In our latest webinar, Executing and delivering value through Investment and Development Management, the team were asked “Why [we] maintain this attitude of always selling off surplus sites.”
This is a question I hear often, and it’s an important one. The decision to sell surplus NHS sites is never taken lightly. Here’s why this approach is not just a policy, but a practical necessity for the NHS and the communities we serve.
Reasons why we sell surplus sites
- Unlocking value for patient care
Surplus sites are properties that are no longer needed for NHS clinical services, as declared by local commissioners. Keeping hold of empty or underused buildings drains NHS resources. Money spent on maintenance, security, and utilities is money not spent on frontline care. By selling these sites, we release vital funds that can be reinvested directly into improving healthcare facilities, supporting new projects, and delivering better environments for patients and staff. - Supporting local and national priorities
At least half of the proceeds from each sale are reinvested locally, supporting priority capital projects agreed with the local Integrated Care Board (ICB), maintenance, and green initiatives. The remainder is reinvested in the wider NHSPS-owned estate to ensure they remain safe, modern, and fit for purpose. This approach ensures that the benefits of each sale are felt both locally and across the wider NHS estate. - Reducing costs and carbon footprint
Holding on to surplus sites increases running costs and backlog maintenance liabilities. Disposing of these properties reduces the NHS’s carbon footprint and operating costs, helping us run a more efficient, sustainable estate. This is not just about saving money. It’s about making the best use of public assets for public good. - Enabling community benefits
Selling surplus land often unlocks wider social value. Many sites are redeveloped for housing, community facilities, or green spaces. Since 2013, we have sold over 600 properties, raising more than £540 million for reinvestment and enabling the delivery of over 8,000 new homes. These projects support local regeneration and help address broader community needs. - A rigorous, transparent process
No site is sold without a thorough review. The process starts with our Estate Strategy Team working closely with local health commissioners who are responsible for declaring sites to be surplus to NHS needs. Properties are first offered to other public sector bodies before being marketed more widely, ensuring best value for the taxpayer. Every sale follows strict government and NHS guidelines, with oversight to ensure transparency and accountability. - Learning from experience
Our approach is shaped by years of experience and feedback from partners. We work closely with local systems to ensure that disposals are aligned with future service needs, and we use tools like phased disposals or overage clauses to retain flexibility where required.
Alternatives to selling surplus sites
While selling is often the chosen route, it’s not the only option considered. Here are some alternatives:
- Retaining sites for future NHS use
Sometimes, sites are held back if there’s a realistic prospect of future clinical or operational need. This might include anticipated service expansion, new models of care, or community health initiatives. In these cases, we work with local systems to ensure land is available when it’s needed. - Leasing to other Public Sector or community organisations
Before any sale, surplus sites are first offered to other public sector bodies. If there’s interest, properties can be leased or transferred for alternative public uses such as social care, education, or community facilities, helping to retain public value and support local priorities. - Temporary or flexible use
Where there’s uncertainty about long-term need, sites can be used for temporary or flexible purposes. This might include short-term leases, interim use for community projects, or phased disposals that allow the NHS to retain some control or benefit from future uplift in value. - Joint ventures or partnerships
In some cases, we explore joint ventures or partnerships with local authorities, housing associations, or private developers. These arrangements can deliver mixed-use developments that combine health, housing, and community benefits, while retaining some NHS influence over the site’s future.
Addressing the need for flexibility and prevention
We understand the importance of flexibility in planning, especially for step-down and out-of-hospital services. International examples show the value of larger, more adaptable sites. In the UK, we recognise that some larger NHS sites are under pressure due to limited space. Our approach aims to balance the need to unlock value from genuinely surplus land with the need to retain flexibility for future service models.
We work closely with local systems to ensure that disposals do not compromise future service delivery. Where there is a case for retaining land for future expansion or new models of care, we can and do hold sites or use phased or adapted disposals to retain flexibility – indeed we have facilitated a number of Community Diagnostic Centres recently on our sites.
In summary
Selling surplus NHS sites is not about reducing flexibility or ignoring prevention. It’s about making the best use of public assets to support patient care today, while planning for the needs of tomorrow. Alternatives are always considered, and we are open to learning from best practice and ongoing dialogue about how we can improve our approach. We explain our approach in more detail in our Guide to Acquisitions and Disposals.
If you have further questions or would like more expert advice, please get in touch, we’re always happy to help.
