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Socio-economic and health impacts of LIFT: 10 years of delivering public-private partnerships

The Local Improvement Finance Trust (LIFT) programme has successfully delivered a significant range of health and regeneration benefits for some of the most disadvantaged parts of England, according to an independent report that examined the programme’s socio-economic impacts over the past ten years. Dr Sue O’Connell, chief executive of Community Health Partnerships, outlines some of the key findings.

As the national LIFT Programme lead, over the past decade CHP has worked with public and private partners to provide the community-based buildings and facilities needed to deliver 21st century health and social care.

This year marks the 10th anniversary since the creation of the first LIFT Company in East London. During that time the LIFT Programme has delivered – and continues to provide – modern, integrated health services in high quality, purpose-built premises in every region of the country, with a particular focus on economically disadvantaged areas. It has resulted in the most concentrated private sector investment in new, locally run primary health and social care facilities since the advent of the NHS.

The 300-plus NHS LIFT buildings accommodate a wide range of tenants including GPs, primary and community healthcare providers, local government services and voluntary organisations, providing improved standards of care for communities in some of the most disadvantaged areas of the country.

Care and wellbeing for disadvantaged communities

LIFT targets areas where there is the most need for improved access to healthcare, with almost nine in every 10 LIFT buildings in areas with above average health needs.

The report’s findings show that a high proportion of LIFT buildings provide services in areas where a significant number of residents suffer from socio-economic disadvantage. 119 LIFT buildings are based in the 10% most deprived areas of England. In addition, there are 3.3 times as many LIFT projects in multicultural areas than would have been expected given an even distribution across all area types.

LIFT investments have often been by far the most significant investment for many years in such areas, with many far-reaching benefits for local communities. There is also some evidence that LIFT developments have the potential to drive regeneration and improve the future prospects of local areas.

Steven Broomhead, chief executive at Warrington Borough Council, said: “The importance of health and wellbeing to Warrington’s prosperity cannot be underestimated.

“This is why the Orford project is so important, as it demonstrates collaboration in action at the super, purpose-built site. Fit bodies via the leisure facilities, fit minds via the library, and easy access to the NHS services make Orford Park unique.”

Integration of services

The report demonstrates how the co-location of services in LIFT buildings has enabled a more united service, which in turn has facilitated improved joint working, as well as better integration of primary and secondary care and specialist services.

It has also helped reduce unnecessary hospital appointments and allowed more effi cient referrals, avoiding people getting lost in the system and bringing care closer to patients.

GP Dr Jack Aw, from Milehouse Primary Care Centre in Staffordshire, said: “Primary care centres will become more community focused as it makes much more sense to have everything geographically under one roof as opposed to scattered throughout the area. Traditional clinics in hospitals need to move closer to the local community and their patients. The hospital is too expensive a setting when the same service can be provided in places like Milehouse, where it is much more personal.”

Through the co-location of previously separate bodies, LIFT has facilitated broader linkages and a more holistic approach to the delivery of health and community services. For example, the Liverpool LIFT developments, such as the Kensington Neighbourhood Health Centre, provide fl exible accommodation where Citizens Advice Bureau, Sure Start projects and third sector providers in fields such as mental health, smoking cessation and counselling services are all based together under one roof.

Inter-agency co-operation has also improved through this integration of services. A good example of this can be seen at Sparkbrook Primary Care and Community Centre in Birmingham. It houses three GP practices along with a range of service providers, including health (dental, physiotherapy, district nursing), local authority (a city council customer service centre, benefi ts and council tax advice and information, adult education services), third sector and private providers (legal advice service for immigration, domestic violence agency, drug and alcohol misuse charity). A survey found that 96% patients at the Sparkbrook Primary Care rated the facility as ‘very good’ or ‘good’ and that 98% thought it to be ‘much better’ than previous facilities.

High-quality accommodation

While the public has greatly benefi ted from the quality of LIFT buildings, the programme has also driven signifi cant improvements in the quality of health service accommodation, enhancing working conditions and facilities for service providers. This has resulted in outmoded and inadequate premises being replaced with high quality, flexible accommodation conforming to NHS standards.

LIFT developments also offer potential financial savings and improvements in service effi ciency. For example, shared services, a more effective use of space and more efficient buildings can reduce overheads and generate potential income as a result of vacating sites and buildings, enhancing the value of assets. The Bransholme Health Centre in Hull provides a shared reception service for some 10 GPs and an alternative provider practice, while Finchley Memorial Hospital’s energy running costs are now estimated to be £46,000 per annum compared to over £120,000 previously.

The success of PPP

The above achievements have only been possible due to the public-private partnerships (PPP) that deliver the LIFT programme. PPP has proved to be a model of development, attracting competitive funding markets, whilst responding to the challenges of increased integration, effi ciency and sustainability, as well as delivering a range of social, economic and health outcomes. Graham Pink is chief executive of Liverpool & Sefton Health Partnerships Ltd and Renova Developments Ltd, the LIFT Companies involved in the development of 31 projects across Merseyside and Warrington (Pink has been interviewed a number of times in National Health Executive).

Commenting on the value of Public Private Partnerships, he said: “The private sector brings commercial skills, but is also able to hold a mirror up to the NHS and offers a new perspective.

“From the public sector’s point of view it’s often about pushing back on that commercial drive and through working in partnership we are able to strike a balance between the two agendas and arrive at what is a pretty good model. It means we are able to deliver high levels of investment in a short space of time.”

Merseyside has the largest number of developments in the country. There are 31 buildings, equivalent to a small district general hospital, which have been delivered over a seven-year period, with nearly £200m of investment.

“It’s the Public Private Partnerships that have enabled that to happen,” says Pink.

“The world-views of the private sector and the public sector are different, but there are common goals and objectives that can be taken forward by the partnership. Time has to be taken to make sure that the decisions are right for the long-term, as well as the short term.

“The present financial environment means that we all need to work smarter and be more innovative.

“I strongly believe we can only do this by working in partnership with public and private sector organisations and embracing the skills and experience offered by each.”

Another view

Following the recent opening of the Biddulph Primary Care Centre in Staffordshire, which was created in a partnership between Prima 200 LIFT Company and the NHS, Dr Mark Shapley, chairman of the North Staffordshire Clinical Commissioning Group, said: “The new multi-million pound centre in Biddulph will serve around 100,000 patients a year and is a fantastic state-of-the-art building that will bring together a range of services under one roof.

“It will be a real asset that the whole community can be proud of.”