NHS Confederation has launched a new report on insights and learning from NHS private finance initiatives in England and abroad, and recommendations on what any future model should look like.
Key takeaways:
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The UK has spent decades underinvesting capital in its healthcare system and now suffers the resultant poor productivity and a £14 billion maintenance backlog that hampers patient care.
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The delayed and underfunded New Hospital Programme, with spiralling costs for poor return, demonstrates the limits of the pure public capital approach.
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NHS leaders believe that a new model of private co-investment, which learns the lessons of the past and has the confidence of the public and private sectors, alongside public investment must play a significant complementary role to public finance in fixing the NHS’s capital woes alongside further public investment, as is already being done in Wales and Australia.
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An effective Public Private Partnership (PPP) model that has the support of both the public and private sector will be critical in rebalancing the NHS estate after decades of underinvestment and given the current fiscal rules.
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The NHS Confederation has worked closely with NHS leaders, the investment industry and central government to understand what went well and what didn’t during the UK government’s PPP programme, the Private Finance Initiative (PFI), in the 1990s and 2000s.
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This report contributes to the ongoing discussion by providing lessons we can learn from PFI in the past and learn from international best practice to make recommendations on what future model(s) should look like.
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A more effective PPP model for the healthcare sector would see a public sector seat on the PPP board to enhance oversight, keep facilities management in-house with the public sector and take a new approach to contracts which is focused on outcomes not rigid specifications. It would also be supported and overseen by an expert central team in the Department of Health and Social Care, working in partnership with local trusts and integrated care boards.
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Putting these lessons into action, while also learning from modern best practice from other countries’ PPPs, can shape a working model for a new model of PPP for both neighbourhood health centres and acute hospitals England.
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There are a wealth of models available that have been used successfully in both the UK and across the globe. This report sets out a range of these options as a contribution to the ongoing policy discussion.
Date: 12 September