Healthcare Property Issue 05 September-October 2024

09/2024

SEPTEMBER-OCTOBER 2024

Contractor appointed to build £15m

community health centre

Keyworker housing model supports

recruitment and retention of staff

Investors and property developers remain

interested in health and care sector

HEALTHCARE-PROPERTY.COM

Comment

W E L C O M E

A new government

— a new approach

Since the last edition of

Healthcare Property magazine,

there has been a change of

government, with the Labour

Party taking power.

In the run-up to the ballot,

the party put forward a number

of proposals to improve health

and care services, including

cutting waiting times, doubling

the number of cancer scanners,

reviving NHS dentistry services,

reforming employment support,

and re-opening the door to

primary care.

And some further detail was

provided in the King’s Speech

on 17 July, where health-specific

announcements included

reforming the Mental Health

Act and tackling smoking by raising the age of sale of

tobacco products.

But the Government was largely silent on the issue

of capital spending on the healthcare estate, with new

Health Secretary, Wes Streeting, also announcing an

urgent review of the New Hospital Programme (p6),

admitting that ‘it’s painfully clear that the previous

government’s New Hospital Programme, that said

they would deliver 40 new hospitals by 2030, is not

deliverable in that timeframe’.

This will mean hospitals continuing to struggle

with outdated infrastructure that they do not have the

capital to address, alongside other pressing issues such

as RAAC and asbestos.

In this edition of Healthcare Property you can

read more about the impact of

the change of government on

the sector; including details of

Handelsbanken’s latest Property

Investor Report, which shows

optimism within the healthcare

property sector, with key players

doubting that a change in the

party in government will lead to

significant changes in the market.

And Knight Frank’s recentlypublished

Healthcare Capital

Markets supports this view,

indicating the demographics, longterm

income, and ESG credentials

‘present an undeniable case’ for

investment.

There are also indepth

features on waste management,

fire compliance, and the legal

implications of energy efficiency contracts.

Plus, we look at the design of keyworker

accommodation and reveal the latest thinking behind

the design of mental health facilities.

Coming up in the next edition features will include

LED lighting solutions; the impact of arts and interiors

on patient, resident, and staff wellbeing; and how we

will be able to fund the next generation of primary

care facilities in light of the Government’s recent

pledge to ‘re-open the front door to the NHS’ through

improvements in GP and community services.

If you can help with any of these features, please email

joanne.makosinski@nexusgroup.co.uk

Jo Makosinski

Editor, Healthcare Property

About Jo: Jo is the editor of Healthcare Property, having

joined Nexus Media in November.

She has been specialising in design and construction

best practice within the health and care sector for the

past 15 years, working on the Building Better Healthcare

Awards and editing both Building Better Healthcare and

Healthcare Design & Management magazines.

She has a special interest in the design of mental

health and dementia care settings and in modern

methods of construction and energy efficiency.

HEALTHCARE-PROPERTY.COM SEPTEMBER-OCTOBER 2024 | 3

Contents

Chief executive officer

Alex Dampier

Chief operating officer

Sarah Hyman

Chief marketing officer

Julia Payne

Editor

Joanne Makosinski

joanne.makosinski@nexusgroup.co.uk

Reporter and subeditor

Charles Wheeldon

Business development director

Mike Griffin

7 32

6-12 News

We round up the latest big stories,

including the Health Secretary’s

decision to review the New

Hospital Programme, the new

Government’s plans for the sector,

and the very latest health and care

construction projects

30-37 Building Design

A fresh approach to delivering

keyworker housing, how end

user engagement is helping

to reimagine mental health

bedrooms, and we announce the

categories for the 2025 Healthcare

Design Awards

Advertising & event sales director

Caroline Bowern

Business development executive

Kirsty Parks

Sales manager

Luke Crist

Publisher

Harry Hyman

Investor Publishing Ltd, 3rd Floor,

10 Rose & Crown Yard, King Street,

London, SW1Y 6RE

Tel: 020 7104 2000

Website: www.healthcare-property.com

Healthcare Property is published six times a year

by Investor Publishing Ltd.

ISSN 3029-0627

© Investor Publishing Limited 2024

The views expressed in Healthcare Property

are not necessarily those of the editor or publishers.

14

14-16 Policy

Details of a new report which sets

out a five-point plan to address

the challenges facing the NHS

estate, plus calls for clarity on how

local planning authorities can

develop tailored policies to support

investment and growth at developed

sites within the Green Belt

40

40-42 Estates and Facilities

Management

Meeting the challenges facing

estates managers in ensuring

fire compliance in health and

care settings

@HCprop

linkedin.com/company/healthcare-property/

24

18-30 Finance and Property

A new report from Knight Frank

reveals why property experts

remain confident in the sector,

and we explore Assura Plc’s

recent acquisition of Northwest

Healthcare Properties, plus you can

read about all the latest property

deals in the sector

48

44-50 Environmental

The importance of seeking legal

advice before embarking on longterm

carbon reduction projects

within the NHS, plus experts

share the top strategies that

hospitals can apply to improve

waste management


News

Streeting orders review of

New Hospital Programme

New Health and Social Care Minister,

Wes Streeting, has ordered a review

of the funding and timetable for the

previous government’s £20bn New

Hospital Programme (NHP).

Facing questions in the Commons about

the Conservative’s pledge to deliver 40

new and refurbished hospitals by 2030,

Streeting vowed not to give patients ‘false

hope’ about when they can expect moreup-to-date

facilities.

He said: “It’s painfully clear that the

previous government’s New Hospital

Programme, that said they would deliver 40

new hospitals by 2030, is not deliverable in

that timeframe.

“I want to see the New Hospital

Programme completed, but I’m not

prepared to offer people false hope about

how soon they will benefit from the

facilities that they deserve.

“That’s why I’ve asked officials as a matter

of urgency to report to me on the degree to

which the programme is funded, along with

a realistic timetable for delivery.”

The New Hospital Programme was

announced in 2020 and aimed to build 40

new hospitals in England by 2030.

It was given £3.7bn in capital funding up

to March 2025, with more to be provided

for the following five years.

The programme is also intended

to transform how NHS healthcare

infrastructure is built in the future, including

by standardising hospital design and

embracing offsite construction methods.

But Streeting said he was ordering a

review of the programme following major

delays and widespread concern that

the projects will not go ahead or will be

watered down.

And he promised to ‘come back to this

House and back to the country with

promises that we can keep and promises

that the country can afford’.

Responding to news of the review,

shadow health minister, Caroline Johnson,

told the House the previous government

Image: Borko Manigoda from Pixabay

had prepared to declare two New Hospital

Programme schemes complete during the

current 2024/25 financial year, with 18 more

projects under construction.

And she warned the review would risk

delaying much-needed projects, adding:

“The Government is now putting this

at risk by launching a review of this

work, delaying those projects which are

of vital importance to patients across

the country.”

Tory MP, James Wild, also raised the issue

of Queen Elizabeth Hospital, King’s Lynn, in

his North West Norfolk constituency, where

thousands of props are supporting the

building’s roof, and urged the Government

to sign off on the business case for a new

hospital in the town.

Streeting replied: “When it comes to

reinforced autoclaved aerated concrete

(RAAC) hospitals, they are top of my list of

priorities.

“I’m extremely concerned about the dire

state that the NHS estate is in.”

6 | SEPTEMBER-OCTOBER 2024 HEALTHCARE-PROPERTY.COM

News

As the new Labour

administration seeks

to put the future of the

NHS at the centre of

its policy agenda, the

new report acts as an

important reminder

of the need to think

holistically and flexibly

about how the NHS

is managed

New Health Secretary, Wes Streeting. Image: Lauren Hurley No 10 Downing Street

Meet the new Health Secretary

Following last month’s General

Election, Labour’s former

shadow health secretary, Wes

Streeting, was named as the

new Secretary of State for

Health and Social Care.

Streeting was first elected

as MP for Ilford North in 2015

and had been shadow health

secretary since 2021.

Before becoming an MP, he

served as the deputy leader of

Redbridge Council and worked

for various charities with a

focus on tackling educational

inequality.

He takes over leadership of the

department from Conservative

MP, Victoria Atkins, who had

served since November 2023

following a string of new

health secretaries over the last

three years under the then-

Conservative government.

Speaking after his

appointment, Streeting said of

his ambitions for the role: “When

we said that patients are being

failed on a daily basis, it wasn’t

political rhetoric, but the daily

reality faced by millions.

“Previous governments have

not been willing to admit these

simple facts, but, in order to

cure an illness, you must first

diagnose it.

“This government will be

honest about the challenges

facing our country, and serious

about tackling them.

A BROKEN SYSTEM

“From today, the policy of this

department is that the NHS is

broken.

“That is the experience of

patients who are not receiving

the care they deserve, and of the

staff working in the NHS who

can see that – despite giving

their best — this is not good

enough.

“This government has received

a mandate from millions of

voters for change and reform of

the NHS, so it can be there for

us when we need it once again.

“It will take time — we never

pretended that the NHS could

be fixed overnight.

“And it will take a team effort.

It will be the mission of my

department, every member of

this government, and the 1.4

million people who work in the

NHS, to turn our health service

around.

“That works starts today.”

PERSONAL

EXPERIENCE

He said he was particularly

driven to repair the health and

care system after suffering from

kidney cancer.

He was diagnosed in 2021 after

being admitted to hospital with

a kidney stone.

After an operation to remove

a kidney he later announced he

was cancer free.

In his first visit following his

appointment, Streeting toured

the Abbey Medical Centre in St

John’s Wood, London, where he

met with, and listened to, staff.

And he declared he will bring

back the family doctor, also

committing to increasing the

proportion of NHS resources

going to primary care to ensure

patients can get through the

front door of the NHS and

access the care they need.

“My first visit as Health

Secretary was to a GP practice

because when we said we want

to shift the focus of the NHS

out of hospitals and into the

community, we meant it,” he

said.

“I’m determined to make the

NHS more of a neighbourhood

health service, with more care

available closer to people’s

homes.

“Because if patients can’t get a

GP appointment, then they end

up in A&E, which is worse for

them, and more expensive for

the taxpayer.

“We are committed to bringing

back the family doctor so

patients can see the same

doctor each appointment, fixing

the front door to the NHS.”


News

New government sets out

its priorities for change

The NHS and social care system

historically play a key role in political

parties’ election manifestos as they are a

priority for most voters.

In the run-up to the General Election, the

winning Labour Party set out a number of

pledges, including cutting waiting times,

doubling the number of cancer scanners,

reviving NHS dentistry services, reforming

employment support, and re-opening the

door to primary care.

And some further detail was provided in

the King’s Speech on 17 July, where healthspecific

announcements included reforming

the Mental Health Act and tackling smoking

by raising the age of sale of tobacco

products.

The new Mental Health Bill is being drawn

up due to criticisms of the current Mental

Health Act 1983, particularly around the

treatment of black people, as well as those

with learning disabilities and autism.

to address the high vacancy rate and help

to attract and retain more staff

• A Cyber Security and Resilience Bill which

will close loopholes in outdated existing

legislation to protect the NHS and other

public services from the devastating

consequences of cyber attacks

• Plans to revive measures to restrict

advertising of junk food to children, along

with banning the sale of high caffeine

energy drinks to children

A spokesman for the NHS Confederation

said: “The legislative agenda from the

speech focused on economic growth, with

less health focus than in recent years.

“However, the King stated the

Government’s intention to ‘reduce the

waiting times, focus on prevention, and

improve mental health provision for young

people'."

UNLOCKING GROWTH

Sarah Woolnough, chief executive of the

King’s Fund health think tank, added that

there should have been greater focus on

social care services, stating: “A central

theme of the new Labour government’s

first legislative programme is unlocking

economic growth, and a strong economy is

inextricably linked with a healthy population,

supported by a strong health and care

sector.

“‘While boosting the workforce would

address one of the many issues facing social

care, more-fundamental reform of the sector

is still needed.

“The social care system in England is not

fit for purpose and the new government now

has the opportunity to create a nation where

people’s care needs are properly met.

“We hope to see more on their plans to

reform adult social care soon.”

She added: “Improving the nation’s health

depends on a wide range of measures in

areas such as housing, the environment, and

employment.

“Cross-government action will be needed

to achieve Labour’s stated aim of halving

the gap in healthy life expectancy between

the richest and poorest regions in England.”

PLANNING REFORM

The King’s Speech has also fast-tracked its

consultation on the reform of the planning

system, which could have major implications

for the health and care sector and the

property market.

Its proposed Planning and Infrastructure

Bill will accelerate the development of

infrastructure and the construction of 1.5

million homes.

The pledge to ‘get Britain building’ includes

simplifying the planning consent process for

significant infrastructure schemes, reducing

the bureaucratic hurdles that currently delay

project approvals.

It will also modernise planning committees,

increasing the efficiency of application

processing and facilitating quicker decisionmaking,

enabling faster project launches.

Furthermore, the bill focuses on unlocking

more sites for development by improving

land assembly processes. This includes

uniting separately-owned parcels of land.

And the Tobacco and Vapes Bill will set

out several changes, including phasing out

smoking and introducing further regulation

on vaping.

The ban on conversion practices is another

proposed reform that is crucial in supporting

vulnerable communities, according to the

NHS Confederation.

SYSTEM SHAKE-UP

Proposals to give more powers to local

authorities and metro mayors also formed a

key part of the speech and were welcomed

for giving local health and care leaders a key

role in local growth policy.

Other key points included:

• Measures in the planned Employment

Rights Bill to increase adult social care pay

The Government has fast-tracked a review of the

planning process for developments. Yolvin Pizan from Pixabay


Projects • News

Nottingham firm to

build health hub

Nottingham-based contractor, Henry Brothers Construction,

has been appointed to build a new £15m centre for community

health services in Belper, Derbyshire.

The modern facilities — designed to have high environmental

credentials to ensure long-term sustainability — will be built on the

site of the former Belper Clinic, as part of the Babington Hospital site

in Derby Road, Belper.

Derbyshire Community Health Services NHS Foundation Trust has

commissioned Henry Brothers to deliver the new building.

Jim Austin, executive director at Derbyshire Community Health

Services NHS Foundation Trust, said: “We are delighted to

announce the award of the contract for this project in anticipation of

the start of work on site.

"Once completed, this new building will deliver healthcare facilities

fit for the 21st Century for people in Belper and surrounding areas.

“It has been a long time in the planning and we’re excited to see

site preparations for building work starting soon.”

The health hub will feature 15 consulting rooms, six treatment

rooms, a health education group room, and other facilities, and

will provide a range of services including community nursing,

midwifery clinics, podiatry services, speech and language therapy,

physiotherapy, continence advisory service, woundcare, and

phlebotomy.

