The original Chiswick Health Centre was outdated and no longer fit for purpose, with significant backlog maintenance estimated at £12m, which impacted service quality and staff working conditions.
Background
The objective of this project was to replace a dilapidated 1970s health centre with a modern, fit-for-purpose facility that supports integrated care and achieves sustainability goals. The scope was to deliver a new four-storey health hub that would provide expanded clinical capacity, co-location of services, and enhanced public spaces. The hub would house a combination of GP and community health services serving over 60,000 patients.
This project was a complex multi-year endeavour to deliver, involving multiple stakeholders, including North West London ICB, West London NHS Trust, Hounslow Consortium, Chiswick Medical Practice, Chiswick Health Practice, West4 GPs and the London Borough of Hounslow. It faced significant challenges, such as maintaining service continuity during the works, legal delays, procurement complexities, and financial constraints. The initial project began in 2017, and the new facility was opened in September 2025.
Challenges
Below is a picture of the original 1970s health centre that the project looked to replace with a modern, fit-for-purpose facility that supports the community health model.
Redevelopment required the demolition of the old centre and decanting clinical services to a temporary facility, necessitating careful planning to minimise disruption to patient care and staff operations.
The project involved multiple stakeholders, including commissioners, service providers, the local authority, and housing partners. Achieving consensus and managing expectations across public sector organisations was complex and required robust engagement strategies.
The process was complicated by government COVID-related stay on eviction regulations, resulting in an 18-month delay to the programme and loss of Estates and Technology Transformation Fund (ETTF) funding, which put additional pressure on project timelines and financial planning.
The team faced commercial challenges, including limited market interest in joint ventures, difficulties securing full planning permission, and the need to maintain flexibility in the delivery strategy.
NHS procurement processes proved challenging, with protracted negotiations with contractors threatening the loss of key funding streams, such as GLA funding for key worker homes.
The project aimed to release surplus land for 55 social rented homes with preference for NHS key workers, delivered by development partner Hounslow Council, requiring innovative structuring of joint development agreements and nomination rights to ensure delivery and long-term benefit to the NHS workforce.
The team had to manage risks related to construction delays, cost inflation, and the need for timely capital receipts to support both health centre delivery and housing provision.
Ensuring a smooth transition from the temporary decant facility back to the new centre, while structuring leaseback and disposal arrangements to meet financial year-end targets, added further complexity.
Solution
Due to the complexity of this project, several of our teams were engaged to support the delivery of the new health centre.
Working through the options and stakeholder engagement
- Our Estate Strategy team have worked with a range of stakeholders to understand healthcare and community needs for this site. Through early stakeholder engagement and data-driven decision-making we were able to recommend an approach that not only met these needs but also aligned with NHS transformation goals.
- NWL ICB identified Chiswick Health Centre as a future health hub, recognising the need for increased GP and community health service provision to cater for changing demographics and health issues.
- We supported the customer by providing a comprehensive options appraisal and by supporting their business case development to ensure compliance with local planning and NHS priorities.
- The final agreed scope was the integration of health and residential schemes to maximise estate value and community benefit.
Learn more about our Estate Strategy team
End-to-end project management
- Once the business case was approved, our Development Management team led the complete lifecycle management of the new build, including design, procurement, and construction.
- It had been identified early on that the clinical services needed to remain operational throughout, we coordinated the temporary decant to Stamford Brook Centre with minimal disruption to service provision.
Funding the project and navigating complexities
- The detail of the financial modelling and funding strategy for this project was led by the Development Managers but leaned on the expertise of our Property Acquisitions and Disposals team to use the capital raised from the surplus land disposal to self-fund the project.
- The team structured the deal and managed the negotiation of agreements with the local authority and housing partners to support the delivery of affordable homes.
- They supported the customer to navigate the legal and contractual complexities to unlock necessary capital for reinvestment.
Supporting the NHS' zero carbon initiative
The Development Management team worked to incorporate low-carbon technologies into the project to support the NHS’ zero carbon initiative, they included:
- Air source heat pumps
- Mechanical ventilation heat recovery
- Solar PV arrays
- LED lighting with sensors
Through their work, the project achieved BREEAM “Excellent” rating and 77% carbon reduction.
Learn more about our Energy and Environment teamMaintaining the building
- Once the site was operational, we were asked by the customer to provide a comprehensive suite of hard and soft facilities management services.
- Hard facilities management services focus on maintaining the building’s physical infrastructure to ensure safety, functionality, and regulatory compliance. These services encompass critical systems such as heating, ventilation, and air conditioning (HVAC), electrical and plumbing networks, fire safety equipment, lifts, and building fabric maintenance.
- Soft facilities management services, by contrast, are designed to enhance the daily experience for building occupants and our offer for Chiswick Health Centre includes cleaning, waste management, grounds maintenance, pest control, security and helpdesk services. Our primary objective is to create a comfortable, efficient, and welcoming environment for colleagues and visitors, thereby supporting productivity and overall satisfaction.
Making the most out of space
- To support the ongoing effective use of space at the site, the Estate Strategy team recommended the implementation of NHS Open Space for flexible room booking and utilisation monitoring.
- There are currently two rooms available for accredited healthcare providers and community groups to use for non-clinical purposes.
Impact
- Eliminated £12m backlog maintenance.
- Increased clinical capacity by 1,000sqm through enhanced GP and community health provision including physiotherapy, mental health counsellors, primary care plus, wound care, community-based activities, culminating to an improved patient experience.
- Delivered 55 affordable housing units for NHS staff.
- Enhanced community wellbeing through use of a community neighbourhood hub.
- Delivered a modern, fit-for-purpose health facility that is BREEAM “Excellent” rated and achieved a 77% carbon reduction.
Key NHSPS value-add areas
- End-to-end delivery: We have partnered with our customer, North West London ICB, over an 8-year period to deliver this project. Supporting every aspect of the project from options appraisals and business case to design, construction and operational readiness and beyond. This approach ensured seamless delivery without the need for external project managers.
- Integrated estate solution: We supported our customer to deliver a modern health hub alongside 55 affordable homes for NHS staff, maximising estate value and community benefit.
- Alignment with NHS Long Term Plan: This site supports the neighbourhood health model. It now delivers services such as physiotherapy, minor surgery, and mental health support to over 60,000 patients.
- Innovative funding model: By leveraging our extensive knowledge and experience, we were able to combine multiple funding sources. Working closely with our customer to release land for housing, which generated approximately 60% of the capital required for the build. The remaining funding was secured through £1.1M of Community Infrastructure Levy (CIL) contributions and additional support from NHSPS.
- Ability to navigate and manage public sector relationships: We coordinated NHS stakeholders, local authority and housing partners to overcome planning challenges and maintain continuity of care during decant.
- Experts in estate optimisation: Through the implementation of NHS Open Space, we have enabled the efficient utilisation of clinical rooms, helping to reduce costs and improve access to a range of services for the local community.
- Experts in complex transactions: With our specialist knowledge of acquisitions, disposals, and lease structuring, we have delivered legal and financial solutions that have unlocked capital and secured long-term occupancy agreements.
