Baxendale’s real estate specialist Saimah Heron explores the benefits of thinking long term about the primary and community care estate.

In many ways understanding the primary and community care estate is straightforward – it’s big and it’s complicated. Estimated to be 4-5million m2 in England, there’s no common ownership structure: properties are held by independent practitioners, NHS Property Services, Community Health Partnerships and parties within the private sector. On top of that, there’s hardly any centrally held data and the quality of properties is variable, with a considerable proportion expected to be unfit for purpose.

Creating a national primary and community care estates strategy would need some heavy-duty untangling – something the Naylor review on NHS estates understandably sidestepped by focusing on the acute portfolio.

Yet as the NHS progressively adopts its Five Year Forward View, the primary and community care estate has a critical role to play. Here’s why:

Estates enable the delivery of integrated services

There is an undoubted ambition for primary and community care to be delivered at scale and in a joined-up way. The Multispecialty Community Provider model for instance brings together primary care, community health, social and third sector providers – who would likely be operating from distinct locations before formally partnering.

The point where a new service model, of any kind, is being considered is when parties can make a thorough evaluation of how best to serve the local community. This includes where services are located to offer accessible high-quality care, and how the spaces are designed to be pleasant and efficient. If planned well, services may find co-locating accelerates the adoption of new ways of working and encourages serendipitous encounters between different parties, and creates a more seamless patient experience.

High quality estates promote wellbeing for patients…

The setting where care is delivered can impact overall health outcomes. Introducing elements of biophilic design such as ventilation, daylight and views of nature are proven to reduce stress for individuals in a clinical setting. Clear signage and considered use of colour can also make spaces more dementia friendly. Other measures are important too – such as being accessible, and providing a ‘frictionless’ experience.

Using spaces for social as well as clinical wellbeing is essential for supporting self-managed care and reducing social isolation.

…and staff

Let’s not forget what the space feels like as a working environment. There is a GP and community nursing shortage that means in many locations posts are unfilled. As a cohort, GPs are increasingly working part time – the average GP works four days a week – which is expected to exacerbate the problem further. With little flexibility on pay, organisations have few levers available to attract individuals. Real estate is one of these tools – 69% of millennials consider working environment more important than pay.

A real step forward for primary care estate will be viewing property as an asset that can enable better outcomes and not as a cost to be managed. Simple changes like creating appealing spaces for stressed workers to take a break or interact with colleagues can introduce new energy to the workforce.

These days the NHS needs to do so much more than patch people up and send them on their way. It recognises this, and is increasingly taking a ‘wellness’ approach centred on long term outcomes. Imagine if we did the same with estates.

To discuss how Baxendale can support you to optimise your estate, contact robin.naudi@baxendale.co.uk