And the development will include environmentally-sustainable

features such as photo-voltaic panels on the roof to harness the

power of the sun, with pledges to use local and recycled material

from demolished buildings where possible, along with timber from

certified sources.

Designed by architects Race Cottam Associates, the building will

accommodate all existing outpatient and clinical services provided

at Babington Hospital.

Ian Taylor, managing director of Henry Brothers Construction, said:

“We are proud to have been appointed by Derbyshire Community

Health Services NHS Foundation Trust to build this important new

community health facility for the people of Belper.

“Henry Brothers has wide experience of delivering community

facilities in Derbyshire and beyond, such as schools and healthcare

services, and we look forward to starting on site.

“Once completed, the Belper health hub will play an important role

in the local community, providing key facilities to residents."

Planning permission for the new community health services

hub was granted by Amber Valley Borough Council in September

last year, paving the way for the process of inviting tenders and

appointing a contractor, procured through the Pagabo Framework.

Enabling work at the site is now getting under way, with a planned

construction period of 66 weeks.

It is being built to BREEAM ‘excellent’ sustainability standards.

Other members of the construction team alongside Henry Brothers

and Race Cottam Associates include project manager, Capita;

civil and structural engineer, Eastwood Consulting Engineers; and

mechanical and electrical engineers, EP Consulting.


News • Projects

£10m care home opens its doors

Care home operator, Yorkare, has

opened a new £10m care home in Haxby,

North Yorkshire, offering 63 en-suite

bedrooms.

Haxby Hall’s facilities include a bar,

restaurant-standard dining rooms, full

beauty salon and hairdressing suite,

cinema, and outdoor terraces on each

floor. There are also large gardens and a

bowling green.

The home was built by construction firm,

Hobson & Porter, and is the eighth project

the company has completed for Yorkare

since 2015.

Yorkare’s marketing and community

engagement manager, Nicola Anderson,

said: “We’re delighted to welcome our first

residents into their new homes at Haxby

Hall and everyone has been blown away by

the facilities and overall quality that flows

through the entire development.

“Every bedroom is designed to be

spacious with superb décor and exceptional

interiors. All the ground-floor bedrooms

have doors leading out to private patio

areas and our premium suites have their

own lounge areas and these are already

proving popular with both couples

and individuals.

“Yorkare’s whole ethos is about combining

safe and luxurious living environments

alongside engaging social activities that

are delivered by our dedicated care teams,

activity co-ordinators, and highly-skilled

chefs. Haxby Hall ticks all these boxes

and more."

Mark Smee, from Hobson & Porter,

added: “We’re very proud to complete our

Contractor appointed for

diagnostic centre project

Bouygues UK has been appointed to

design and build the new Ambulatory

Diagnostic Centre at West Middlesex

University Hospital.

The contract builds on the long-term

partnership between the trust, Bouygues

UK, and its subsidiaries.

The new five-storey facility will provide

diagnostic and treatment services in cancer,

renal, and imaging for local residents in

Hounslow, Richmond, and Ealing.

It aims to reduce health inequalities,

improve patient outcomes, and provide care

closer to home, freeing up space in the main

hospital for inpatient care. It will also support

outpatient care and offer day services for

patients.

The project includes five storeys of new

build, a rooftop plant, and a small terrace

area, while the ground floor will incorporate

a new single-storey link corridor to the

existing hospital building.

Bouygues UK will be supporting the

local community with apprenticeships and

work experience placements, working with

educational institutions in the area and

taking part in local charity initiatives.

Lesley Watts CBE, chief executive of

Chelsea and Westminster Hospital NHS

Foundation Trust, said: “The new diagnostic

centre at West Middlesex University Hospital

will provide a vital service for our residents,

speeding up diagnosis and treatment.

eighth project for Yorkare in less than 10

years. Every detail at Haxby Hall, from the

grand water fountains in the landscaped

gardens to the magnificent communal

areas, has been impeccably designed and

speaks volumes about the standard of the

whole development.

“It’s more akin to a five-star hotel than a

care home and there’s no doubt it’s going to

be a very special place for residents to live

as they start the next chapter of their lives.”

Yorkare now has 12 homes in Yorkshire

and Lincolnshire, with five more

under construction.

“Most importantly, it will improve early

diagnosis and health outcomes for patients

in our community for years to come.”

The development is designed to be an allelectric

building.


Projects • News

Handover marks milestone

in community healthcare

A 35,000sq ft refurbishment to the

existing Hollinswood House in Stafford

Park, Telford, has been handed over,

marking a significant milestone in the

provision of community-based health

services in Shropshire.

Morris Property has completed a

comprehensive interior refurbishment

of Hollinswood House, transforming

what once served as offices into a new

healthcare facility for Shropshire, providing

a more-efficient service for the non-urgent

needs of patients.

The works were completed in two phases

and central to the transformation has

been the establishment of Shropshire’s

first Community Diagnostic Centre (CDC),

boasting cutting-edge medical equipment

including a CT scanner, X-ray, and

ultrasound, as well as dedicated cardiorespiratory

and phlebotomy rooms, all

conveniently located on the ground floor.

The first and second floors have been

repurposed to accommodate a relocated

renal service from Princess Royal Hospital,

with more than double the previous space.

Both floors also house consulting and

interview rooms alongside staff areas on the

first floor, while the second floor includes

dialysis facilities for lower-risk patients,

while also catering for future demand.

The latest phase includes completion

of the third floor with dedicated spaces

(L-R) Andy Richards, contracts manager; Lee Evason, site manager; NHS

staff; Anwar Ali, director at Rev-A Associates; Conor Roberts, apprentice

site manager; and James West, chief operating officer at Morris Property

for cardio-respiratory and dermoscopy

departments, complemented by a bespoke

reception area crafted by Morris Joinery.

Since the inauguration of the Community

Diagnostic Centre, more than 13,000

patients have benefitted from streamlined

access to routine diagnostic and blood

tests, reducing the need for hospital

visits and alleviating strain on healthcare

resources.

And the CDC continues to grow and

develop, with the recent introduction of a

teledermatology service, meaning patients

can now access quicker diagnosis and

treatment for skin cancer.

James West, chief operating officer at

Morris Property, said: “This building project

has required us having to work within and

around a live building site with ongoing

healthcare provision, but through close

collaboration with department heads

and centre managers, we’ve been able

to minimise disruption and ensure the

continuity of care in the community.”

Kier to deliver £25m endoscopy unit

Kier has been appointed by the King’s

College Hospital NHS Foundation Trust to

deliver a new £25m endoscopy building

at the Princess Royal University Hospital

(PRUH) in Farnborough.

The two-storey, 2,400sq m building will

support the delivery of vital health services

in the south of London, including the

ambition to help an additional 4,500 cancer

patients each year.

The new building has been designed to

improve the patient experience, with the

patient’s journey adhering to accredited

pathways set by the Joint Advisory Group

(JAG) on Gastro-Intestinal (GI) Endoscopy.

Facilities will include consultation,

treatment, and recovery rooms, a sterile

services unit, plus rest and training spaces

for staff.

A new 1500kVA substation will also be

installed to improve the resilience of the

hospital’s electricity supply infrastructure.

David Rowsell, managing director at

Kier Construction London, said: “We are

delighted to be appointed by King’s College

Hospital NHS Foundation Trust to deliver

this important new endoscopy unit for

PRUH.

“We look forward to using our wealth

of experience in delivering first class

health facilities to improve the hospital’s

infrastructure and help support patient care

in South London.”


News • Projects

Psychiatric unit takes shape

Work to build a new £20m

mental health unit began

last week as NHS staff and

construction colleagues, along

with local people who have

lived experience of learning

disabilities and autism,

watched the first spades break

ground.

The new facility will be based

in Bristol and will provide care

and support for people with a

learning disability or autism from

across the northern half of the

South West region.

It will be able to support up to

10 patients at any one time, with

the building specifically intended

for those whose needs cannot

be met by existing hospital or

community-based services.

With the doors expected to

open in 2025, the unit will help

keep people much closer to

home and reduce the need

for patients to be admitted to

facilities far away from their

family and friends.

Among those who witnessed

the turf being officially cut was

Ben Stunnel, an autism peer

mentor whose lived experience,

along with that of others with

the condition, has helped to

influence the design of the new

build.

He said: “It has been very

rewarding and confidence

building to have our thoughts

and ideas listened to and it

will be very exciting to see the

building going up and taking

shape knowing that we’ve

contributed so much.

“I really hope that in future

many people and families will

benefit from what this new

building can offer and that it

will help to ensure that people

get the best care possible to

meet their needs and support

recovery.”

The new unit, which will be

run by Avon and Wiltshire

Mental Health Partnership NHS

Trust, will complement another

similar facility currently under

construction in Devon.

Once operational, the two sites

will not only ensure that people

from across the South West in

need of inpatient care can get

the support they require closer

to home, but also help, wherever

possible, to avoid unnecessary

hospital admissions.

Laura Ambler, executive lead

for learning disabilities and

autism at Bath and North East

Somerset, Swindon and Wiltshire

Integrated Care Board, said: “I

am delighted that after months of

rigorous planning and working in

partnership with local people and

their families, work on this new

unit is formally under way.

“When fully open in 2025, this

site will be a fantastic addition

to our existing mental health

services, and I know from

speaking with local people

that having something like this

based in our region will make

an enormous difference to those

who may have otherwise needed

to have travelled significant

distances for the right care and

treatment.”

David Jarrett, chief delivery

officer for Bristol, North Somerset

and South Gloucestershire

Integrated Care Board, added: “It

is fantastic to see work starting

on this much-needed facility.

“Its development demonstrates

our shared dedication

to delivering specialised,

compassionate care that meets

the unique needs of local

people, ensuring they receive

the support and services they

deserve.”

Construction of the new unit,

which is yet to be named, is

being led by Willmott Dixon, with

the project expected to complete

next spring, ahead of an official

opening later in the year.

Avery Healthcare to open Peterborough home

Avery Healthcare’s latest purpose-built

care home, Waterhouse Manor Care

Home in Peterborough, Cambridgeshire,

has been completed and is awaiting Care

Quality Commission approval to open to

residents.

The 80-bedroom, three-storey home will

provide residential, respite, and dementia

care for older people, and includes suites

for couples, a lounge, hair salon, café, and

therapy facility.

The building forms part of the Hampton

Gardens development, which also

includes a convenience store, residential

accommodation, and a nursery.

Clegg Construction completed a £10.3m

contract to deliver the home — the third

it has built by for Avery Healthcare. Clegg

previously delivered Middleton Lodge

Care Home in Littleover, Derbyshire; and

Mousehold View Care Home in Norwich.

Other members of the project team

included Harris Irwin Architects, project

manager; quantity surveyor, Holden and

Lee; and mechanical and electrical engineer,

Harniss.

Avery Healthcare’s director of

developments, Adrian Doyle, said:

“Waterhouse Manor Care Home is part of an

extensive development programme being

undertaken by Avery Healthcare and we are

proud that this is the latest in a number of

new care homes that will be opening over

the next year, with others in Sheringham,

Burley in Wharfedale, Downham Market,

Eastbourne, and Gravesend all under

construction.”


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Policy

System-wide strategy

needed to secure the future

of the NHS estate

A new report sets out a five-point plan to address

the challenges facing the NHS estate

Harnessing the potential of flexible

modular buildings to directly

reduce the NHS backlog of some

7.6 million cases can help transform the

future of the service and make it secure

for the long term, according to a report

published today by healthcare facilities

experts, Darwin Group and Portakabin.

The report titled The End of the Waiting

Line, commissioned by Portakabin and

endorsed by the NHS trust membership

organisation, NHS Providers, concludes

that the ageing NHS estate, which carries

a staggering ongoing maintenance cost of

£11bn, can benefit directly from a holistic

approach to the patient journey which

factors in the use of adaptable clinical

and non-clinical buildings to safeguard

patient care, safety, and staff support.

FLEXIBILITY

These flexible spaces can be added

to existing hospital buildings in a

matter of weeks, offering an instant

solution to enable patients to be

seen and treated more quickly.

“Contrary to some beliefs, the safety and

quality standards of modular buildings

are equal to those of long-standing

facilities across the NHS estate,” said

Nick Dawe, director of strategy and

transformation at Darwin Group.

“As the new Labour administration

seeks to put the future of the NHS at

the centre of its policy agenda, the new

report acts as an important reminder of

the need to think holistically and flexibly

about how the NHS is managed.

“Eating into the incredibly-high list of

patients waiting to be treated is a critical

priority to ensure the service is sustainable,

and a cost-effective approach to integrating

modular buildings and spaces, whether used

for operations or other forms of patient

care, is vital to achieving that reduction.”

FIVE STEPS

The report isolates five key steps which

the authors believe can deliver a fullysustainable

future for the NHS.

Beyond the adoption of a system-wide

approach to securing the NHS estate,

it recommends increased collaboration

between different NHS disciplines, a focus


Policy

on workforce wellbeing by including a

clinical perspective on staff management,

a plan to actively consider the adaptability

of existing NHS buildings to meet future

needs, and a major focus on reducing waste

by active planning.

“Waste is one of the most-important

problems the NHS needs to address

in order to make itself fiscally and

operationally sustainable for the long term,”

said Dawe.

“The healthcare needs of our expanded

population are a million miles from the

NHS when it was founded.

“This means creative and lateral thinking

is required to meet the current and future

needs of the patients it serves.

“The astonishing speed and agility

which was shown around the creation

of Nightingale facilities during the

COVID-19 pandemic is one example of

the power of flexible facilities to predict and

respond to escalating patient need.

“The opportunity now is to recognise

and learn from that experience to fully

futureproof our health service in a way that

brings down the waiting list backlog and

enables all those who work tirelessly inside

the NHS to deliver treatment and care

without compromising standards.”

SMART THINKING

According to the report, thinking actively

about the adaptability of NHS estates

via early engagement and improved

collaboration alongside that of clinical

strategies as a ‘golden thread’ during capital

building projects is among the mostimportant

actions in reducing waste during

the patient care journey and building

the resilience of the service for future

generations.

And it concludes that smart ways of

planning for capital expenditure can result

in a higher degree of NHS sustainability.

The report also makes the case for

considering purpose-built facilities designed

to optimise resources to be more energy

efficient and environmentally conscious, via

reducing the number of buildings which

are no longer suitable for clinical use and

focusing on adaptable strategies which

directly impact waiting times and allow

patients to be seen, diagnosed, and treated

more efficiently.

