Westminster Health Forum

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Next steps for NHS estates - funding, infrastructure modernisation and optimisation, net-zero, and learning from the response to the pandemic

March 2021


Price: £95 PLUS VAT
Format: DOWNLOADABLE PDF


***Full-scale policy conference taking place online***
This conference is examining key priorities for policy and practice in the development and management of NHS estates, as the Government commits to building new hospitals and improving healthcare infrastructure.


Areas for discussion include:


  • funding and allocation of investment
  • working towards net-zero, and sustainability targets
  • optimising the role of the NHS estate in healthcare provision
  • the challenges posed by the pandemic and learning from implementation of the Nightingale hospitals

The conference is bringing together stakeholders with key policy officials who are due to attend, including from the DHSC; the Cabinet Office; the Care Quality Commission; the HSE; the MHCLG and the Office of Government Property.


The agenda:


  • Optimising the NHS estate - progress and remaining issues
  • The role of the NHS estate in responding to the pandemic - provision of safe care to patients and COVID-free hubs, responding to demand, and the development of Nightingale hospitals
  • Priorities for funding - investment allocation, NHS surplus land disposal, and assessing the scope for further efficiencies
  • Effective public-private partnerships and key issues and opportunities going forward
  • Improving environmental sustainability in the NHS estate and next steps for working towards net-zero targets
  • Case study: strategic partnership working to optimise and evolve the NHS estate in Manchester
  • Priorities for health infrastructure - identifying need, effective strategy formulation, efficient new development and delivery, and addressing variation
  • Next steps for strategic estates policy

Areas for discussion:


  • the Healthcare Infrastructure Plan:
    • progress in delivery and looking forward - including in the context of the impact of COVID-19
    • achieving goals - assessing progress, as well as:
      • how the Plan can deliver improvements in safety
      • priorities for new building projects
      • its role in supporting the systems approach taken in the NHS Long Term Plan
  • funding - looking at financial priorities at a local, regional and national level:
    • impact - examining additional government funding put forward for NHS infrastructure, including the six initial builds and further schemes that are planning delivery in 2025 to 2030
    • primary care infrastructure - priorities for enabling care closer to home, with discussion expected on the role that private finance can play in primary care estate development
    • maintenance backlog - priorities for bringing facilities back to a suitable condition, with concerns mounting over the cost of this backlog, following the Review of capital expenditure in the NHS
    • surplus NHS land:
      • progress in disposal - and strategies for incentives, taking into account regional disparities in prices
      • reinvestment - options for proceeds to go back into the estate
      • collaboration - the way forward for closer working between NHS organisations and local planning authorities
    • capital expenditure - with discussion expected on issues highlighted in the NAO review on rising costs, the age of the NHS estate, and capex allocation, access and strategy
  • environmental sustainability - looking at challenges, options and best practice for:
    • climate targets - meeting the aim for the NHS to be net-zero by 2040, with:
      • some NHS trusts declaring climate emergencies
      • progress outlined in the Annual Report, with initiatives introduced that include switching to 100% renewable electricity, and the the potential for a net-zero ambulance fleet in London by autumn 2021
    • waste management - across NHS estates, looking at single-use PPE including during the pandemic, the role of procurement, and learning from successful waste management initiatives
  • COVID-19 - and what can be learned and applied going forward:
    • the impact on the NHS estates - assessing the approaches taken to ensure local services have enough capacity to deal with increased demand
    • vaccinations - assessing the impact on:
      • NHS capacity with the growth of vaccination hospital hubs and the use of primary care settings
      • facilities, as two 24-hour vaccination centres are piloted
      • NHS Estates in the future, with increased vaccine rollout
    • delivery - priorities for ensuring the correct NHS estates infrastructure is in place to deliver a vaccination programme of this size, after reports of problems with the IT system that tracks COVID inoculations
    • hospital design - understanding different priorities for the use of manufacturing technology when creating new builds
    • Nightingale hospitals - their developing role in the national response to the pandemic and more widely in their role as potential centres for COVID-19 vaccine rollout, future options for repurposing, and value for money
    • safety and providing care - looking at public engagement on continuity of care and safe use of services, including the establishment of COVID-free cancer hubs across the country, and the infrastructure needed for efficient discharging of patients from hospitals
  • meeting capacity challenges - prospects and priorities following the PM’s announcement of A&E facilities funding
  • the Naylor review - examining developments since Sir Robert’s recommendations on disposal of surplus NHS land, development of strategic estate plans, and work with local integrated care systems
  • technology - implementation and modernisation in the NHS estate, and its role in estate management, as well as priorities for contributing improvements across the NHS estate, including in the delivery of care:
    • digital and remote care - looking at how this has been developed, enabled and rolled out through the pandemic
    • online records - progress in digitising patient data and improving information systems, remaining technical challenges and engagement with staff and patients
    • improving health outcomes - priorities for identifying need and supporting integrated care
    • overcoming logistical and financial challenges and sharing best practice
  • efficiency improvements - looking at options, strategies, challenges and best practice in areas including:
    • effective use of NHS land - as well as the role of multi-function spaces, and designing infrastructure that improves space utilisation
    • strategy - planning, project management, integration of innovation in technology and organisational processes
    • services - improving accessibility and enabling more integrated models of care

