Published date: 08 June 2023

Partnering with an ICS to deliver their Infrastructure Strategy

In response to NHS England requiring all 42 ICSs to develop an infrastructure strategy in FY 2023/24, Cambridgeshire & Peterborough ICS (C&P) approached NHS Property Services (NHSPS) to produce their ten-year infrastructure strategy in Autumn 2022.

NHSPS provided end-to-end support from scoping to delivery, and brought a wealth of experience and expertise in estate optimisation, data analysis and project management to produce the ICS’ infrastructure strategy.

“Writing any strategy can be a daunting and often time-consuming process. It is fraught with the tension of articulating a vision that is inspiring, but balanced with the reality of practicalities and constraints that occupy our day-to-day decisions. However, our partnership with NHSPS and the focus and passion of the entire team ensured that we had a clear plan of action and remained on track to deliver sustainable results at the agreed timelines,”

Kit Connick, Chief Officer Partnership and Strategy, Cambridgeshire & Peterborough ICB

The challenge

In September 2022, C&P partnered with NHSPS to develop their infrastructure strategy. The ICS needed support in understanding the key estate issues which impact on the ICS’s ability to provide modern healthcare to its population, including:

  • Data around the estate that is currently used for delivery and support of services.
  • The age, extent and appropriateness of its estate, particularly primary care.
  • What opportunities existed to move services that were being delivered in a secondary setting into more local integrated neighbourhood settings (hubs) as envisioned by The Fuller Report.
  • What the blockers are to providing efficient and fit-for-purpose estate.
  • How the current estate could be better utilised, such as back office accommodation, and the critical capital issues relating to the estate, such as RAAC (Reinforced Autoclaved Aerated Concrete).
  • How managing multiple workstreams and stakeholders can be best achieved to deliver the objectives of the infrastructure strategy.

To be affordable, the strategy needed to be radical and capable of being delivered across a five to ten year timeframe, taking into account national, regional and local priorities that will emerge over this period.

The solution

NHSPS convened a cross functional team of experts to meet with C&P to establish requirements, including timelines, roles and responsibilities. NHSPS developed a framework and storyboard for the delivery of their infrastructure strategy which was approved by ICS Executives.

Key milestones in the development of their infrastructure strategy included:

1. One-to-one meetings: NHSPS spoke with 25 key stakeholders from C&P’s Board and system members to understand their clinical and financial priorities and requirements from the infrastructure strategy. Key questions focused around the existence of individual Trust estate strategies, challenges and opportunities (across the wider system and their own estate) as well as more specific questions around utilisation, costs and leases. This helped NHSPS get a thorough understanding of the task and expectations and key estates issues, while also building strong working relationships.

Speaking with multiple stakeholders across the system was extremely valuable in building relationships, understanding the issues and challenges they faced, gathering useful information that helped shape the strategy, and setting clear expectations, concerns and timelines to deliver a successful outcome,” Kully Dhillon, Head of Relationship Management North, NHSPS.

2. Data review: NHSPS gathered and analysed the relevant estate and population data through multiple data capturing exercises to understand the position of their current estate and develop actionable plans to support population needs both now and in the future. This included an initial exercise to understand what NHS system estate existed outside the four main acute settings basing the study on C&P’s 22 Primary Care Network (PCN) geographies. NHSPS gathered information against 10 key property data fields before reviewing and cleansing the data and checking it against other sources such as SHAPE (Strategic Health Asset Planning and Evaluation). This property level information was mapped against local population demographics and other socio-economic data to understand the appropriateness of the existing estate.

3. Drafting and feedback: Using the outcomes from interviews and data findings, NHSPS developed a list of potential estate objectives and enablers. These key determinants of a strategy were workshopped with estate stakeholders to collect feedback and further direction was gathered by engaging with the Local Medial Committees and PCNs. NHSPS consistently sought feedback, incorporating changes and adapting key messages.

‘When developing the strategy, we carefully considered how the existing supply would need to adapt to support both current and future demand, specifically where housing and population growth would have an impact on NHS infrastructure. The strategy needed to reflect local place-based requirements while being cognisant of national policies and direction.

A key theme throughout the strategy was how places and spaces could be transformed to integrate primary and community services by optimising and getting best value from the existing NHS and wider public core estate, and we look forward to continuing to work with system partners to drive this opportunity and the further development of the strategy,” Simon Taylor, Estates Strategy Director, NHSPS.