By doing so, the NHS can not only

reduce its impact on the environment, but

be more flexible in adapting to the likely

future needs of individuals as the UK

population continues to age and chronic

diseases requiring ongoing management

become more common.

“We understand the critical role that

estates and facilities play in safeguarding

As the new Labour administration seeks to put

the future of the NHS at the centre of its policy

agenda, the new report acts as an important

reminder of the need to think holistically and

flexibly about how the NHS is managed

the future of the NHS and its patients,”

said Dan Ibbetson, chief executive of

Portakabin.

“For this reason, we are proud to launch

the Five-Point Plan, The End of the Waiting

Line, which has been timed to support the

newly-formed Government and health and

care colleagues in addressing urgent system

priorities.

“To strengthen our healthcare expertise,

Portakabin acquired Darwin Group last

year, a specialist in healthcare construction

with over 18 years of industry experience.

“This partnership has significantly

enhanced our combined capacity and

speed, enabling us to deliver high-quality

clinical and non-clinical buildings swiftly to

meet immediate NHS needs.

“Together with the teams at Portakabin

and Darwin Group, I stand with our health

and care colleagues as they navigate the

ever-changing landscape of care.

“And we look forward to welcoming

supportive and decisive action from

the country’s leadership to protect and

safeguard, not only the future of the NHS,

but also the safety of its patients and

workforce.” n

The full End of the Waiting

Line report can be accessed

at https://contact.

darwingroup.co.uk/

five-point-plan-review

The astonishing speed and agility which was

shown around the creation of Nightingale

facilities during the COVID-19 pandemic is

one example of the power of flexible facilities to

predict and respond to escalating patient need


Policy

Policy reform could unlock

potential of Green Belt sites

A national planning and development consultancy has called for the Labour

government’s review of national planning policy guidance to provide clarity to

local planning authorities (LPAs) on how they can develop tailored local policies

to support investment and growth at developed sites within the Green Belt.

Following Chancellor Rachel Reeves’

recent announcement regarding

Green Belt development, Lichfields’

report highlights the potential economic

and social benefits of planning reform.

In new research, it refers to the inherent

challenges posed by current national Green

Belt policy guidance that could stifle, or at

least delay, investment and undermine the

ability for existing organisations to improve

their facilities, remain competitive, and

continue delivering a range of important

services.

A MISSED OPPORTUNITY?

The Major Developed Sites in the Green

Belt — The Land That Policy Forgot? report

reveals that a portion of the Green Belt,

which covers approximately 12.6% of

England’s land area, could be developed

for a range of uses including hospitals and

other medical institutions.

The report explains that pre-2012

national policy used to recognise many of

these locations as Major Developed Sites

(MDS) and provided clearer guidance

on how LPAs should assess development

proposals. However, this was removed

by the 2012 National Planning Policy

Framework (NPPF).

This established more-subjective,

generalised guidance, stripping out the

detail around how an LPA could approach

the identification, definition, and guidance

of development at such sites in local plans,

potentially limiting the ability of these sites

to evolve and contribute to local economies

and services.

REINVENTING THE WHEEL

Ian York, a planning director

at Lichfields and co-author of

the report, said: “Our research

shows that the majority of

LPAs are adopting generalised

policies that repeat national

Ian York guidance.

“We must move away from a

one-size-fits-all approach and

adopt local, bespoke policies

that recognise the unique

characteristics of these sites.

“The report urges LPAs to

engage with landowners and

operators to create detailed

policies that clearly define

development parameters,

ensuring these sites can thrive

without compromising Green

Belt integrity.”

The research shows that of

the 180 LPAs with Green Belt

land, only a third have adopted

criteria-based, bespoke policies,

while two thirds default to

generic NPPF guidelines.

This local policy context

means less certainty for owners

and operators to plan for the

future of their sites where there

is a continuous need.

Furthermore, there is a

regional disparity in the policy

approach, with the North West

of England having the highest

reliance on generic NPPF-based

Green Belt policies and the

South East of England leading

in bespoke approaches.

CLARITY AND SUPPORT

York said: “National Government has a very-important

part to play.

“With the new Labour government’s commitment

to updating the NPPF within its first 100 days, there is

a crucial opportunity to reintroduce policy guidance

akin to the previous MDS framework.

“This will provide much-needed clarity and support

for LPAs and developers alike.”

And Lichfields urges policymakers to consider these

recommendations seriously.

“Tailored local policies are essential to unlocking the

full potential of developed Green Belt sites, enabling

them to significantly contribute to local economies,

enhance community services, and support sustainable

growth across the UK,” said York.

The Government’s consultation on changes to the

policy will end on 24 September. n


Finance and Property

Healthcare property market

‘in a strong position’

for the long term

Knight Frank has released its Healthcare Capital Markets – 2024 report. Here, we look

at the key findings and why property experts remain confident in the sector

Demographics, long-term income,

and ESG credentials ‘present an

undeniable case’ for investment in

the healthcare property market, according

to a new report from Knight Frank.

The Healthcare Capital Markets —

2024 report provides an annual assessment

of the latest investment trends and

performance in the UK healthcare property

sector.

It focuses on emerging trends from

both an operational and real estate

perspective and dives into the sentiment

of investors to understand the state of

the market by surveying most key UK

market players including major REIT,

institutional, and overseas investors to gain

a comprehensive insight of the current state

of the sector.

Ryan Richards, associate for commercial

research at Knight Frank, said:

“Unsurprisingly, UK healthcare markets

have felt various pressures over the past year.

However, a broader lens ultimately shows

this to be more of a real estate trend than a

healthcare one.

“Despite this, the sentiment remains

positive, and the view is that healthcare’s

fundamental drivers, such as demographics,

long-term income, and ESG credentials,

present an undeniable case.”

GAUGING THE MARKETS

He added: “2023 carried on 2022’s trend of

general uncertainty, with investors stepping

back to gauge markets; and we saw recorded

volumes close at circa £1.2bn.

“We did, however, see the continued

movement towards normality in operator

trading.

“This, in line with improved operator

trading in our annual Care Homes Trading

Performance Review, is a welcome boost to

sector confidence.

“Overseas capital dipped again this year,

accounting for 25% of transactions, down

from 31% and even further from its longterm

average.

“Average annualised returns sat at 4.4% at

the end of Q4 2023, up from 3.50% in the

previous period. This, as always, highlights

the healthcare sector’s strength in terms of

stability of returns.

“The overall outlook for the healthcare

sector is undoubtedly positive, with key

market participants already transacting in

Q1 2024.”



INVESTOR DEMAND

Knight Frank’s Attitudes Survey highlighted

that healthcare ranked as the second leading

sector, with 13.2%, just slightly behind the

living sector’s 13.8% in terms of investor

demand.

More interesting is that the living sectors

demand comprises PRS, senior living, and

student, suggesting that healthcare remains

a standout choice on an absolute basis.

Factors driving the sector’s popularity

among investors include:

• Demographic shift: In the UK the

over-85 population is set to increase

from 1.7 million to 3.7 million by 2050.

An ageing population means increasing

demand for residential care, primary care,

and acute hospital services

• Long-term income: Weighted average

unexpired lease terms average 25-30

years in the residential care and hospital

sectors. And leases are commonly index

linked to inflation

• Secure income: Operator revenue is

reinforced by a healthy mix of self-funded

care and publicly-funded care. Income is

supported by high occupancy and patient

demand across the healthcare arena

• Investment performance: Total returns

measured 4.4% in 2023, higher than

many core property sectors. And returns

are historically stable, offering investors

protection and diversification

• Structural change in real estate: Real

estate investors are already derisking

from traditional sectors such as retail

into alternatives like healthcare

• Demand for safe havens: Broader UK

real estate offers security and liquidity in

a global downturn. UK healthcare’s longterm

and often government-supported

income offers further defence

• Social impact: The influence of

impact or ESG investing in real estate

is growing at a faster pace than ever. A

range of investors are now focusing on

social infrastructure investments, and

healthcare is part of this

The resilience of the healthcare sector

and its lack of sensitivity to wider

economic shocks is further illustrated

when comparing the annual movement in

healthcare volume to that of all property

classes.

CAPITAL TRENDS

According to the report, healthcare, which

accounted for around 3% of all commercial

property transactions, has historically seen

a trend of growth in transaction volumes,

despite a slight dip in volume experienced

by all property classes this year.

Further highlights of the sector’s

consistency can be seen when assessing

2023 SUMMARY

£1.2bn

Total transaction volume

52%

Portfolio transactions

We are seeing an emerging trend of private

operators reinvesting profits into major capital

expenditure projects at their hospitals, such

as construction of new operating theatres,

upgrading of diagnostic equipment, and other

building fabric improvements

transaction volumes on a quarterly basis.

“A key trend emerging from this data is

the lack of spikes from outlier transactions,

which results in smooth volumes between

quarters,” the report states.

“This suggests we are experiencing a

more-sustainable and normalising level in

healthcare real estate demand.

“Investment by sub-sector is another area

to consider when discussing market volume.

“Elderly care continues to generate the

most interest from investors on all fronts,

accounting for 83% of volume. In addition,

The case for healthcare

as an investment

Demographic shift

UK over 85 population is set to increase from 1.7 million to

3.7 million in 2050.

An ageing population means increasing demand for

residential care, primary care and acute hospital services.

Investment performance

Total returns measured 4.4% in 2023, higher than many

core property sectors.

Returns are historically stable, offering investors protection

and diversification.

Demand for safe havens

Broader UK real estate offers security and liquidity in a

global downturn.

UK healthcare's long-term and often governmentsupported

income offers further defence.

25%

The percentage of 2023 demand

from Overseas Capital

£14.7m

Largest single asset transaction

4.40%

Average Annualised Returns *As at

end of Q4 23

£2.11bn

Five-year average transaction volume

Source: Property Data, MSCI

adult care took some share of the reported

volume, accounting for 11%.

“Notably, of this demand in elderly

care, there is a circa 80/20 split between

investment and occupier deals respectively.

“It continues to be helpful to understand

where capital is being placed and how this

differs from historic investing trends.”

When quizzed on the biggest issues with

the current quality of real estate stock,

respondents cited size (8%), lack of en-suite

facilities (17%), lack of a full wetroom

(25%), ESG credentials (42%), and scope

Long-term income

Weighted average unexpired lease terms (WAULT) average

25-30 years in the residential care and hospital sectors.

Leases are commonly indexed-linked to inflation.

Secure income

Operator revenue is reinforced by a healthy mix of selffunded

care and publically-funded care.

Income is supported by high occupancy and patient

demand across the healthcare arena.

Structural change in real estate

Real estate investors already de-risking from traditional

sectors such as retail into alternatives like healthcare.

Social impact

The influence of impact or ESG investing in real estate is

growing at a faster pace than ever.

A range of investors are now focusing on social

infrastructure investments, and healthcare is part of this.



Recorded healthcare investment volumes (£bn)

Percentage change in

property 2024 PREDICTIONS

investment volumes

3.0

2.5

2.0

1.5

1.0

HEALTHCARE PROPERTY

ALL COMMERCIAL PROPERTY

Strong healthcare demand and transaction volume

200%

to come

With 2024 starting off on a much more positive note we are optimistic for the year ahead.

Consistent and organic transaction levels in the absence of large outlier portfolio deals suggest the sector is

150%

experiencing sustainable demand.

100%

Investors likely to increase activity

As per our investor sentiment and debt surveys, investors and lenders are well positioned in terms of dry powder

and cost of capital for an active year.

50%

ESG to feature

Investors and operators 0% will be keen to service their sustainability targets through care settings and businesses

that boast strong ESG credentials.

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

0.5

0

Source: Property Data

2014

2015

2016

2017

2018

2019

-50%

Sector's reliance will continue to shine through

Well capitalised investors and lenders, in addition to robust operator trading and the underlying drivers we have

mentioned suggest that healthcare is in a strong position for the long run.

2020

2021

2022

2023

-100%

Source: Property Data

Sectors in demand

% respondents

Living Sectors 13.8%

Healthcare 13.3%

Education 11.3%

Development Land 9.8%

Data Centres 8.7%

Logistics & Industrial 8.3%

Hotels and Leisure 7.3%

Farmland 5.8%

Life Sciences 5.3%

Offices 4.6%

Forestry 4.3%

Real Estate Debt 4.1%

Retail 3.4%

Source: Knight Frank

While 2023 presented as a slow year,

there is a silver lining in the fact that

this was a trend present across global

real estate, and with 2024 starting

on a much-more-positive note, we are

optimistic for the year ahead

for repurposing (8%).

And 33% thought the current pricing tone of the

market was too high.

PRIVATE INVESTMENT

In particular, private hospitals demonstrated strong

operational resilience in 2023, despite the impact of

cost inflation (wages and energy prices) and rising

interest rates.

Top-line performance has been supported by the

growing NHS backlog fuelling demand from the public

sector for private sector capacity; growth in the self-pay

market; and higher levels of Private Medical Insurance

(PMI) as patients seek alternative ways to reduce the

waiting period for treatment.

In the report, Nicholas West, UK head at Northwest

Healthcare Properties REIT, said: “We are seeing

an emerging trend of private operators reinvesting

profits into major capital expenditure projects at

their hospitals, such as construction of new operating

theatres, upgrading of diagnostic equipment, and other

building fabric improvements.

“For example, in 2023 Spire undertook £2.8m of

capital expenditure to repurpose admin space to a new

minor operations theatre at its asset in Sheffield.

“We anticipate that these improvements will

boost operator profitability and energy performance

credentials going forward.”

And he said location was key to the operational

performance of a hospital.

“Access to top-quality consultants, proximity to NHS feeder sites, and

patient affluence profiles are some of the key criteria which are important to

hospital operators,” said West.

PRIMARY CARE

Harry Hyman, non-executive chairman of Primary Health Properties, adds that

the primary care sector continues to face challenges.

He says in the report: “Development in the primary care space continues

to face headwinds as yields have softened and build cost inflation has

put significant upwards pressure on the rental levels required to enable

scheme viability.

“As a result, the modernisation of the primary care estate which is so crucial

to the delivery of the NHS strategy — by allowing much more care to be

carried out of the hospital environment — is under significant threat with

many new schemes being lost to alternative land uses.

“The challenge now rests on progressing the rental tone in the sector, which

is improving, but has a long way to go to achieve viability given the long period

of benign rental growth experienced until recently.”

The report concludes: “While 2023 presented as a slow year, there is a silver

lining in the fact that this was a trend present across global real estate, and with

2024 starting on a much-more-positive note, we are optimistic for the year ahead.

“The sector’s fundamental drivers remain strong, and investors are seemingly

aware of this, with a number of standout transactions already completed or

pipelined for completion this year.

