I’ve spent many years working directly with Public Finance Initiative (PFI) contracts and helping NHS organisations understand what is really happening inside their buildings.
With Public Private Partnerships (PPPs) now being considered as a funding route for Neighbourhood Health Centres (NHCs), there are several lessons we need to learn from PFI if we want to avoid making the same mistakes.
PFI: good intentions, poor outcomes
PFIs were created to give the NHS modern facilities without needing upfront capital. The private sector funded, built and maintained the buildings, and at the end of the contract, they were expected to hand everything back in Condition B — essentially “as new”, with no major capital investment needed for several years.
But across many sites, that’s unfortunately not what happened. As contracts progressed, maintenance backlogs grew, lifecycle work slipped, and assets often fell below the standard trusts expected at expiry. Many buildings were returned in poorer condition and with gaps that should have been addressed earlier in the contract lifecycle.
Where things went wrong
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Self‑monitoring didn’t work: PFI contracts relied on project companies reporting their own performance and declaring penalties when they failed to meet standards. In practice, this almost never happened, which meant issues stayed hidden for years.
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Oversight capability faded over time: Local estates teams changed. Structures changed. Expertise was lost. With fewer specialists able to interpret contract obligations or challenge reports, performance assumptions often went untested.
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Problems only surfaced too late: Where maintenance or lifecycle works weren’t being delivered, the consequences built quietly in the background. I’ve seen buildings deteriorate to the point where demolition was considered because problems were never properly challenged.
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The financial impact was huge: Once proper monitoring was introduced, penalties at one site we look after rose from £100–150k per year to £1.5m, showing just how much non‑performance had gone unnoticed.
These things happened not because the contract failed, but because it wasn’t managed actively.
How estates leaders in ICBs and Trusts can embed active management of PFI and PPP contracts
With the commitment to PPPs, we’ve got an opportunity to tackle some of these challenges with stronger assurance and oversight from day one, something I’ve been advocating for in discussions.
Estates leaders must:
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Build specialist contract support early: Contracts of this scale need dedicated commercial, technical and lifecycle expertise from the moment they begin.
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Challenge early and often: Performance reports, lifecycle plans and compliance evidence must be tested. Never assume the building is being managed as the contract promises.
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Treat handback as a day‑one priority: Whether it’s PFI or PPP, your future building condition relies entirely on what happens throughout the contract, not just at the end.
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Use real PFI examples as your guide: We now have years of evidence showing where performance drops, where lifecycle slips, and where compliant buildings become non‑compliant. Use this learning. Don’t ignore it.
Let’s make sure PPPs don’t repeat PFI mistakes
PPPs can absolutely help deliver NHCs. But we need to make sure we go into them with the right foundations — strong assurance, clearer accountability, and consistent monitoring.
If you already have a PFI property, or you’re exploring PPPs, now is the right time to strengthen your position.
Speak to us about PFI Management and upcoming PPPs
If you want support with PFI Management, we’re here to help.
We can walk you through the pitfalls, the assurance steps, and the actions you should take now to protect long‑term value.
We actively manage 22 PFI contracts across 26 buildings in England, and 9 Lease + (LIFT) and our portfolio is 100% contractually compliant.
And if you’d like to understand how we can help you in more detail, you can download our PFI Management handbook. It’s designed to make these lessons practical and actionable for estate leaders.
