Agenda item
NHS Estate in Brent
- Meeting of Community and Wellbeing Scrutiny Committee, Wednesday 23 November 2016 7.00 pm (Item 5.)
- View the declarations of interest for item 5.
This paper provides an overview of the NHS community estate in Brent and the strategic estates plans for the future development of the estate. These plans are being developed in partnership with Brent Council and other key stakeholders and are an enabler to the delivery of the Strategic Transformation Plan (STP) and North West London Shaping a Healthier Future programme.
Minutes:
At the invitation of the Chair, Councillor Nerva, briefly explained the committee’s reasons for requesting the report and noted that NHS Estates Strategy would be a significant driver of changes to local health services. Of particular interest to the committee was the cost implications of the underutilisation of NHS buildings.
Sue Hardy (Head of Strategic Estate Development Brent, Harrow, Hillingdon and Ealing CCGs) introduced the report before the committee which provided clarification on the costs of the NHS estate in Brent, detailed current levels of occupation and outlined plans to address areas of underutilisation, known as voids. It was explained that ownership of the Brent NHS Estate was divided amongst three organisations; NHS Property Services, London North West Hospitals Trust and Community Health Partnerships. The rent and running costs of these buildings was recovered from the service providers who used the sites and the burden of void space was therefore principally borne by the Brent Clinical Commissioning Group (CCG) who held responsibility for commissioning services, along with NHS England. TheBrent CCG was proactively working with the property companies to reduce void space across the Brent NHS estate. A site presenting a particular challenge in this respect was the Willesden Centre for Health and Care, though plans were in place to further reduce the percentage of void space at this site. The committee also heard from Jake Roe (NHS Property Services) who briefly outlined the responsibilities and supporting role played by NHS Property Services.
In the ensuing discussion members queried whether the reorganisation of the NHS had posed difficulties for developing the NHS estate in Brent, whether the facilities comprising the estate were in a good condition and how well situated they were to meet the needs of the borough. Confirmation was sought of the overall cost of void space to the Brent health economy, the specific cost of the void space at Willesden Centre for Health and Care and the strategy for addressing this underutilisation. The Committee questioned how the council could support the CCG in minimising void spaces across the Brent NHS estate and it was queried whether the rental cost of these buildings were typical of the market. A further query was raised regarding whether the CCG had any discretion regarding the NHSE policy of charging market rents. Members questioned whether the CCG had a formal policy on working with the voluntary sector and emphasised the mutual benefit of allowing voluntary organisations to occupy void spaces at reduced rents. A member commented that the requirement for the CCG to fund void spaces undermined the principle on which the CCGs were established and questioned the cost of voids annually, estimated to be approximately 2m per annum.
Members subsequently queried how Brent CCG worked with the council to appropriately project and respond to the health needs of Brent’s residents. Noting that GP services were independent business, it was queried how the CCG would meet commitments to provide health facilities in new private developments. Members highlighted that South Kilburn had not been included as a population growth area and questioned the accuracy of the population projections which stated that the populations of Willesden and Kensal Green were reducing. It was further noted that the report included no reference to facilities on the periphery of the borough which though not in Brent, still served Brent residents. A query was raised regarding how Brent CCG planned for the needs of an aging population. Additional details were sought regarding the rationale for the locations of the planned out-of-hospital hubs and members questioned how Brent residents were involved and consulted in the development of the Brent NHS Estates Strategy.
Sarah Mansuralli (Chief Operating Officer, Brent CCG) advised that the efficacy of the relationship between the CCG and NHS Property Services had improved as the new structure had bedded-down. Paul Cross (NHS Property Services) confirmed that Brent’s NHS estate was in a fit state, though there were a few areas that required investment to ensure that they remained fit for future use. Sarah Mansuralli noted that as part of the One Public Estate project, a practical approach was being taken to review whether the effectiveness of the existing estate was being maximised and how better synergy might be achieved with the council.
Sue Hardy (Head of Strategic Estate Development Brent, Harrow, Hillingdon and Ealing CCGs) explained that the void space at Willesden Centre for Health and Care had been reduced from 25 per cent for 2014/15 to 19 per cent in 2015/16. As the annual costs for the site amounted to £5.6million, it was acknowledged that costs for the void space at this location equated to approximately £1m for 2015/16. The total cost of void space across the Brent NHS estate was circa £2million per annum. It was emphasised that it was Department for Health policy, endorsed by NHSE, that required CCGs to pay for void spaces in NHS Property Services buildings. Sarah Mansuralli advised that in line with the out-of-hospital strategy and the Sustainability and Transformation Plan (STP), Brent CCG was working to bring more services out in to the community and these would be accommodated within the existing NHS estate; this was an incremental approach to reducing void space and maximising use of the estate.
Sue Hardy confirmed that the rental costs of buildings within the estate were typical of the specialist market for health provision but were higher than the market rent for general office space. Jake Roe (NHS Property Services) advised that the move to charge market rent for NHS buildings was determined by Department for Health and NHSE policy. Sarah Mansuralli advised that Brent CCG was currently working with the Brent Council for Voluntary Services to identify how to support voluntary groups to increase their ability to meet these rents. In view of the committee’s comments, Brent CCG could explore the possibility of releasing void space on a sessional basis for use by the voluntary sector.
Addressing members’ queries on the work between Brent CCG and the Council, Sue Hardy advised that Brent CCG had contributed to the Local Development Framework and planning guidance and would continue to work to align the NHS Estate Strategy with council policy to ensure that this informed planning decisions. Members heard that Brent CCG was strongly guided by the Council’s Planning team regarding the type of units that would be delivered by developments when anticipating health infrastructure requirements. In response to members concerns regarding the accuracy of the population projections, Sue Hardy advised that the figures referred to in the report were provided by the GLA and following the meeting, members would be signposted to where these figures could be accessed. It was confirmed that Brent CCG took account of the population profile when planning primary and community care provision and reviewed this annually. Sarah Mansuralli explained that the three out-of-hospital hubs referred to in the report had been identified in 2014, prior to the STP and One Public Estate programme and reflected a practical assessment of where there was scope for extension in the NHS estate. The locations and numbers of the hubs were currently being reviewed as part of the work between Brent CCG and the council. Consultation with the public was being undertaken under the STP; this included stakeholder engagement and the testing out of various scenarios with different groups.
The Chair thanked the representatives of the Brent CCG and NHS Property Services for their contribution to the meeting.
RESOLVED:
i) That Brent Clinical Commissioning Group together with NHS Property Services develop a Social Value Policy detailing how to maximise use of void space in NHS buildings by the Voluntary Sector;
ii) That the Brent Clinical Commissioning Group detail in its commissioning intentions how it will use the Estates Strategy to support and enable the voluntary sector;
iii) That a report be submitted to the Health and Wellbeing Board on how social value could be incorporated into the NHS Estates Strategy;
iv) That future reports from the Brent Clinical Commissioning Group and NHS partners detail in full at the start of the report the engagement activity undertaken or due to be undertaken;
v) That the NHS Estates Strategy include South Kilburn as a growth area.
Supporting documents: