The NHS has recognised that the development of integrated care systems requires a significant change to the way planning and resourcing estates has been undertaken. Rather than the conventional institution-based approach, planning and managing assets has to be managed on a collective basis across a wider area involving several partner organisations, including local authorities.
In late 2017 and early 2018, the Nuffield Trust and the Realisation Collaborative brought teams from five local health systems together to consider some of the practical challenges to developing and implementing estates strategies in today’s NHS. It was clear from the outset that the challenges experienced by these teams were far from unique, and insights about what would help resolve them had much wider relevance. It is those challenges and insights that form the basis of this report. We have also drawn on background articles prepared by Nuffield Trust and other contributors as resources for programme participants, and conversations during and following the three workshops between ourselves, the participating teams and expert advisors.
The report provides an overview of the challenges facing most health and care systems in developing integrated estates strategies, and practical suggestions for national bodies, local systems and third party advisors to address these challenges and enable local systems to deliver a health and care infrastructure that is sustainable and fit for the future.