“The sector remains well capitalised, which, in addition to robust operator

trading and the underlying drivers we have mentioned, suggests

that healthcare is in a strong position for the long run.” n

To download the report in full, scan the QR code, or visit

https://content.knightfrank.com/research/105/documents/en/

healthcare-capital-markets-2024-11301.pdf



Bridging the gap

Digital bank, OakNorth, has provided

a £26.4m loan to newly-launched and

Matter Real Estate-backed developer/

operator, Untold Living.

Founded in 2022, Untold Living is a

newly-established developer, owner,

and operator of Integrated Retirement

Communities (IRCs) across England.

Untold’s mid-market offering bridges

the gap between high-end later living

properties and housing associations

by providing an affordable product that

extends the IRC model to as many people

as possible.

The IRC service offering itself sits

between the more-traditional care home

and retirement housing models, offering a

community designed specifically for those

in later life that adapts to the needs of

residents as they grow older.

Having acquired its first site in Westbury,

Wiltshire, Untold currently operates one

scheme with several more in the pipeline.

The company is backed by London-based

real estate investment firm, Matter Real

Estate, whose partnership is helping the

business’s ambitious plan to build a large

portfolio of retirement villages over the

coming years.

The recent £26.4m loan from OakNorth

will be used to develop Untold’s 77-unit

IRC in Newport, Shropshire, which recently

achieved planning consent, as well as

support the operations of its existing 68-unit

Chantry Court site in Wiltshire.

Untold Living is actively seeking to acquire

other suitable sites and assets across the

UK to expand its portfolio and is open to

discussions with landowners, landlords and

agents, targeting a GDV of £300m for its

initial development pipeline.

Russell Jewell, chief executive, said: “The

UK’s retirement community sector is no

longer in its infancy, but it still has many

lessons to learn.

“Our approach has been to learn from best

practice not only in the UK, but in countries

such as the US and New Zealand, where

the market is much more mature.

“As such, our focus has been on ensuring

Untold Living’s developments have a

thriving culture where residents are

engaged, a low affordability barrier that

democratises the product, and a flexible

approach to amenities.

“We feel this is key to broadening access

to the sector, which will ultimately reduce

strain on the NHS, ease public finances, and

enable our elderly citizens to live longer,

more-fulfilled lives.”

Alantra, led by Bobby Fletcher and Danilo

Bardella, acted as exclusive financial advisor

to Matter and Untold on the transaction.

Property investors focus on rate

cuts ahead of politics

Property investors are cautiously

optimistic and focusing on the prospect

of base rate cuts ahead of UK and global

political issues, according to a new study.

Handelsbanken’s latest Property Investor

Report, based on exclusive insights from UK

property investors with an average of 35

properties each, found more than half (52%)

say the prospect of a rate cut in the coming

days, and potentially a further cut before

the end of the year, makes them more

optimistic about the market.

That is partly reflected in the easing of

signs of tenant stress — with around 53% of

those questioned reporting issues of rental

deferral/contract negotiations, compared

with 60% in Handelsbanken’s 2023 report.

And the number experiencing overdue

or late payments fell to 34% this year

compared with 41% in the previous year.

Despite the drop in reported tenant stress,

void periods have increased. 60% of the

panel reported an increase in voids, up

from 54% in the previous year, although

Handelsbanken believes this may be partly

driven by tenant demand for quality and

EPC ratings.

Polled ahead of the General Election, the

panel reflected wider market sentiment on

the impact of a change in government, with

the majority (51%) saying it would not affect

HANDELSBANKEN PROPERTY INVESTOR SURVEY - VOLUME 3

Property Investor

report

May 2024

plans for their business.

Around two fifths (40%) said geopolitical

uncertainty made them more positive about

the UK property market, while 44% said it

had no impact.

Handelsbanken commissioned the

research in March this year through

independent company, Pure Profile.

Around 28.5% classified their business

as real estate investment, while 33.5%

classified their business as property

management, and 38% classified their

business as landlords (residential or

commercial).

Of those, 8.5% owned healthcare

properties.

Simon Bradley, chief credit officer at

Handelsbanken, said: “There is cautious

optimism around the property market and

activity among existing investors is picking

up.

“It may be that many have decided the

economy has potentially reached the top of

the interest rate cycle and that the time is

right to engage in new deals.

“We are seeing many of our

Handelsbanken property professionals

already looking to increase their credit lines

in anticipation of potential acquisitions as

market rates soften and property values

stabilise over the coming months.

“The report also shows signs of tentative

improvements in the stress factors affecting

tenants, which have been driven in recent

times by the cost of living and energy crises.

“However, most respondents appear

unaffected by potential political uncertainty

and don't believe that a change in the

party in government will lead to significant

changes in the market.”


Health Investor Seniors Housing Awards

Leading the pack

The finalists have been announced for the 2024 HealthInvestor Seniors Housing Awards

A total of 75 entries have been selected by a panel

of esteemed judges to move forward to the finals of

the annual competition, which celebrate the very

best in seniors housing across categories including

advisory, development, innovation, and more.

Organised by Healthcare Property publisher, Nexus

Media Group, the winners in each category will be

announced at a ceremony at the Grosvenor

House Hotel in London on 24 September.

To find out more, or to book your ticket,

visit https://seniorshousingawards.com

FULL LIST OF THE

FINALISTS FOR 2024

IRC SCHEME OF THE YEAR

(Sponsored by Octopus Real

Estate)

FINALISTS

• Adlington Retirement Living

• Audley Villages & Balfour

Beatty

• Belong Villages

• Inspired Villages Group

• Jewish Care

• Richmond Villages

• Siddington Park – Rangeford

Villages

• The Shires – MBTHA

RETIREMENT HOUSING

SCHEME OF THE YEAR

FINALISTS

• Audley Villages

• Augustinian Care – St George’s

Park

• Brio Retirement Living

• The Hawthorns Braintree

BEST PIPELINE

OF THE YEAR

(Sponsored by Knight Frank)

FINALISTS


• Birchgrove

• Inspired Villages Group

• McCarthy Stone

• Octopus Real Estate and

Pension Insurance Corporation

• Rangeford Villages

INVESTOR OF THE YEAR

(Sponsored by Silbury)

FINALISTS

• LSM Capital

• Octopus Real Estate

LENDER OF THE YEAR

FINALISTS

• Beaufort Capital Management UK

• Cain International

• OakNorth

• Octopus Real Estate

• Silbury Finance

LEGAL ADVISOR

OF THE YEAR

FINALISTS

• Bevan Brittan

• Browne Jacobson

• Gowling WLG

• Irwin Mitchell LLP

• Lester Aldridge

• Pinsent Masons

• Trowers & Hamlins

ARCHITECTURE & DESIGN

OF THE YEAR

(Sponsored by Third Age

Design in conjunction with

Wissner-Bosserhoff)

FINALISTS

• Carless + Adams

• ColladoCollins Architects Ltd

• Gaunt Francis Architects and

Bernard Interiors Ltd

• Pollard Thomas Edwards

• PRP

• Whichelo Design Studio

REAL ESTATE ADVISOR

OF THE YEAR

FINALISTS

• CBRE

• Christie & Co

• JLL

• Knight Frank

• Savills

• SAY Property Consulting

• Whiteley Consulting Ltd

PLANNING CONSULTANT

OF THE YEAR

FINALISTS

• DLBP Ltd

• DLP Planning Ltd

• Montagu Evans LLP

• Tetlow King Planning

BEST HOSPITALITY

PROVIDER / RESTAURANT

OF THE YEAR

FINALISTS

• Auriens

• Country Court Care Homes

• LifeCare Residences

• Rangeford Villages

BEST HEALTH AND

WELLNESS SERVICE OF

THE YEAR

FINALISTS

• Aura Care Living Ltd

• Auriens

• Belong Villages

• Brio Retirement Living

• Jewish Care

• Riverstone

BEST USE OF TECHNOLOGY

IN SENIORS HOUSING

FINALISTS

• Country Court Care Homes

• Cubigo & Elysian Residences

• Porters Care Limited

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(Sponsored by Lester

Aldridge)

FINALISTS


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healthinvestor.co.uk


UK private hospital portfolio

acquired in £500m deal

In this article we explore Assura

Plc’s recent acquisition of Northwest

Healthcare Properties and how it

signifies growing interest in the

healthcare property market

Assura HQ

The board of Assura plc has

announced it has agreed with

Northwest Healthcare Properties

to acquire its fully-operational UK private

hospital portfolio comprising 14 assets for a

consideration of £500m.

The deal will be fully funded through a

mix of cash and shares including:

• 245,298,262 or c.£100m of

consideration shares issued to Northwest

on a 30-day VWAP basis and subject to a

six-month lock-in agreement

• £266m of debt, which has been

refinanced through a new term loan

• £134m using £54m of cash and drawing

down £80m from the group’s existing

revolving credit facility

Assura believes there is significant

opportunity in the structurally-supported

private hospital market, with strong

growth potential and attractive investment

characteristics, as outlined at its Capital

Markets Event in February.

All three strands of private (PMI, selfpay,

and NHS-referred) are experiencing

growing demand, with the private market

providing essential capacity to local

healthcare infrastructure.

Assura will capture these opportunities

given its long-term relationships in

healthcare, its development and asset

enhancement capabilities, and focus on

social impact and sustainability.

The acquisition significantly accelerates

Assura’s strategy to diversify into new

sectors at scale by adding high-quality, fullyoperational

assets in the private market

spread across the UK at an attractive price.

It also brings with it a number of financial

benefits including earnings enhancement,

long-term, secure, and growing income

through index-linked reviews and supports

a covered and progressive dividend policy.

As a result of the acquisition, Assura

is uniquely positioned in the UK as a

diversified healthcare REIT.

THE PORTFOLIO

• The acquisition comprises Northwest’s

entire UK portfolio of 14 fullyoperational

private hospitals with an

average of 36 registered beds per hospital

• WAULT of 26 years, rent roll of £29.4m,

yield on cost of 5.9%, and day one rent

cover of 2.3 times

• Assets located across the UK, with

64% London weighting based on latest

current passing rent

• Estimated rental value of £30.2m,

3% above passing rent based on latest

estimated rental value as of December

2023

• All assets annual index-linked rent

reviews (60% to RPI and 40% to CPI),

capped and collared, typically at 4% and

1% respectively

• All acquired properties feature fully

tenant repairing and insuring (FRI)

leases, resulting in limited incremental

overheads



• Tenant base mostly comprising tier 1

private operators, including Nuffield

Health, Circle, and Spire, with 92% at

‘Good’ or ‘Outstanding’ Care Quality

Commission rating

STRATEGIC RATIONALE

The acquisition offers a number of strategic

benefits including:

Accelerating Assura’s ability to realise

attractive investment characteristics

of structurally-supported private

healthcare market.

- The addition of a private hospital portfolio

valued at over £500m represents a material

expansion into the private health market

in line with Assura’s strategy, cementing

its position as the leading listed UK

healthcare property investor and developer

- Assura aims to be the partner of choice

for the NHS primary care estate and the

target portfolio, combined with its existing

exposure to Ramsay Health Care UK

and HCA International, will enable the

company to access significant relationships

with all Tier 1 healthcare providers

operating at scale in the UK

- Socio-demographic drivers in the UK,

and an NHS system that remains under

considerable strain, are leading to growing

demand across all three strands of private

health (PMI, self-pay, and NHS referred

services)

- Private hospitals typically benefit from long

lease lengths of 25-30 years with indexed

rents let to long-established operators

Complementing Assura’s existing strategy

and sector expertise to make it the ideal

estates partner to the private health sector.

- The target portfolio is fully aligned with

Assura’s aim to generate attractive financial

and social returns for its shareholders

and wider stakeholders by investing in,

developing, and managing high-quality,

sustainable healthcare buildings that

provide crucial infrastructure for their

local health economy

- Being a socially-responsible owner remains

at the core of what Assura does and the

private hospital sector is an increasinglyvital

component in the UK’s healthcare

landscape

- Development and asset enhancement

capabilities: the target portfolio includes

opportunities for asset enhancement

including extensions, reconfigurations,

and upgrading the sustainability

performance. Assura already has proven

development capabilities in the private

space, having recently completed several

new schemes for Ramsay as well as the

cancer treatment centre in Guildford

showcased at the Capital Markets Event in

February

Acquiring an attractive portfolio of highquality

assets.

- The target portfolio acquired at an

attractive price relative to most-recent

valuation

- Long average lease length of 26 years —

extends proforma WAULT from 10.8

years to 13.0 years

- Rent reviews 100% index-linked with all

assets subject to annual reviews; 42% of

pro forma portfolio subject to indexed or

fixed-basis rent reviews

- Strong underlying tenant covenant

complementary to the existing Assura

private tenant mix, with 96% of target

portfolio rent from Tier 1 private

operators and day one rent cover at

2.3 times

- Excellent patient mix at each site reflective

of local demands

- 64% of target portfolio exposed to

London market which has heavier PMI

and self-pay weighting, supporting rental

growth and asset values

- Remaining regional sites providing

additional capacity for local NHS needs



Improving short and long-term Group

financial profile.

- Additive to existing net rental income

profile with proforma Group rent roll

growing from £149m as to 30 June 2024

to £179m (c.20% increase)

- Earnings accretive in the first full year and

will enhance earnings in the medium term

with rents efficiently flowing through to

earnings

- Significant future growth potential

from a supportive rental backdrop for

private hospitals and incremental asset

management and ESG opportunities

- Proforma LTV of 48%, within policy

range of 40-50% with intention to reduce

LTV to below 45% and target net debt to

EBITDA below nine times over the next

18-24 months

- Balance sheet strength has allowed

refinancing of debt at attractive rate

- Assura will maintain a covered and

progressive dividend policy

BALANCE SHEET AND

DISPOSALS PROGRAMME

Assura recently announced a joint venture

with Universities Superannuation Scheme

Limited to support investment in essential

NHS infrastructure.

This, along with the acquisition, will see

group property value increase to £3.2bn.

In addition, the issuance of consideration

shares will ensure Assura continues to

This represents a unique opportunity

to participate in the growing demand

for private healthcare services to help

ease growing NHS waiting lists amid

the ongoing UK healthcare crisis

maintain leverage within the stated LTV

policy range of 40-50%, with proforma LTV

of 48%.

Over the following 18-24 months, Assura

intends to strengthen the balance sheet by

targeting LTV to below 45% and net debt

to EBITDA below nine times through the

use of third-party capital and a disposals

programme which will include a mixture of

portfolio and individual asset disposals.

