more flexible approach to its operational estate, improving space utilisation between clinical, estates and FM functions.
To assist London NHS Trusts in their quest to increase staff retention, a key worker housing policy could be developed more robustly by the GLA to provide a more meaningful definition of the London Living Rent, particularly prioritising NHS key workers at this level of intermediate rent within the Private Rented Sector.
The panel agreed a series of follow-up actions should be undertaken ahead of the next meeting in March. These included organising a roundtable between London ICS estates and facilities leads and Integrated Care Partnership (ICP) members to further investigate issues discussed above and how these might evolve into a key policy recommendation(s) within the New London Agenda.