A scan of relevant developments:


  • Integration and Innovation: working together to improve health and social care for all - the government white paper on the future of health and social care, with proposals to update integrated care systems and improve the use of NHS resources 
  • the Healthcare Infrastructure Plan - which:
    • sets out a five-year programme of investment and a strategic approach to improving healthcare infrastructure
    • announced an additional investment of £2.8bn capital funding for hospital infrastructure
    • includes the £3.7bn hospital building programme aiming for 40 new hospitals by 2030
  • the Naylor review - Sir Robert Naylor’s recommendations on NHS property and estates, and the Government’s response
  • Review of capital expenditure in the NHS - the NAO review of capital expenditure in the NHS, which looked at the rising costs and age of the NHS estate, the allocation of capital investment and access to capital funds, as well as the challenge of delivering an effective capital strategy
  • Delivering a ‘Net Zero’ National Health Service - from NHS England and NHS Improvement, outlining the analysis behind producing a more environmentally sustainable NHS, including measures required to achieve net-zero and a section on reducing emissions for NHS estates and facilities
  • Build back better: £600m to upgrade and refurbish NHS hospitals - as part of the £1.5bn announced in the summer, 178 NHS trusts will receive a share of £600m to help tackle the most urgent maintenance issues by March 2021
  • Prime Minister confirms funding to prepare the NHS for winter - £300m for NHS trusts to upgrade A&E facilities and improve capacity
  • NHS Property Services Annual Report and Accounts 2019/20 - outlining the response to COVID, £90m of capital investment into NHS sites over the last year, and progress with the NHS Long Term Plan, including introducing social prescribing sites, and their priorities for 2020/21

Policy officials attending:


Our forums are known for attracting strong interest from policymakers and stakeholders. Places have been reserved by officials from the DHSC; the Cabinet Office; the Care Quality Commission; the Health and Safety Executive; the Ministry of Housing, Communities and Local Government; and the Office of Government Property.


This is a full-scale conference taking place online***


  • full, four-hour programme including comfort breaks - you’ll also get a full recording and transcript to refer back to
  • information-rich discussion involving key policymakers and stakeholders
  • conference materials provided in advance, including speaker biographies
  • speakers presenting via webcam, accompanied by slides if they wish, using the Cisco WebEx professional online conference platform (easy for delegates - we’ll provide full details)
  • opportunities for live delegate questions and comments with all speakers
  • a recording of the addresses, all slides cleared by speakers, and further materials, is made available to all delegates afterwards as a permanent record of the proceedings
  • delegates are able to add their own written comments and articles following the conference, to be distributed to all attendees and more widely
  • networking too - there will be opportunities for delegates to e-meet and interact - we’ll tell you how!

Full information and guidance on how to take part will be sent to delegates before the conference



This pack includes

  • Dropbox video recording of the conference
  • PDF transcript of the discussion, including all speaker remarks and Q&A
  • PDFs of speakers' slide material (subject to permission)
  • PDFs of the delegate pack, including speaker biographies and attendee list
  • PDFs of delegate articles