DEBT TERMS AND FINANCING

INTENTIONS

Assura has refinanced the £266m debt

through a new term loan provided by

Barclays Bank PLC.

Key terms of the loan include:

• 110bps margin above SONIA

• Matures August 2026

• Option to extend by two additional oneyear

periods

• Interest rate swap to be taken out for full

two-year period with expected rate of c.4%

The loan is repayable at any point at Assura’s

discretion, with no break costs.

And the proceeds from the

aforementioned disposal programme will

help to reduce net debt over the next 18-24

months.

As a result, Assura’s debt maturity profile is

tightened from a weighted average maturity

of 5.75 years as of 30 June 2024, to 5.3 years

for the pro forma group, with weighted

average cost of debt increasing from 2.30% to

2.99%.

Assura has been in full engagement

with rating agencies with respect to the

acquisition.



NORTHWEST

CONSIDERATION SHARES

As part of the consideration for the

acquisition, applications have been made

to the Financial Conduct Authority and

to the London Stock Exchange plc for

245,298,262 new ordinary shares of 10p

each in the issued share capital of Assura to

be admitted to the premium listing segment

of the Official List of the FCA and to

trading on the main market of the London

Stock Exchange.

Admission became effective and dealings

commenced at 8am on 9 August.

Following admission, the company will

have 3,236,951,244 ordinary shares of 10p

each in issue.

There are no shares held in treasury.

Therefore, following admission the total

number of voting rights in the company

will be 3,236,951,244 and this Voting

Rights Figure may be used by the company’s

shareholders as the denominator for the

calculations by which they will determine

if they are required to notify their voting

rights interest, or a change to that interest,

in the company under the FCA’s Disclosure

Guidance and Transparency Rules.

Commenting on the deal, Jonathan

Murphy, Assura chief executive, said: “The

acquisition of Northwest’s high-quality

UK private hospital portfolio accelerates

the delivery of our broader healthcare

strategy, securing increased exposure to the

structurally-supported private healthcare

market as we continue to diversify our

offering in line with UK healthcare

demands.

“The acquired portfolio — with long

average lease length of 26 years and indexlinked

rent reviews — complements our

existing assets and will benefit from our

sector relationships, development, and asset

enhancement capabilities as the leading

listed UK healthcare property investor and

developer.

“Expected to be earnings accretive in

the first full year, the transaction offers

attractive financial benefits including

Jonathan Murphy

sustainable long-term top-line growth

to underpin a covered and progressive

dividend policy.

“While the strength of our balance sheet

has supported refinancing at an attractive

rate, we intend to reduce our leverage in the

next 18-24 months via a targeted disposal

programme.

“The portfolio’s diversified occupier base,

combined with our existing private occupier

mix, means we now have relationships with

all Tier 1 private healthcare providers.

“This represents a unique opportunity

to participate in the growing demand for

private healthcare services to help ease

NHS waiting lists amid the ongoing UK

healthcare crisis.”

This worsening crisis is driving increased

demand for healthcare infrastructure

including private health estates, and

today’s acquisition positions us as the

clear leader in this sector of the market

Ed Smith CBE, Assura chairman,

added: “The UK healthcare crisis is

getting more severe with each year, a point

well recognised by the incoming Labour

Government.

“This worsening crisis is driving increased

demand for healthcare infrastructure

including private health estates, and today’s

acquisition positions us as the clear leader

in this sector of the market.

“We are now better positioned than ever

to use our expertise and capital to help

support the NHS and the country’s wider

healthcare market as together we address

the health challenges of the modern day.”

And Craig Mitchell, Northwest chief

executive, said: “These high-quality

assets represent significant future

growth potential buoyed by favourable

healthcare market dynamics in the UK

and Assura’s sector-leading position,

long-term relationships, and expertise

in asset management, development, and

enhancement.

“Our conviction in Assura and its

strategy is evidenced by Northwest taking

an equity stake in Assura as part of this

transaction, allowing us to benefit from its

future success.”

Assura was advised by Barclays Bank

PLC, CMS (corporate legal), and

Addleshaw Goddard (finance legal). n


Finance and Property Deals

Developer purchases

retirement community site

McCarthy Stone¸ a developer and

manager of retirement communities,

has acquired a development site in

Cowbridge, South Glamorgan, from

property firm, Mercian Developments.

McCarthy Stone submitted and

secured planning consent for a scheme

of 50 retirement living apartments with

communal facilities.

Leah Tattersall, land manager at

McCarthy Stone, said: “It is great news

to complete on this site acquired from

Mercian Developments after successfully

securing a first-time planning consent.

“We very much look forward to bringing

more high-quality retirement living homes

to South Wales.”

Chris Towers, managing director of

Mercian Developments, added: “This

strategically located site will bring forward

the redevelopment of a former farmstead,

which will be regenerated to deliver new

retirement apartments for the elderly

Finance deal for

care home group

residents of Cowbridge and beyond

that will integrate well within the local

community.”

Business property advisor, Christie & Co,

facilitated the sale.

Jordan Rundle, director and head of

healthcare development at Christie & Co,

said: “According to the ONS, as of 2021

the total population in Wales was circa

3.1 million, with those aged 65 years and

over accounting for circa 21%, equating to

approximately 650,000 people.

“Consequently, there is a significant

opportunity for developers and operators to

provide much-needed futureproofed laterliving

accommodation in the country.

“McCarthy Stone’s high-quality retirement

living scheme in the desirable market

town of Cowbridge is another example of

increased development activity we are now

seeing as a trend in Wales.”

The site was sold for an undisclosed price.

Two care homes

sold off

Care home operator, Lovett

Care, has secured a £65m

revolving credit facility

from real estate investment

company, Cain International.

The facility will finance a

pipeline of new care homes

across the UK, starting with

three in the South of England:

at Kings Hill, Kent; Chelmsford,

Essex; and Abingdon,

Oxfordshire.

Founded in 2009, Lovett Care

specialises in providing care

facilities with a particular focus

on residential, nursing, and

dementia care.

Keith Crockett, chief executive,

said: “We are delighted to have initiated this

relationship with Cain International, which

will help us execute our strategy to deliver

high-quality, new-build care homes across

attractive markets.

“Cain’s expertise in the sector has been

helpful in putting together a framework

that fits well with our growth strategy and

ambitions to deliver best-in-class facilities.”

Nikos Yerolemou-Ennsgraber, director at

Cain, added: “By agreeing this deal with

Lovett Care, we have established a strong

relationship with a highly experienced

provider.

“As the UK faces a significant demand

for care beds, far exceeding the current

supply, we are proud to contribute to the

development of this sector.”

An unnamed operator has purchased Greater

Manchester-based care group, iCare International.

Established in 2001, iCare comprises two care homes:

Marple Lodge in the town of Marple, and Grove Lodge

in Hazel Grove village.

Registered for 39 residents in total, the settings provide

group residential care for individuals over the age of 45

with dementia, sensory impairments, and mental health

issues.

The vendor sold the business in order to retire.

Property company, Redwoods Dowling Kerr, facilitated

the sale.

Its senior sales negotiator, Asif Musa, said: “The sale

of this residential care home demonstrates that the

appetite for residential care home remains high in

England.”



Former hospital on the

market for £4m

Christie & Co has been instructed to sell

Smallwood Manor Hospital in Uttoxeter,

North Staffordshire.

Originally designed by Robert Edis and

built in 1886, the 48.66-acre estate is centred

around Smallwood Manor, a Grade ll-listed

Elizabethan-style country residence partly

refurbished in 2021 to accommodate a

children’s hospital and mental health centre.

The Quadrangle, a former stable block, has

planning permission for conversion to an

eating disorder clinic and semi-secure unit.

The property also benefits from an art

block, an enclosed swimming pool, a chapel,

which now has planning permission for a

restaurant, and four residential properties.

And the surrounding grounds

accommodate a walled garden, tennis

courts, playing fields, and artificial turf pitch.

The estate sits in a desirable setting within

East Staffordshire, close to the hamlet of

Netherland Green, and accessible via a

private driveway which leads to the estate.

The closest town is Uttoxeter which is

4.8km to the north.

It recently ceased trading as a private

school and is being sold with vacant

possession with an asking price of £4m.

Julie Kitson, director at Christie & Co, who

is handling the sale, said: “This beautiful

setting is an excellent opportunity to acquire

a building that has been partly refurbished

to provide semi-secure accommodation for

children stepping down from hospital.

“The properties on the grounds offer

children’s accommodation and a longterm

project to provide additional

accommodation and horticultural

opportunities, as well as C2 use.”

Consortium acquires Solihill home

Care home operator, Affinity

Care Consortium, has acquired

the 50-bed Silver Birches care

home in Solihull in the West

Midlands with the support of a

seven-figure funding package

from HSBC UK.

Affinity Care Consortium stated

it will use the funding to continue

its nationwide growth strategy.

Silver Birches will undergo

a full estate review, with plans

to upgrade and modernise

the home, including a full

redecoration and technological

advancements.

The acquisition is part of

Affinity Care Consortium’s

plan to open six homes in the

West Midlands by next year, in

addition to its existing site in

Coventry, Coundon Manor, as

well as five other services across

Stoke-on-Trent and Staffordshire.

Tanzeel Younas, co-owner of

Affinity Care Consortium, said:

“Buying Silver Birches marks a

pivotal milestone in our strategic

expansion into Birmingham and

Solihull.

“Our vision is to breathe

new life into existing homes

through modernisation

and enhancement, while

simultaneously pioneering new

services in the region to cater to

those in need.”

David Subba, healthcare

sector lead for Thames Valley

and Solent at HSBC UK, added:

“We are very proud to be able

to support the growth ambitions

of Affinity Care Consortium,

particularly as in doing so the

care facilities for residents in

Solihull are being improved.

“The healthcare sector

needs regular investment to

ensure facilities are suitable

for increasing numbers in

need of support and HSBC

UK is keen to support this

wherever possible.”

Affinity Care Consortium

operates 48 adult care homes,

100 supported living homes, 10

children’s homes, one school,

and 30 homeless housing units.



Shaw agrees deal with

specialist care charity

The future of more than 50 care home

residents and 10 users of an extra care

facility, all located in south Wales, has

been secured following an agreement

between a national care charity and

an employee-owned health and social

care provider.

Shaw Healthcare, headquartered in

Cardiff, has taken operational control of the

properties and additional care provision

previously managed by specialist care

charity, Leonard Cheshire.

Danybryn is a 31-bedded home in Radyr,

Cardiff; and Ty Cwm is a 20-bedded home

located in Carmarthen. The latter is also the

location of the 10 residents receiving care

in extra-care accommodation.

Both homes are known for providing

high-quality care services, consistently

maintaining a strong occupancy rate

with a stable and experienced team

of approximately 190 staff, who will be

transferring to Shaw Healthcare as part of

the acquisition.

Shaw healthcare delivers a range of

care services, including elderly residential,

nursing, dementia, and complex care

across the UK and is currently the largest

employee-owned (EO) care provider in

the UK, with a workforce of over

3,000 people.

Leonard Cheshire provides a range of

services, including care at home, supported

living, and residential care. It also runs lifechanging

employment programmes.

Russell Brown, chief executive of Shaw

Healthcare, said: “We are delighted with

the acquisitions, which increases our

footprint in South Wales, where we are

headquartered.

Shaw Healthcare has taken ownership of Danybryn and Ty Cwm

“The facilities at Danybryn and Ty Cwm

offer caring environments, aligning with our

vision to deliver the quality of care that we

would want for our own loved ones.

“Shaw is actively looking for opportunities

to grow its portfolio of services in the care

sector.”

Ruth Owen OBE, chief executive of

Leonard Cheshire, added: “Shaw’s values

of wellness, happiness, and kindness

perfectly align with what we want for our

residents and employees.

“Throughout the entire process, everyone

has collaborated exceptionally well and we

are confident that both residents and staff

are in safe hands.”

Mysa Care completes three acquisitions

Mysa Care, a care provider backed by

investment manager, Downing, has

completed three acquisitions.

In Greater Manchester, Mysa acquired

EAM Group, a residential care business

with three specialist care units for adults

with profound and multiple learning

disabilities and complex needs.

And, in South Wales, Mysa acquired two

residential properties — Parc Farm and

Britannia House — which it will convert into

supported living services providing a home

for individuals with learning disabilities,

autism, and complex needs.

Mysa’s portfolio now comprises 39

care homes and supported living units

in Hampshire, Surrey, South Wales, and

Greater Manchester.

Downing’s investment director, Torsten

Mack, said: “We are very much focused

on continuing to support Mysa Care and

its growth ambitions and are particularly

excited by the first acquisition in the

Greater Manchester area which expands

the company’s geographic reach and

growth footprint.”

Chris Breen, chief executive of Mysa

Care, added: “We are very excited for

EAM to be joining the Mysa family —

its person-centred approach and

commitment to quality are core pillars of

our business.

“We look forward to growing our

presence in the Greater Manchester area

and continuing to provide high-quality care

for those most in need.”


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Inside issue 02, March-April 2024

• The future of PFI — trusts told to act now

before it’s too late

• NHS capital budgets must double to

protect the estate

• Decommissioning medical gases helps to

drive carbon efficiencies

• The evolution of healthcare fencing design

Inside issue 03, May-June 2024

• Milestone for £85m maternity hospital

development in Belfast

• Spotlight on best practice for dementiainclusive

design

• Framework agreements provide support for

next-generation healthcare buildings

Inside issue 04, July-August 2024

• Advocating a simpler approach to

the healthcare planning process

• The implications of a new accountancy

treatment on NHS leases

• Designing mental health

facilities closer to home

HEALTHCARE-PROPERTY.COM

Building Design

Modular mental health

bedroom earns praise

Exploring the design approach to Darwin Group’s innovative Bedroom Evolved modular mental

health bedroom and the importance of manufacturers listening to feedback from end users

Industry experts and service users

have welcomed changes to Bedroom

Evolved; a pioneering modular mental

health bedroom developed by healthcare

construction firm, Darwin Group.

The firm recently showcased its

new-look project at the Design in Mental

Health Conference for a second year

running and feedback from visitors was

very positive.

The close collaboration with Tough

Furniture, Safehinge Primera, and Medical

Architecture, has resulted in a space that

is not only capable of meeting stringent

BREEAM ‘Excellent’ sustainability

requirements, but also addresses the specific

needs of mental health service users.

Built and furnished entirely offsite in

Darwin Group’s factory, this year the

volumetric modular bedroom was taken to

Manchester Central Conference Centre for

the conference.

