The role of system estate management in meeting ICS aims

On the 1st July 2022, the Health and Care Act 2022 established Integrated Care Systems (ICSs) across England to achieve the following aims:

• Improve health and wellbeing
• Reduce health inequalities
• Improve system productivity and value for money (VFM)
• Act as an anchor institution and contribute socio-economic benefits to their local communities

ICSs constitute a fundamental reform of health and care services, with the management of health and care real estate forming part of this radical overhaul.

The Good Governance Institute (GGI) & Primary Health Properties (PHP) have partnered to identify the role of estate management in achieving the ICS aims. This paper is the third in a series of GGI-PHP papers on estate management.

There were two previous papers:

• Innovative capital solutions to achieving STP goals (2017)The first paper provided insight into the various capital financing options available to providers, commissioners and GPs. It also explored how those looking to develop new estates could use the experience of providers in order to design a balanced development strategy.
• Primary Care Estate: Delivering value and improving care (2021)This second paper explored the commissioning of primary care premises by CCGs, Primary Care Networks (PCN) and trusts, and the influence of healthcare integration and digital access to primary care, post-Covid-19.

For this third paper, we conducted over 15 qualitative video interviews with a variety of stakeholders from ICSs, NHS Trusts, primary care and the local government association.

Interviewees were asked a series of questions about the following topics:

• The current landscape of their organisations, including their estate strategy, primary care innovation/ambition, and culture and behaviour around estates
• The potential opportunities arising under the new ICS arrangements
• The barriers and enablers they encountered to collaboration between partners
• The future forms of estates in ICSs and what they may look like

Findings from interviews were complemented by desk research. The objectives of this paper are to raise awareness of the importance of estate management in helping to facilitate the integration of health and care and the achievement of the ICS aims. It also seeks to help galvanise system estate management by identifying the key levers and sharing best practice examples.