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Former Health Secretary: LIFT has an ‘enormous contribution’ to make to the NHS

As part of the twentieth anniversary celebrations for the NHS Local Improvement Finance Trust (LIFT), former Health Secretary, The Rt. Hon. Alan Johnson, writes for The LIFT Council about why he became involved in the NHS LIFT programme in his role as Chair of the Citycare LIFTCo.

The NHS LIFT (the Local Improvement Finance Trust) is probably the most successful public infrastructure project that you have never heard of.

Despite its successes, even many politicians are unaware of its existence. But as the programme marks its twentieth anniversary this year, it is time to change all that by recognising the contribution NHS LIFT has made to improving primary care, particularly in cities like Hull, where I am now Chair of Citycare, one of forty-nine LIFT companies across the country. Of the 350 high-quality, flexible, well-maintained primary and community care facilities delivered through the programme since 2001, nine out of ten are in areas of above average healthcare need.

Primary care has always been the gateway to the NHS but struggled to attract capital investment from the start. GP practices were too often provided from sub-standard terraced housing by single-handed practitioners whose patients missed out on the enormous benefits of clinical collaboration as well as experiencing squalid conditions at their surgeries. Investment was fragmented and piecemeal.

The need to address these problems was recognised from the very beginnings of the NHS. That famous leaflet delivered to every home in the country in 1948 setting out the services that would be provided included a paragraph headed ‘Health Centres’. The leaflet said these would “later be opened in your district” for doctors to be accommodated along with “other services on the spot.” Fifty-three years later, NHS LIFT has played a pivotal role in helping to realise this vision. It is no wonder that the Prime Minister recently paid tribute to the programme; LIFT has never been more relevant or more worthy of cross-party support.

Over the last 18 months it has played an important role in supporting 1,400 clinicians to deliver in-community care during the pandemic. The newest LIFT building, the Tessa Jowell Health Centre in Dulwich (a fitting tribute to a great politician), has enabled renal treatments to continue outside of hospital settings throughout COVID. In Barnard Castle the Richardson Community Hospital worked with a locally led network of GPs to give a thousand of the most vulnerable residents of Teesside their vaccines in just three days. And here in Hull the HSJ award-winning Jean Bishop Integrated Care Centre has continued to provide a base for geriatric services across the City.

The LIFT framework enjoys advantages that has meant it has thrived whilst other public-private partnerships (PPP)s have fallen by the wayside. The NHS retains a substantial stake, 40% in every project, more than other PPPs. LIFT also provides bang for its buck. Over its twenty years, the model has secured £2.5bn of investment for just £100m of public sector capital. Such returns must be considered against the challenges faced by the NHS estate. Whereas there is a huge maintenance backlog in some parts of the NHS estate, as recognised by the Naylor Review, LIFT buildings are maintained virtually in Day One condition. They are iconic structures that local communities cherish, admire and rely on for vital everyday services.

The success of NHS LIFT over the last two decades and its resilience during the pandemic has shown the enormous contribution it could make as the NHS moves into a new era of integration.

Integrating services has been at the heart of NHS LIFT projects since 2001, whether it is the co-location of vital health services under one roof, such as the sexual health clinic at The Flying Scotsman Centre in Doncaster or the provision of sports pitches at the Finchley Memorial Hospital. Alongside the sports pitches, the health campus at the latter includes a memorial garden and a therapy garden that is utilised by the clinical teams and patients alike.

We entrust our care to skilled clinicians and medical practitioners relying on their experience. Why would we settle for anything less when it comes to infrastructure? LIFT is a proven model that has been independently verified (twice) by the National Audit Office as providing value for money in delivering and managing portfolios of high quality. Its locally embedded expertise and knowledge exists right across the country.

Yet there has been a brake on the public discourse that has prevented these achievements from being aired. Politicians from all sides need to end the ambiguity around Public Private Partnerships to ensure that this twenty-year success story can begin a fresh chapter in its narrative of transforming primary care facilities, enhancing local communities and helping tackle health inequalities.

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