I’m coming to them from the point of view

of where I’ve been in hospital, and I’ve seen

that if you can’t keep it clean and if you can’t

provide me with a warm, comfortable, vibrant,

inspiring place, what am I supposed to do?

SAFETY AND WELLBEING

The incorporation of anti-ligature fixtures

and fittings is a critical aspect of the design,

ensuring the safety and wellbeing of patients.

And the offsite construction approach

adopted by Darwin Group allows for a

controlled environment that can potentially

reduce construction time and costs while

maintaining high quality standards.

This year, the team behind the bedroom

made several improvements based

on last year’s feedback, including an

entirely-new interior fitout consisting of

furniture, lighting, flooring, and colour

palette changes.

One of the visitors to last year’s event was

Nick Smith, who has personal experience

of living through a mental health crisis and

shared his views with the Darwin Group

team about the design and what he would

like to see from a modern mental health

bedroom space.

He said it was vital that people in the

industry listened to feedback from end

users to create more-accessible and userfriendly

spaces.


Building Design

Last year, we had

some incredible

feedback from people

about how it can be

improved and what

they would like to

see, and we got firsthand

knowledge

from people working

within the industry

and users of this

type of space, which

really inspired us to

go back and work on

something that was

even better

PICKING FAULT

“Quite a few people at the Design in

Mental Health Conference will hear me

pick fault and think it’s ridiculous and say

they can’t think of everything,” said Smith,

who now helps to support vulnerable

people who have suffered emotionally or

experienced a mental health crisis through

his peer support group.

“I’m not saying that they can, but I’m

coming to them from the point of view of

where I’ve been in hospital, and I’ve seen

that if you can’t keep it clean and if you

can’t provide me with a warm, comfortable,

vibrant, inspiring place, what am I supposed

to do?

“Being mentally unwell, you don’t trust

people, you are naturally hyper vigilant, and

you’re looking at things closely.

“What I liked about Darwin Group is

that they took what I thought was quite

harsh criticism last year really well, and I

was really pleased that they had made some

positive changes when I returned this year,

including simple things like colour and

choice of materials.

“They had no blinds on the window

last year, but now they’ve got integrated

internal blinds.

“The colours they’ve used are also better,

including in the shower where they’ve

replaced a blue with a really-nice sage,

earthy green.

“What I also liked was that they also

explained why they couldn’t change

certain things about the design for this

year’s conference.”

IMPROVING OUTCOMES

The idea for the original Bedroom Evolved

project came from the recognition that

the NHS not only needs a high-quality,

cost-effective solution that can be deployed

at speed, but also one which provides a

calming, serene place to improve people’s

chances of responding successfully

to treatment.

Louis Sullivan, Darwin Group’s principal

architect, who spoke to Nick at both

conferences, said: “As an industry, a lot

of thought has gone into developing the

bedroom over the last decade.

“We felt last year’s event was the right

place to show people first-hand what our

approach looks like and how we’ve pushed

it in terms of kit-of-parts adaptability,

efficient standardisation of parts and

process, and careful, considered detailing to

create a beautiful design.

“It’s about iteration and building onto all

the thought that’s gone into the design of

these spaces.

“Last year, we had some incredible

feedback from people about how it can

be improved and what they would like to

see, and we got first-hand knowledge from

people working within the industry and users

of this type of space, which really inspired us


Building Design

to go back and work on something that was

even better and which we could bring back

to this year’s exhibition.

“We worked really closely with

Tough Furniture this year to develop an

intentionally-minimal set of beautiful

details, which is how we put the joinery

back together.

A HOME FROM HOME

“Quite a few people who saw it last year

came back this year and instead of making

comments about changes, this year they just

sat in the room and spent time appreciating

the space.

“Personally, I think the space feels more

like a familiar piece of home rather than an

institutional place that is there to enforce

recovery on you.”

Sullivan said Smith’s first comment at last

year’s conference was probably the most

impactful.

“As soon as he stepped through the front

door of the bedroom, he clocked that

there was this microscopic kind of camera

embedded in the media TV, which was only

intended to give them access to their friends

and family if they wanted to talk to them

on a video call,” he said.

“Nick said he would not sleep in the bed

because even if we told him the camera was

off, he would think that it was watching

him. It’s that kind of feedback we received

which was fantastic.

“There were also comments made

last year about how elements of joinery

go together.

“Most of the comments last year were

about safety and anti-ligature risk and we

worked hard to introduce 18mm bullnose

It has really inspired me, knowing that good

design can really be appreciated and make a

difference in how we provide care for people

edges around all joinery, so it was a nice

sinuous surface that was welcoming, safe,

and cocooning.

SMART DESIGN

“Changes to colour were also a big focus

this year, and we went for a more-biophilic

palette and used more-neutral, earthy,

relatable colours. We also included design

elements that encourage circadian rhythm

through things like smart lighting that

could be synced to the media screen and

integrated blinds to create intentional

atmospheres within the room.”

Sullivan said this year’s discussions with

visitors were more about trust choice, their

taste, and how they like to operate.

“It wasn’t a list of changes they want

to see in terms of how we provide care,”

he said.

“It was more to do with trust options,

such as do they want to look after the

patient’s belongings in the room themselves,

so they no longer need a lost and found

property cupboard.

“Do they want the bed in orientation A,

B or C? Do they want to have the media

TV or not?

“The buzzword this year was ‘serenity’

and trying to inspire calmness in the space.

“We had a really good comment from

someone who just sat on the bed, looked

at the joinery and edges and how the desk

moulds into a bench, and felt we had really

thought about them in the way we had

designed the space.

“I’ve always appreciated that good design

can heal, and just hearing that comment

was evidence that what we designed was

doing exactly what we intended it to do.

“Instead of that person wanting to pick

at that space and wanting to take it apart,

they felt more inclined to care for it and

nurture it.

“It has really inspired me, knowing that

good design can really be appreciated and

make a difference in how we provide care

for people.

“What we did this year absolutely paid

off, and the comments we had were exactly

what we were hoping for.”

He added: “My hope is that through

built, functioning prototypes like Bedroom

Evolved, which people can come to visit,

spend some time in, and feel welcomed,

we can foster an appreciation of the

importance good design can make to

mental health strategy and care.” n


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Building Design

Innovative design supports

NHS staff retention

As the health service struggles with the recruitment and retention of staff, we look at how one

innovative model is helping to deliver modern keyworker accommodation that meets the needs of

employees from the UK and overseas

Health and care workforces have

been under immense strain,

with NHS trusts reporting a

staff shortfall of 150,000 employees — a

figure set to rise to 360,000 by 2036 unless

significant action is taken.

And one of the priorities for workers

considering joining the NHS is where they

will live.

Not only have economic pressures

made private renting or purchasing homes

unattainable for many health and care

workers, but the standard of living in

existing rental accommodation has declined

rapidly, with widespread reports of mould,

damp, and other major failings.

And, while dedicated keyworker housing

does exist across the UK, these are often

designed in a similar way to student housing

provision, typically with shared bathroom

and/or kitchen facilities, and are deemed

inappropriate for those working in the

health and care sector who are usually older

adults, often with families.

MIND THE GAP!

This has left a gap in the market for the next

generation of keyworker accommodation,

a gap which developer, Prime plc, is hoping

to fill.

Michelle Robinson, associate director at

Prime, explains: “The NHS has long been

impacted by a lack of capital investment,

as evidenced by an increasing backlog

maintenance requirement.

“It is understandable that constrained

capital is focused on improvements to

clinical spaces to support direct patient

care. However, NHS staff also deserve

quality accommodation.

“Ensuring staff have a safe, comfortable,

and convenient place to live can

significantly impact their wellbeing and, by

extension, the quality of patient care.

“But investment in keyworker

accommodation is not just a moral

imperative; it’s a strategic one as reducing

commute times and living costs can

enhance job satisfaction, strengthen

retention rates, and attract a morediverse

workforce.”


Building Design

…investment

in keyworker

accommodation

is not just a moral

imperative; it’s a

strategic one as

reducing commute

times and living

costs can enhance

job satisfaction,

strengthen retention

rates, and attract

a more-diverse

workforce

NO PLACE LIKE HOME

Most existing keyworker housing schemes

are operated by a housing group and offer

a range of accommodation — typically

studio or one-bed apartments — on a shortterm

basis.

But there is very little available for staff

more long term, or for those with families.

Hyve by Prime has been set up by

Prime plc as a not-for-profit management

company aimed at addressing the high

demand for desirable, affordable, and

bespoke keyworker accommodation close

to hospital sites.

Offering flexible tenancy lengths that

meet the changing lives of residents,

developments are built to sustainable,

energy-efficient, and functional building

designs to create comfortable and safe

spaces for health and care professionals to

call home.

Robinson told Healthcare Property:

“Recruitment and retention is a challenge

for health and care operators — and is now

the worst it has ever been.

“International recruitment over the last

few years has exacerbated this challenge, with

trusts having to find places for staff to live.

“Trusts have found that international

recruits struggle to get into the private

rental market as they may have no credit


Building Design

history, guarantors, or UK bank accounts.

“Home-grown NHS employees are also struggling to

afford their own homes.

“And many people make decisions on which jobs to

take depending on if they can find somewhere to live

and that they consider this affordable accommodation.”

A STANDARD DESIGN

Through Hyve by Prime, developers are looking to

refurbish existing properties and construct new-build

units up and down the country using a standardised

design approach.

Robinson said: “Currently a lot of keyworker housing

stock does not offer en-suite facilities.

“Our standardised design of one-, two-, and three-bed

apartments ensures there is enough space and room to live.

“These are going to be people’s homes, so each

apartment provides private en-suite bedooms, a

kitchen, and living area.

“This flexibility means you could have three

individuals living in a three-bedroom apartment, for

example, each with their own en-suite bedroom, or you

could have a family living there.”

Under its model, Prime plc is responsible for

purchasing and developing each site. Partner

organisation, Hyve by Prime, then uses its not-forprofit

status to keep rents affordable for keyworkers.

And this means NHS trusts do not have to put the

cost of providing this accommodation on their balance

sheets, thus protecting their ever-dwindling capital.

With keyworker developments recently having been

built in Yeovil and Dorchester, NHS trusts now have a way

to provide appropriate and long-term accommodation and

in turn attract much-needed new talent.

SAFE AND CONVENIENT

Robinson said its research had revealed that while the

optimal site for these developments in within trusts’ own

estates; they are also looking further afield and working

with local authorities to find additional sites, such as

vacant high-rise blocks.

Robinson said: “We look for sites within 20 minutes

walk from the hospital site due to the cost of travel

and parking.

“In big cities, where public transport is better, we may

go slightly further out, but, after a 12-hour shift, staff

want to get home quickly.

“They also want to be safe and we have rejected sites

where we would not want to walk that route home.

Safety is very important.

“We then work with trusts to understand what

accommodation they already have, what they need, and

who they want to place there.”

In Yeovil, Prime secured £21m in funding to develop a

new-build 176-bed complex across 66 apartments.

The units were funded by Canada Life and built by

Speller Metcalfe.

And, in Dorchester, Hyve by Prime provided 63 oneand

two-bed apartments just a 10-minute walk from

Dorset County Hospital.

Robinson said: “Housing costs in Dorset are

significantly above the national average.

“Set against a crisis in medical staffing, the increased

costs of employing agency nurses has seen the trust

The commercial structure and

funding model created ensured the

new accommodation met our needs

without requiring NHS capital, demand

guarantees or approvals — meaning

our staff could move into their new

homes quickly

employ a growing number of overseas nurses in recent years.

“In addition to offering homes to international and UK-based staff, the trust

believes that a major incentive to work at DCH is to provide good quality, wellmaintained

accommodation close to the hospital and this is what we have done

with the Alexandra House development.”

BREAKING DOWN BARRIERS

Nick Johnson, deputy chief executive at Dorset County Hospital NHS

Foundation Trust, added: “Here in Dorset, a lack of accommodation offering is

further exasperated by its rural location and the fact that it is a holiday hotspot,

with one in 13 houses a holiday home.

“I recall during one hospital walkaround a valued colleague telling me that

they were moving to another NHS trust across the country simply because

house prices were much cheaper and they could afford a family home.

“With this region-specific challenge staring us in the face, we turned to Prime

to help us find a solution, and fast.

“The commercial structure and funding model created ensured the new

accommodation met our needs without requiring NHS capital, demand guarantees

or approvals — meaning our staff could move into their new homes quickly.

“By mitigating the housing-related barriers to recruitment and improving staff

retention rates, we will reduce the financial strain associated with constant turnover.

“Consequently, this helps us allocate resources more effectively, enabling

enhanced patient care, investment in training and improved overall

service delivery.” n


Healthcare Design Awards

Healthcare Design Awards 2025

— categories are unveiled

Entries are now being invited for the 2025 Healthcare Design Awards.

Previously run by Pinders, the awards,

which were first launched in 1991, were

last year taken over by Nexus Media

Group, which also publishes Healthcare

Property magazine.

The competition recognises innovation

and excellence in the design of health and

care facilities across the UK.

And the categories for next year’s

competition have recently been announced.

There are a total of six trophies up for

grabs in 2025. They are:

• Best Architectural Design: Recognising

outstanding architectural design of a new

care home, taking into account innovative

layouts and aesthetics

• Best Interior Design: Recognising

creative interior design of a new care home

– e.g. use of colour, materials, and signage

to improve the resident experience

• Best Exterior Design: Recognising

standout design of care home gardens,

terraces, balconies, and other outdoor

spaces

• Best Specialist/Dementia Care Design:

To be awarded to facilities for specialist or

dementia care where innovative design has

improved the lives of residents or patients

• Best Acute Care Design: Recognising

innovatively-designed facilities for acute

care service delivery

• Best Primary Care Design: To be

awarded to innovatively-designed facilities

for primary care

Jo Makosinski, editor of Healthcare Property,

said: “The way we design health and care

buildings is critical to the delivery of effective

and efficient services.

“Increasingly, the environment is playing

an even more-important role, and these

awards aim to recognise this by rewarding

those who are innovating in order to provide

the very-best settings for modern health and

care services.

“Whether they be care homes, GP

surgeries, hospitals, or specialist care

centres; the Healthcare Design Awards will

celebrate those projects which are setting a

precedent for the future, both in the UK and

overseas.”

The entries will be considered by a panel of

experts, with the winners being announced

at a ceremony at the Royal Lancaster Hotel

in London on 13 February 2025.

For more information on how to enter

the awards, or for details of sponsorship

packages and tickets to the

ceremony, scan the QR code

or visit the website at https://

healthcaredesignawards.co.uk


Estates and Facilities Management

Of particular note for new or existing

healthcare facilities looking to undertake

variation or expansion works will be the

proposed new gateway procedure.