4. Final production: After four months of development and upon receiving sign off from C&P’s Board, NHSPS’ Brand and Design team produced a final, 173-page infrastructure strategy. The document was accessible, incorporating NHE England’s accessibility guidelines, and designed in line with C&P’s brand guidelines.

The impact

1. Strategy creation

In early March 2023, C&P published their first ever infrastructure strategy, focusing on:

  • Transforming Places and Spaces to deliver their Health and Wellbeing Integrated Care Strategy
  • Making best use of the existing estate and making sound investments where capital is available. 
  • Making the estate more efficient and releasing under-performing assets – both clinical and non-clinical – to reduce revenue costs and releasing capital for reinvestment. 
  • Improving the quality of estate data to help them make insightful decisions on our shared estate both now and in the future. 

The strategy includes chapters such as Estate strategy framework, Health and wellbeing requirements, State of the estate, Progress since 2018, ICS estate priorities and delivering the strategy. You can find the externally-facing strategy summary on C&P’s website.

2. ICS estate knowledge

C&P has developed an in-depth understanding of its current estate and its suitability to the services it plans to provide over the next 10 years. This will help them make informed decisions about how their estate will need to change to meet population health needs in the future as well as embed the strategy within their workforce and engage with local communities.

3. Patient benefit

This strategy was tailored to the health and social care needs of Cambridgeshire and Peterborough.

Mapping population health needs against the estate and forming a ten-year strategy helps enable patients get the care they need, both now and in the future, in the best place and space for them, helping improve their overall health prospects.

4. Partnership

C&P and NHSPS have built a strong strategic partnership throughout the development of the ICS’ infrastructure strategy.  As a result, NHSPS colleagues continue to work closely with the C&P team and other system organisations to ensure the milestones and actions within the strategy are executed.

Key NHSPS value-add areas

  • Estate expertise and data analysis: NHSPS undertook a detailed estates review and distilled thousands of pieces of information to create a tailored ICS infrastructure strategy. All actions suggested within the strategy are realistic and achievable, based off NHSPS’ experiences of collaborating on strategic estates planning with customers for over ten years.
  • Engagement: NHSPS built strong relationships across the ICS and at all levels, including estates, primary care, acute and ambulance trusts, local authority, GPs and policy leads, to understand their different challenges, capture their vision and produce a strategy that is tailored to meet the needs of Cambridgeshire and Peterborough.
  • End-to-end support: NHSPS provided end-to-end support from interviewing ICB leaders and facilitating workshops to the ongoing delivery of actions within the strategy. NHSPS brought together a team of experts across Relationship Management, Estate Strategy, Town Planning, Digital and Data, Brand and Design and Marketing among others.
  • Collaboration: NHSPS worked with the ICS as one team, creating a positive working culture by providing regular and honest updates, responding to feedback and working flexibly to best support the ICS.
  • Project management: NHSPS successfully aligned multiple workstreams to run concurrently and delivered updates and drafts at pace to meet the tight timescales to successfully launch the infrastructure strategy in March 2023.

Customer feedback

“We are delighted to have published our first estates strategy after four months of hard work and dedication. We know that without the support, guidance and expertise of NHSPS we would not have delivered this strategy with collaboration from all our system partners. Their knowledge and expertise in strategic health estates planning has been invaluable, alongside their commitment to understand the Cambridgeshire & Peterborough’s landscape of population, property and providers. I look forward to continuing to work together with colleagues at NHSPS who share our values and are equally committed to improve the health and wellbeing of our local communities through our work together,”

Kit Connick, Chief Officer Partnership and Strategy, Cambridgeshire & Peterborough ICB

“Working with NHS Property Services has been a really valuable experience in helping us create our new Estates Strategy. Their team became part of our team – working with our ICB and wider system partners to gain a deeper understanding of the challenges and opportunities that exist across Cambridgeshire and Peterborough. They then took these insights and combined it with data to co-create a strategy that will help us to transform our Estate over the next five to ten years to support our priorities to create healthier futures for our local people. We look forward to continuing to work with the team in the future to bring the strategy to life.”

Jan Thomas, Chief Executive Officer of NHS Cambridgeshire & Peterborough ICB, part of Cambridgeshire & Peterborough ICS