Recommendation 4

NHS Property Services has not got the balance right between local initiatives and incentives and national control. NHS Property Services aims to dispose of properties that are under-used or no longer needed. By March 2019, it had disposed of 410 surplus properties with a capital receipts value of £347 million. The Department noted that NHS Property Services’ release of surplus land has delivered 1,921 housing unit equivalents, as part of the government’s scheme for releasing public land for housing. However, the decision on whether a property is surplus to requirements is made by the health commissioners and clinicians who use the property and not by NHS Property Services. Receipts from property sales are reinvested in the estate at a national level rather than going back to the local area in question. NHS Property Services acknowledges local occupiers or health systems are not sufficiently incentivised to release property because they may not benefit from a sale. We are also concerned that there is a lack of transparency in NHS Property Services’ property disposal decisions, for example, whether decisions are taken that are in the best interests of the local health system or to achieve the greatest financial benefit. NHS Property Services has reduced the number of separate facilities management arrangements across its portfolio from 2,400 to about 50. Some of these services are delivered by NHS Property Services themselves and some are outsourced. Rationalising the arrangements has had clear benefits, but it is not clear to us why NHS Property Services has a mix of in-house and outsourced facilities management services and why these decisions were made. NHS Property Services 7 Recommendation: The Department and NHS Property Services should engage local areas as how best to maintain and improve their local estate. As part of this: • the Department should consider the benefits of developing a shared incentive plan that guarantees local areas a percentage of the disposal value of any local property disposals by March 2020; • NHS Property Services should engage more with local bodies in making decisions about their local estate; and • NHS Property Services should review whether its mix of inhouse and outsourced facilities management contracts delivers value for money to both the taxpayer and local tenants.