This is intended to ensure that fire

safety plays a key factor in the design and

occupation of buildings and will need to be

factored into the planning stage for any new

construction project.

Hospitals come

under fire

Following the Grenfell Tower fire

in June 2017, it became clear there

was a need for the Government to

step in and change legislation for high-rise

buildings (HRBs) so that such a tragedy

never occurs again.

And, building on the recommendations

within Dame Judith Hackitts’ Independent

Review of the Building Regulations and Fire

Safety, published in May 2018, the Building

Safety Act received Royal Assent on 28

April 2022.

It takes forward the commitment to

fundamental reform of building safety

by strengthening the regulatory system

and ensuring greater accountability and

responsibility for fire and structural safety

issues throughout the lifecycle of buildings.

Legislation provides a laser focus on

quality, with building regulations front and

centre. Under the legislation building owners

will be required to manage safety risks, with

clear lines of responsibility for safety during

design, construction, completion, and

occupation of high-rise buildings.

It will also require a ‘golden thread of

Image: Andrea from Pixabay

Jo Makosinski speaks to Bonnie Chu of Wates to explore the

challenges facing estates managers in ensuring compliance with

fire regulations in healthcare settings

information’, with safety considered at every

stage from design to occupation.

MANAGING RISK

And building owners will need to

demonstrate that they have effective,

proportionate measures in place to manage

safety risks, and will need to register

their buildings.

Significant incidents that cause loss of life

or injury will need reporting to the Building

Safety Regulator, which will sit within the

Health and Safety Executive (HSE).

The Regulatory Reform (Fire Safety)

Order 2005 will also be amended to ensure

tougher sanctions for non compliance and

those who do not meet their obligations

may face criminal charges.

These changes are having a significant

impact on hospital estates and facilities

managers as, while they primarily focus

on residential buildings, the introduction

of a new regime for ‘higher-risk buildings’

of at least 18m high, or with at least seven

storeys, applies to many hospital tower

blocks and some care home units.

LESSONS LEARNT

So, what can trusts do? And how do they

ensure they do not falling foul of the

new rules?

To address this issue, Bonnie Chu, design

director at Wates, is developing a White

Paper, due to be released later this year,

which will explore the challenges with fire

compliance on healthcare estates.

Developed in conjunction with HLM

Architects and fire and risk consultancy,

OFR; the document will be informed by a

series of roundtable discussions exploring

the challenges that healthcare providers

are facing with achieving fire compliance;

their experiences in delivering positive

outcomes while working in live, clinical

environments; lessons learnt; and some

of the unprecedented challenges facing

the NHS.

Chu said: “We had some great

discussions, sharing lessons learnt,

including the complexity of hospital estates,

experiences with managing expectations

upwards and with staff/patients/visitors,

and funding challenges, such as prioritising

where to spend the funding.

“It was clear that NHS trusts are ALL

facing similar, if not the same, challenges.”

She added: “We believe the buildings

and spaces health services operate from

should enable them to expand, develop, and

enhance the valuable work they deliver for

the patients in their care, without the worry

of fire compliance issues and the serious

risks associated with inadequate protection

for staff, patients, and visitors.”

COMPLIANCE

Through her research she has identified

four common challenges facing healthcare

estates managers when it comes to fire

safety within their estates:

• A lack of accurate estates information

• Lack of compliance with current

statutory recommendations

• These are not typical capital projects

• Stakeholder management

She said that while most trusts have fire

risk assessments, the key to compliance,

and ensuring the safety of all building

users, was an up-to-date fire strategy for

existing facilities.

She added: “Are we giving enough



importance and emphasis to having an upto-date

fire strategy for retained estates?

“New-build projects will have a

dedicated fire strategy, but what about

retained estates?

“How do we expect estates team and

fire consultants to undertake fire risk

assessments without a strategy?”

And she called for greater collaboration

and a focus on fire safety from the very start

of any building project.

“The resounding message from our round

table events was that we must accept the

traditional approach to procuring capital

projects does not work for these types

of projects and that early cross-industry

collaboration on projects is essential to

driving forward change and delivering the

outcome efficiently and effectively.

COLLABORATION

“The discussions always circled back on the

need to collaborate and work together from

the inception of fire compliance projects —

get the client, designers, fire engineers, and

contractors together so we all understand

and develop the right affordable solutions

to mitigate and engineer out fire risks

where possible.

“Is this perhaps a return to what

design and build is meant to be — the

contractor comes on board early with their

design team?

“I would like to think that having

been an architect, and now working for

a main contractor, this is where I’m best

place to drive this collaborative approach

to ensure we achieve success in these

complex projects.

“Every trust is different and their

experiences are differing, so we need to

develop a strategy that works for them

and starts breaking down what needs to be

done, sooner rather than later.

“We also need to consider the estate as a

whole, rather than just pockets of it.”

Her research comes as reports of fires

and fire safety issues at hospitals across the

UK continue.

A GROWING PROBLEM

In March of this year figures from NHS

Digital revealed a concerning rise in fire

incidents recorded by NHS trusts, with

1,372 fires reported in the 2022/23 period.

This marks an increase of over 18% from

the previous year, translating to almost four

fires daily across the NHS.

One of these incidents, in June 2023, led

to patients and staff being evacuated from

Watford General Hospital after a blaze

broke out in a basement electrical store.

And earlier this month patients were

moved from a stroke ward at Cornwall’s

Fire Safety Roundtable

The discussions always circled back on the

need to collaborate and work together from the

inception of fire compliance projects — get the

client, designers, fire engineers, and contractors

together so we all understand and develop

the right affordable solutions to mitigate and

engineer out fire risks where possible

Bodmin Community Hospital after

an independent fire safety review for

the hospital identified issues which

meant planned works needed to be

brought forward.

Central to fire safety compliance,

according to Tom Ford, Honeywell’s

national business development manager for

connected life safety systems in the UK and

Ireland, will be embracing digital solutions.

He said: “Fire systems require testing,

inspection, and maintenance to continue

functioning effectively, with smoke

detectors needing annual functional testing

and inspection.

“However, this process can be disruptive,

requiring access to every room across an

estate, and meticulous manual recording,

which can result in inaccuracies and

missed detectors.

“Digitising fire system testing and

maintenance creates audit trails that allow

users to prove that their sub contractor

has completed a full functional test of the

fire system.

“This helps service providers and estate

owners save time on site, and provides realtime

updates on the performance, testing,

and overall compliance with local fire

safety codes.” n



Inspiring hospital caterers

to buy British

Love British Food has

produced and released a

film to inspire NHS catering

managers, procurement

teams, and trust chief

executives to consider

the connection between

how food is produced and

its contribution to patient

outcomes.

The film was shot onsite

during the ninth farm visit for

NHS caterers through the Love

British Food Hospitals and Care

Catering Working Group to the

Holkham Estate in Norfolk.

The visit to one of Britain’s

largest historic country estates,

and the largest privately-owned

nature reserve, was hosted

by Jake Fiennes, director of

conservation.

The Holkham Estate leads the

way in delivering exceptional

food production, together

with pioneering conservation,

and is focused on soil health,

connecting habitats, enhancing

the environment, developing

science-led innovations, and

making operations leaner

and greener.

Alexia Robinson, founder and

chief executive of Love British

Food, said: “We know it is not

enough to ask catering teams

to buy British. We need to

explain why.

“The aim of these farm visits

has been to enthuse catering

teams to see buying British as

a carrot rather than a stick, as I

Guaranteeing the effectiveness

of laundry services

At its spring conference, the Textile

Services Association (TSA) presented

a new standardised test protocol for

evaluating the disinfection efficacy of

laundry wash processes in hospitals.

This marks the latest stage in the

ongoing partnership between the TSA

and De Montfort University (DMU),

which they believe will help to guarantee

the effectiveness of infection controls in

healthcare laundry services.

The new protocols have been developed

following a four-year research project led

by Professor Katie Laird at DMU, which

was funded and supported by the TSA and

other national associations from Europe

and America.

The research aims to provide accurate

information and usable methods of ensuring

hygienic cleaning of textiles, particularly

in relation to sectors more vulnerable to

infection, such as healthcare.

TSA board member, Simon Fry, himself an

owner of a specialist laundry firm, explains

why this work was necessary. “The idea for

this project came about when manufacturers

began introducing chemicals for cold

washing,” he says.

“While it’s a great idea in terms of energy

saving, it can introduce risks in terms of lesseffective

disinfection, which is compounded if

the traditional tests being used weren’t giving

accurate results.

“You could almost pick the test to get

the results you wanted and I realised that

we would need something that accurately

showed the kill rates of bacteria, which

could be used by all stakeholders to deliver

data that allows everyone to work on a level

playing field.”

The research aimed to create standardised

testing protocols that definitively measure

how many pathogens are killed by laundry

washing processes.

In order to achieve this the DMU team

needed to study existing infection controls

and the current processing methods for

healthcare laundry. They also needed to

understand the attitudes and knowledge of

healthcare staff in terms of infection control

SCAN TO WATCH

fear the perpetually-consultedupon

New Government Buying

Standards make it sound.

“I genuinely believe these

visits have created excitement

about buying British in NHS

catering teams.

“Together with the farmers who

have hosted the visits with me,

we have answered the question

‘Why buy British’ and explained

how doing so contributes to

patient outcomes, sustainability,

net zero goals, and trusts’

roles as anchor institutions for

supporting their community.”

The short film encompasses

some of this philosophy, and

included feedback from some

of those who attended the

Holkham Estate visit.

Love British Food has now

hosted 43 hospitals from 36

NHS trusts on farm visits.

policies and how these apply to textiles.

Alongside funding the research, the TSA

also organised surveys of its members in the

UK as well as overseas.

The test developed by Professor Laird

and her team accurately demonstrates the

disinfection efficacy of laundry during a

wash process in a way that can be used

throughout the healthcare sector, whether it is

in outsourced or on-premise laundries.

The test involves placing a sample of

inoculated fabric within a membrane, which

looks similar to a teabag, that allows water

and chemicals through, but stops bacteria

from escaping, meaning that the effectiveness

of the decontamination of the laundry process

can be properly evaluated.

This allows for a like-for-like comparison

of different washing methods and

equipment types.

The next phase will see the test

methodology incorporated within best

practice standards driven by the other

national associations including the TRSA in

America and ETSA in Europe.


Environmental

Dotting the i’s and

crossing the t’s

In this article we consider the importance of

seeking legal advice before embarking on longterm

carbon reduction projects within the NHS

With the NHS having been set

tough targets to reach net zero

carbon emissions by 2040, the

race is on to implement changes at pace.

And this challenge is being supported by

a number of energy efficiency procurement

and financing frameworks.

While these are helping trusts to find

the necessary funding for often-high-value

interventions, and providing the legal

support for contracts between health

organisations and private technology

and service providers, there are still risks

associated with these long-term contracts.

Recently, UK law firm, Mills and

Reeve supported South Warwickshire

University NHS Foundation Trust on the

implementation of an energy infrastructure

and energy infrastructure maintenance

contract funded through phase 3b of the

Public Sector Decarbonisation Scheme

(PSDS) and delivered through the Carbon

and Energy Fund (CEF) Framework

5 agreement.

MAKING SAVINGS

Under the agreement, contractor, F P

Hurley & Sons, will install air source and

water source heat pumps and a new district

heating mains feed to the trust’s satellite

plantrooms at Warwick Hospital.

The works also include the installation

of solar PV panels and a comprehensive

upgrade of windows at the hospital.

Over the next 15 years, the works will

deliver an estimated saving of 11,313 tonnes

of CO2e, and save in excess of £150,000 on

energy and maintenance costs.

But, while the standard contract

provided under the CEF agreement sets out

guarantees from the contractor in terms of

expected energy and cost savings; trusts are

being advised to seek legal advice to ensure

that the contractor’s performance meets

any carbon intensity and other net-zero

parameters.

Benjamin Bull, senior associate at Mills

and Reeve, told Healthcare Property:

“Projects such as this go some way to

reaching the ambitious targets set by NHS

and its aim to become the world’s first netzero

health service.

“However, it is vital that the trust looks

at the detail within the contract to ensure it

sets out the agreed level of service with clear

obligations for the contractor to meet.”

Benjamin Bull


Environmental

While there is not

much scope to

significantly change

the terms of these

standard contracts,

we have been able to

provide the trust with

guidance on how

to ensure they are

executed properly

TERMS AND CONDITIONS

Nick Helm, infrastructure and energy

lawyer at Mills and Reeve, adds: “While

there is not much scope to significantly

change the terms of these standard

contracts, we have been able to provide the

trust with guidance on how to ensure they

are executed properly.

“Our first task was to look at the

wording of the contract and what the trust

and the contractor were expecting from

the agreement.

“We did some work around the trust’s

liability as the heat pumps were being

installed on estate it owns, so there

is a responsibility to ensure the site

is maintained.

“This is a major long-term financial

agreement for the trust, and it is crucial that

it understands all the risks and liabilities.”

And Bull advises: “As this contract covers

installation and maintenance over a long

period of time, the contract must ensure

the equipment is being maintained and the

contractor is meeting the agreed service

Nick Helm

requirements from a technical position,

with any dip below the agreed level

resulting in the trust having recourse.

“For us this involves looking at how

the contract is structured throughout the

course of the agreement.

MANAGING EXPECTATIONS

“Firstly, we need to find our what the trust’s

sustainability officers expect the project to

deliver and what the contract provides for.

“Over such a long period of time, people

involved in the contract from both sides

may change and the contract needs to

provide a commitment that will ensure it

is adequately managed, regardless of the

individuals involved.

“There also need to be termination

clauses covering when both sides can

terminate the contract and what obligations

lie with each party, which differ depending

on when in the term of the contract

termination occurs, should this happen.

“This is why we would advise trusts to

seek advice early in the process to ensure

those contracts have been reviewed and that

they cover every possible eventuality and

support the trusts to deliver their goals.”

Commenting on the work, Cristina

Calleja, sustainability manager at South

Warwickshire NHS Foundation Trust,

said: "We are very excited to be developing

our site with a sustainable future in mind.

“This project will form the foundations

of a new and long-term relationship with

our sub contractor and we are grateful for

the support Mills & Reeve provided while

navigating the agreement and signing of

legal documents.” n


Environmental

Image: Gerd Altmann from Pixabay

Sustainability matters –

collaboration is key

Jonathan Freeman, group sustainability director at

CareTech Group, reveals how social care is adopting a

green agenda, asking how a competitive care sector can

work together to tackle sustainability challenges

Rightly or wrongly, the social care

sector is a complex patchwork of

provision, from local authority run,

to charity operators, to private provision.

