SUMMARY OF REPORT CONTENTS
Value of UK NHS Expenditure 2008-2015 (£billion)
major reforms proposed in the Health and Social Care Act, the NHS is
undergoing the most dramatic change in its history, which will see
the management of the NHS, including the estate, decentralized as
more power is handed to GPs and clinicians. In addition, with
NHS capital spending now drastically reduced
the process of
funding new hospitals and primary care facilities is set to change
over the coming years. Responsibility for commissioning services
will be devolved to local consortia of GP practices, now to be known
as Clinical Commissioning Groups (CCGs). These proposals are being
implemented by the Health and Social Care Act, which has recently
gained Royal assent. CCGs are now expected to be in place by 1st
April 2013 to replace Primary Care Trusts (PCTs).
Government’s Health & Social Care Bill has been heavily amended in
response to industry concerns over the original proposals. However,
the broader policies of developing GP-led commissioning and
encouraging greater co-operation between private and public care
providers remain and, as financial constraints continue and public
sector capital becomes more difficult to obtain, the procurement of
construction services will increasingly look towards increased
partnership with the private sector
These increased powers are expected to form the basis of a new
system for procuring healthcare estate facilities, reducing the need
for direct capital funding from the public purse. As a result of
these reforms, the nature of future work in the healthcare sector is
likely to change to reflect a more rationalized estate, with the
majority of healthcare clients reviewing their healthcare estates in
a bid to achieve efficiency savings.
Industry response to the new Act indicates a move away from
secondary healthcare developments such as large PFI hospitals,
towards upgrading, refurbishing and extending the primary healthcare
around a quarter of NHS trusts looking to increase the size of their
estates through extensions to existing premises over the next 2-3
years. Indeed, the DH
said that in future there will be more emphasis on improving
existing premises rather than building new ones.
Going forward, existing methods of delivery of new capital
developments, such as PFI, LIFT, Procure 21+ and Express LIFT may
change under NHS organisational reforms. As financial constraints
continue and public sector capital becomes more difficult to obtain,
the procurement system will increasingly look towards solutions with
private sector partners.
routes and construction programmes specifically included for review
in this report include: LIFT and ExpressLIFT; Hub Initiative in
Scotland; Procure21/Procure21+; Designed for Life: Building for
Wales (P21 in Wales) and Frameworks Scotland.
of £2.5bn has been invested across 4 waves of LIFT since its launch,
this time, the DH is unable to set estimates for the amount expected
to be spent on LIFT in the future and investment will be subject to
change as more schemes are added to the forward pipeline.
date, the Procure21 programme has seen
completed; totaling around £4bn. Around 50 schemes are currently
either on site or under development and worth approximately £680m.
Based on the data available from the HM Treasury forward
construction pipeline data, which details schemes currently going
ahead, the total value of P21+ projects is around £733m to 2015.