Driven by austerity, there are changes afoot in the NHS that present significant opportunities for housing associations to work more closely with the NHS in England.
The vision for the NHS’s future direction: improving public health, patient centred care and integration of services across health and social care. These are set out in the Five Year Forward View, which is currently being developed by local Sustainability and Transformation Partnerships (STPs).
STPs are 44 geographically based partnerships between the NHS and local authorities and other organisations which are working together to plan how services will be integrated across health social care in their area and improve the health of the local population whilst balancing the NHS budget.
In this context, the government commissioned an independent review of the NHS estate by Sir Robert Naylor. The Naylor Review (March 2017), concluded that delivering the vision put forward in the Five Year Forward View, for a strengthened primary care sector and out-of-hospital services as well as the use of technology in the delivery of health care, would necessitate a change in the way that the NHS used its estate.
Critically, the Naylor Review proposed a financial opportunity for the NHS to generate £2.6bn to help with the delivery of the Five Year Forward View, by disposing of surplus NHS assets.
The opportunity highlighted by the Naylor Review is that unused or under-utilised NHS land could be released to deliver an estimated 30,000 new homes and that the sale of smaller sites should be accelerated for that purpose. The Review recommended that where land is sold, provided there is demand, new homes should be prioritised for NHS staff.
These Recommendations have since been accepted by the government (January 2018). Yet, the New Economics Foundation, who carried out a review of sold NHS sites this year, have said that there are “no homes for nurses”, that four out of five new homes built on former NHS sites will be unaffordable to nurses and only one in ten of the new homes will be at an affordable rent. In London, according to the New Economics Foundation, the average expected sale price is £561,589 – 18 times the annual salary of a nurse. It is therefore unsurprising perhaps that a reported decline in nurse numbers is so often in the headlines with staff pay and hours cited as key factors.
Given the pressing need to generate cash receipts for the NHS and the shortage of affordable housing this presents an excellent opportunity for both the NHS and housing associations to work more closely together particularly in the new policy context of STPs, in order to maximise the financial return and social impact of the disposal of NHS surplus land. As HACT (Housing Associations Charitable Trust) has pointed out, housing associations are well placed to form joint ventures with local NHS organisations. Registered providers have the ability to leverage low cost private finance and to deliver open market homes, which cross subsidise key worker housing for NHS staff. A joint venture between registered providers and the NHS is a sensible approach that would benefit both parties.