The Government’s latest announcement signals a bold step towards tackling NHS waiting times and modernising healthcare infrastructure. At its heart is a commitment to deliver 250 new health hubs and more than 100 centres or refurbishments by 2030, under a refreshed public-private partnership (PPP) model.
Neighbourhood health centres are a key part of the Government’s plan to build an NHS fit for the future and bring care closer to home. Initially these services will focus on access to general practice and supporting patients with complex needs and long-term conditions.
With the autumn budget looming, it will be interesting to see if the Government decides to go further and include a promise for PPP hospital buildings and other parts of the NHS.
Learning lessons and driving value
The Treasury has been clear: this new PPP approach will “learn lessons from past and current PPP models”, ensuring that private capital “only supplements public investment” where it offers value for money. This marks a decisive shift from previous frameworks, prioritising transparency and fiscal prudence.
Beyond “bricks and mortar”
However, as the Independent Healthcare Providers Network (IHPN) argues in its recent publication Building Better Health, partnerships must go beyond “bricks and mortar”. The private sector is ready to play its part - not just in construction, but in fixing the “broken” NHS capital regime that has constrained progress to date.
Lord Darzi’s independent investigation laid bare the scale of the challenge: a £37 billion shortfall in capital spending since 2010, driven by chronic “underinvestment” in capital and a “dysfunctional” capital regime. This has left hospitals grappling with outdated estates, limited capacity, and mounting maintenance backlogs, now exceeding £16bn.
IHPN’s new report calls for a Strategic Council for Healthcare Infrastructure to be established to provide cross government support to accelerate private investment into the NHS, including the development of the Neighbourhood Health Centres.
Other recommendations include updating the Treasury’s Green Book guidance, to clarify the off-balance sheet capital investment mechanisms available to senior NHS leaders to stimulate PPPs.
What lies ahead
The Government’s pledge to modernise the NHS’s Neighbourhood Health Centres is ambitious – but success will depend on strategic collaboration, robust governance, and a willingness to embrace new models that prioritise value, efficiency, and patient care.
Groups of private sector investors, contractors and facility management providers have for some time advocated for an adapted PPP model, taking the best of PFI, NHS LIFT and including features from Wales MIM and overseas. There is also a desire to promote the successes of PFI/PPP, which over the years have rarely made the news in contrast to negative stories.
As HM Treasury notes, this is about supplementing - not replacing - public investment. With the independent sector signalling its readiness to contribute, the question is whether government can create the conditions for partnerships that truly transform healthcare delivery.
Our multi-disciplinary team is experienced in advising the health and care sector on all aspects of capital development including Healthcare PFI/PPP and social infrastructure PPP more widely. Please contact Nick Helm, Jennifer Lewis, Rob Day, David Stead and Jens Henniker Heaton if you’d like to discuss any of the issues raised here.
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