Browne Jacobson comments on NHS Confederation report

The NHS Confederation has published a report advocating for the government to explore how private finance can be leveraged to invest in public healthcare infrastructure.

Towards a new co-investment model: what is next for NHS public-private partnerships?, which was published on 7 September, calls for an effective public-private partnership (PPP) model to help “rebalance the NHS estate”.

In the report, the NHS Confederation says healthcare infrastructure has suffered from “decades of underinvestment” and cites “current fiscal rules” as a barrier to future government investment.

As a result, it calls for a new model of private co-investment alongside public investment to “play a significant complementary role to public finance”.

NHS Confederation report follows government’s pledge to explore PPP models

Craig Elder, partner specialising in public procurement at UK and Ireland law firm Browne Jacobson, said: “The government's 10-year health plan prioritises the shift of patient care into the community through neighbourhood health centres, acting as 'one-stop-shops' for patients. The fundamental question remains: how will government fund potentially hundreds of these centres nationally, given the condition of public finances?

“The NHS Confederation’s report, Towards a new co-investment model: what is next for NHS public-private partnerships?, makes clear that NHS leaders view private finance – when lessons are learned of the past and adopts international best practice – as a key part of the solution.

“The 10-year infrastructure strategy's suggestion that community health infrastructure could be an area for private finance, coupled with government's pledge to develop new public-private partnership (PPP) models learning the lessons of the private finance initiative (PFI), aligns perfectly with the co-investment approach outlined in this report.

“It’s already clear this isn’t just theoretical, with the Department for Health and Social Care (DHSC), in conjunction with the National Infrastructure and Service Transformation Authority (NISTA), publishing a preliminary market engagement notice for “Project Wings” over the summer. This includes the 'design, build, finance, operation and maintenance of primary and community health infrastructure projects through a PPP model'.

“The co-investment model proposed by the NHS Confederation offers a path forward. The potential advantages of private sector innovation, project management rigour and the ability to deliver economies of scale through consistent project pipelines could be transformative for community healthcare delivery.

“However, we must ensure any new model delivers genuine benefits while avoiding PFI's perceived drawbacks – including high transactional fees, lengthy procurements, and poor-value risk transfer.

“The market will seek well-resourced public sector delivery vehicles with capacity to engage effectively, and the co-investment approach could provide exactly this framework. As contracting authorities prepare for this new era, they must equip themselves with the commercial and project management skills crucial to delivering on government's ambitious healthcare infrastructure vision.

“The NHS Confederation's report provides valuable guidance on how co-investment can bridge the gap between public ambition and private sector capability.”