That was the political decision taken by

successive governments and it’s unlikely this

mixed economy will change soon.

But it does pose some serious questions

as to how best to tackle sustainability

challenges.

With commissioners driving ever-harder

funding decisions, all of us in social care

tend to default to competition. How can we

deliver more than our competitors? How can

we deliver at a lower cost? How can we get

people to work for us, not our competitors?

Where does sustainably fit into that

mix? In particular, how can we square

the baked-in competitive nature of the

sector with environmental sustainability,

when tackling the climate crisis effectively

requires collaborative effort of the like not

seen before?

UP YOUR GAME

First, we need to work with commissioners

— particularly those in local authorities —

on our sustainability efforts.

Local authorities are increasingly seeking

to drive pressure on their providers to

achieve their own sustainability targets.

And the Government is under pressure to

support local authorities to up their game.

For social care providers with NHS

contracts, the sustainability requirements

are increasingly stringent with all contracts

for £5m requiring the operator to set out a

public carbon reduction plan.

A collaborative approach between the

sector to drive collective change is therefore

essential.

Each commissioner appears to have its

own approach and its own asks of providers,

creating unnecessarily complicated and

wasteful work.

We need to work together, agree our shared

priorities, streamline, and make consistent the

asks of commissioners on providers.

We also need to work together with

the Local Government Association and

the Association of Directors of Adult

Social Services to agree on expectations

on sustainability that will support the

ambitions of local authorities and the social

care sector alike.


Environmental

All too often, social care providers look to

succeed by competing with other providers.

That approach will simply not work when it

comes to sustainability

UPPING THE ANTE

Secondly, we need to collaborate with our

suppliers, all of whom are, of course, on

their own sustainability journeys.

To address our indirect emissions,

known as Scope 3, we have to work with

all of our suppliers to drive down our

carbon emissions.

These emissions include, for example, all

of the products that operators buy, use, and

dispose of from suppliers.

As those operators looking at their

indirect emissions are discovering, the

majority (typically, around 70%, but often

as high as 85%-95% of an organisation’s

indirect carbon emissions are driven by

these Scope 3 emissions).

It is inevitable that suppliers to the sector

will want to address their own carbon

emissions as regulators, national and

international, up the ante on these issues.

Consumer demand, however, is likely to

drive the pace more quickly. At CareTech,

we have found just asking a simple set

of questions of our suppliers about their

approach has unlocked some mutuallybeneficial

opportunities.

Our stationary providers, for example,

have swapped in a new range of recycled

and more-environmentally-sensitive

products at no extra cost.

And our cleaning products supplier

is piloting a range of new products that

promise to reduce plastic waste dramatically

— again, at no extra cost.

And this is just from opening up the

conversation with our suppliers.

WORKING TOGETHER

Thirdly, we need to start working together

more as operators. That’s why a group of us

came together to establish the Social Care

Sustainability Alliance.

The alliance brings together senior leaders

in providers across the social care sector

to pool their thinking on sustainability,

to work together on the tricky issues with

which we are all grappling, and to support

more providers to start or accelerate their

sustainability journeys.

The alliance has already published

a comprehensive ‘Business case for

sustainability in social care’and other papers

on the way include those on retrofitting

for older properties, the expectations of

investors, a guide to statutory and voluntary

requirements on sustainability, and best

practice on measuring and reporting on

carbon emissions.

By working together in this way, we will

all make faster progress on key issues, and

we will all benefit as a result.

All too often, social care providers look to

succeed by competing with other providers.

That approach will simply not work when it

comes to sustainability.

Sustainability gives us a very-real and

pressing opportunity for the sector to

come together behind a shared objective

to make a deep and lasting change for

the better.

Perhaps, this might even be a lesson that

we could apply more generally to tackling

the challenges facing the social care sector. n

Sustainability gives us a very-real and pressing

opportunity for the sector to come together

behind a shared objective to make a deep and

lasting change for the better


Environmental

Waste not, want not!

Sustainability and waste experts, Business Waste, share the top

strategies that hospitals can apply to run more sustainably

A

hospital’s primary focus should be

to provide care for its patients. But

there is also an increasing need to

adopt more-sustainable practices within

the institution.

And hospitals are now under more

pressure than ever before to reduce their

environmental footprint.

Integrating waste reduction strategies

into hospital operations offers a direct

and impactful approach to address

this challenge.

With this in mind, sustainability and

waste experts from Business Waste have

shared the top strategies that hospitals can

apply to run more sustainably.

1. Introduce comprehensive recycling

programmes

Recycling is the foundation of sustainable

waste management.

Hospitals can reduce waste by

implementing comprehensive recycling

programmes that go beyond paper and

plastics to include metals, electronics,

and glass.

Special attention should be given to

recycling single-use medical devices which,

after proper sterilisation and reprocessing,

can safely be reused.

Advanced segregation techniques will

take this a step further.

For example, clear signage and distinct

bins should be used for the following

categories: infectious waste, pharmaceutical

waste, chemical waste, and radioactive waste.

Hospitals should partner with certified

recycling companies that can provide

bins and containers for these waste types,

and the segregation will not be such a

complicated and time-consuming process.

2. Invest in reusable products and materials

Transition from single-use to reusable

products where possible in your hospital.

This plays a big role in moving towards a

more-sustainable administration.

It could include items such as surgical

instruments, linens, and even certain types

of personal protective equipment (PPE).

Investing in durable and reusable

alternatives reduces waste, but also

decreases long-term costs associated with

purchasing disposable items.

Hospitals must ensure, however, that

the transition to reusable items does not

compromise patient safety by adhering to

strict sterilisation and handling protocols.

3. Optimise energy and water use

Sustainability in hospitals is not limited to

waste management; it also covers efficient

use of energy and water.

Hospital management should look into

waste audits, which should check all the

main systems including lighting, heating,

ventilation, and air conditioning systems.

Are they as energy effective as they can

be? If not, consider replacing old bulbs with

LEDs, which are a lot more efficient and

long lasting.

Hospitals can also replace some of the

old heaters with smart thermostats that are

guaranteed to save both costs and energy.

And they can consider adopting watersaving

fixtures, which will help reduce water

overuse too.

Conducting regular energy audits and

investing in more energy-efficient devices

and technology can further enhance

sustainability efforts in your hospital.

4. Foster a culture of sustainability

Last, but not least, fostering a culture

of sustainability within the hospital

is essential.

This involves educating and engaging

all staff members, from administrative

personnel to nurses and doctors, about the

importance of sustainable practices.

Encourage staff to participate in eco

initiatives and provide training and

guidance on the hospital’s green goals

and what each one of them can do to help

achieve them.

The most eco-conscious and diligent staff

members could even be rewarded.

Hospitals can also engage patients to take

part in their sustainable efforts by promoting

an overall culture of environmental care,

responsibility, and action.

By incorporating at least some of these

strategies, hospitals should significantly

reduce their waste output and move

towards more-sustainable operations.

The benefits of such practices extend

beyond environmental impact; they also

include financial savings, improved patient

and staff satisfaction, and a stronger

reputation in the community.

As pillars of health and wellbeing,

hospitals that also take an interest in green

practices will lead by example within their

communities. n


Mitie wins NHS waste contract

Environmental

Waste management specialist, Mitie,

has been awarded a contract to collect

and manage all healthcare-related waste

produced by the Nottingham University

Hospitals NHS Trust.

The contract includes hospital gowns,

gloves, testing kits, and other single-use

plastics from Queen’s Medical Centre and

Nottingham City Hospital.

The waste will be treated using Mitie’s

specialist autoclave technology — a

sustainable waste management alternative

— which can treat up to 1.8 tonnes of

infectious waste, like sharp syringes,

swabs, and dressings, every 45 minutes.

By using the autoclave technology,

the trust’s clinical waste will be treated

with high-pressure steam which

destroys bacteria and pathogens on the

material, preparing it for safe disposal.

Whenever possible, Mitie will also work

with partners across the UK to recycle

and repurpose the decontaminated

material by turning it into plastic pellets

that can be used to make new products

to be used in healthcare environments,

supporting a circular economy.

A spokesman for Mitie said: “This

method is far more sustainable than

the traditional carbon-intensive, hightemperature

incineration process

which destroys waste at over 1,100˚C,

and does not allow for recycling.”

Cliniwaste, a specialist in treating waste

from healthcare environments using

alternative treatment, was acquired

by Mitie in October 2023 and will be

central to the delivery of the contract.

Cliniwaste’s Nottingham treatment

facility is located just three miles

from Queen’s Medical Centre, ensuring

waste will only travel a short distance

before being treated, further enhancing

sustainability across the contract,

and assisting the NHS in its

decarbonisation targets.

Michael Taylor, managing director of

Mitie Waste, said: “This contract not

only demonstrates our approach to

innovative waste treatment, but also our

commitment to supporting the NHS in

achieving its sustainability targets.

“Through our expert Cliniwaste team,

and our advanced autoclave technology,

we can ensure that all clinical waste

across the trust is managed efficiently

and responsibly, contributing to a

greener future for healthcare.”

Trusts join forces to improve sustainability

Five healthcare trusts have come

together to form the Circular Economy

Healthcare Alliance in a display of

commitment towards a greener and

more-sustainable NHS.

University College London Hospitals

(UCLH), University Hospitals Sussex,

Cambridge University Hospitals, Imperial

College Healthcare, and Chelsea and

Westminster Hospital NHS Foundation

Trust will co-operate to help reduce waste

and associated carbon emissions.

In a joint statement, the trusts said: “Our

collaborative group of NHS trusts aims

to reduce single-use medical equipment

and consumables, reusing wherever it is

clinically feasible and appropriate to do so.

“This will be reflected in our evaluation

criteria for selecting products and suppliers

through the procurement process, and

through building skills, knowledge, and

processes in our trust to enable this

transition.”

Professor Mahmood Butta, a consultant

ear, nose and throat (ENT) surgeon and

clinical lead for environmental sustainability

at University Hospitals Sussex, is

spearheading the alliance.

He said: “The NHS in England generates

440 tonnes of medical waste a day.

“While discarding items has become

commonplace, our research and

analysis reveals that this is often

unnecessary and perpetuated by

misconceptions about infection risk.

“By forming this alliance, we advocate

for a shift towards using reusable products

whenever safe to do so, and will always

use suppliers that value sustainability. We

encourage others in the NHS to join us.”

The alliance is focusing on three key

areas of change:

Joe Burton, sustainability transformation

project lead at UCLH, said: “Our ambition

is that this alliance signals to suppliers

a shared desire to change the way that

trusts procure single-use items in favour of

reusables, supporting the national objective

for the NHS to be net zero by 2045.

“We have multiple projects underway

at UCLH to reduce our use of single-use

items and continue to share our progress

with the alliance.”


Environmental

A man on a mission

One of NHS Grampian’s assistant

domestic services managers is

being recognised for single handedly

cutting waste by 1,300 bags of rubbish

every week.

Aaron Sutcliffe, 32, who is originally from

Manchester and now lives in Elgin, joined

NHS Grampian in 2016 as a domestic and

has been promoted three times since.

And he has now been handed a Green Star

Award for his efforts to reduce the health

board’s impact on the environment.

His passion for removing general waste bins

in favour of fewer recycling stations started

when he looked after Ashgrove House in

Aberdeen.

He has since gone on to transform the

way waste is handled in the warehouse at

Aberdeen Royal Infirmary as well as two

floors of offices in the hospital’s Yellow Zone

and at Foresterhill Health Centre.

Overall he has helped colleagues ditch

nearly 450 general waste bins, which equates

to more than 1,300 black bags every week.

He said: “We’ve found engaging with

people is the most-important bit — asking

‘we would like to’ and explaining we’re

trying to make a positive impact on our

sustainability goals.

“Every single general waste bin I’ve ever

checked contains recyclable materials and

what we’re doing is trying to make it easier

for everyone to think about recycling first.

“It’s a win-win for everyone as it means less

bending to under-desk bins for domestics

and it’s good for those sitting at desks to get

up and about too.”

Sutcliffe was presented with a certificate

by waste manager, Neil Duncan, who said:

“Swapping lots of small waste bins for fewer

recycling points helps encourage staff to

recycle and it reduces the workload for our

domestic assistants.

“But, with more than 70-plus sites to review,

alongside hundreds of teams, there’s an

opportunity for others to take a lead and

make the changes in their areas.

“Aaron has plans to double what he’s

achieved so far by the end of this year and

this is commendable work which should be

replicated across all areas.”

The organisation currently spends around

£125,000 every month disposing of clinical

waste alone and it is estimated that recycling

more of this could save the health board at

least £150,000 per year.

Welsh ambulance trust leads the way

The Welsh Ambulance Service has

been recognised for its commitment to

reducing its environmental footprint and

improving performance.

The trust has been awarded the ISO

14001 Environmental Management Systems

Standard by the British Standards Institution

after a rigorous five-day inspection of its

environmental governance system.

ISO 14001 is an internationally-recognised

standard for environmental management

systems, which supports organisations

in identifying, managing, monitoring, and

controlling environmental processes.

And the Welsh Ambulance Service is

currently the only ambulance service in the

UK to hold this standard.

Richard Davies, the trust’s assistant

director of capital and estates, said:

“To retain accreditation is a massive

achievement.

“It’s a validation of the great work

headed by the estates team and especially

environment and sustainability manager,

Nicci Stephens; and

environment and

sustainability support

officer, Sharon Jones.”

The trust introduced a catalogue of new

initiatives in its bid to secure ISO 14001,

including new plug-in hybrid rapid-response

cars to replace the older diesel-powered

vehicles; 270 speed-limited non-emergency

patient transport vehicles installed with

solar panels to minimise the need for mains

charging; the use of video conferencing

to reduce travel time, emissions, and cost;

installing new renewable energy systems;

and reducing reliance on fossil fuels by

installing low-carbon heating.

Stephens said: “The accreditation provides

assurance to the trust’s management and

employees, as well as external stakeholders,

that the environmental impacts of the trust

are being measured and improved.

“The assessor noted that, during their

visit, the trust demonstrated that the

environmental management systems in

place continue to support the strategic

direction of the organisation and

achieve objectives relating to improving

environmental performance, which we are

very proud of.

“In order to support the Welsh

Government’s ambition of a net-zero carbon

public sector by 2030, we have developed

a decarbonisation plan and are working

towards the NHS Wales decarbonisation

target reduction of 34%.”

The trust was accredited following an

audit which took place at a sample of

stations and office buildings across Wales

during May.


Healthcare Property Issue 05 September-October 2024

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