NHS England devolution: In a significant shake-up, the government plans to abolish NHS England, aiming to streamline bureaucracy and accelerate healthcare delivery. This controversial move grants more autonomy to ICBs, potentially speeding up crucial infrastructure projects and enhancing patient care
The government has announced its plans to abolish NHS England, a shock for many across the country. The decision aims to cut out bureaucracy believed to be hindering the delivery of health services, hoping that by removing a body for decisions to go through, administrative processes will be streamlined, speeding up the health service’s activity.
As a result of this decision, Integrated Care Boards (ICBs) will also have more responsibility and autonomy in how they use their funding, tailoring how Trusts run regionally.
NHS England devolution: Harnessing accelerated project delivery
The NHS England devolution has sparked debate, but this shift presents an opportunity for greater efficiency across the service, including critical infrastructure projects. While the full impact remains to be seen, the hope is that abolishing NHS England will help to reduce unnecessary red tape, streamline the approvals process and speed up project delivery, enhancing patient care for years to come.
The power of fast-tracking projects should not be underestimated, and COVID-19 is a great example of what accelerated project delivery can do for patient care. In order to respond to urgent need, planning rules were cast aside to get the Nightingale Hospitals up and running. The result was much more immediate care for those who urgently needed it, and reduced pressure on overwhelmed existing hospitals.
Common obstacles hindering healthcare project completion
Delays in the delivery of healthcare projects have unfortunately become extremely common. This is due to a host of factors, some avoidable, some not. Those which could easily be addressed include slow approvals processes, which have a knock-on effect on other stages of project delivery and funding matters.
Funding hurdles and the importance of early visibility
Securing funding is always a barrier to overcome for projects trying to get over the finish line, with capital being particularly hard fought-over. In the case of permanent, bespoke construction projects, Trusts commonly receive an allowance at the last minute, and access to this is subject to their capacity to put a business case together at short notice, which is often a challenge amidst other important deadlines. Moving forward, the new structure will hopefully mean Trusts have earlier visibility of funding and be given the time and support required for preparing their business cases.
This is where flexible options, such as rental solutions, become increasingly important. Renting healthcare facilities offers a future-proofed, adaptable approach, particularly in uncertain financial times. Rather than committing significant upfront capital costs, Trusts can choose high-quality rental solutions that are scalable, customisable, and quick to deploy. These options not only provide immediate relief by adding clinical space rapidly but also deliver long-term value. If clinical needs change, rental buildings can be reconfigured or relocated, giving Trusts greater agility in managing their estates. This flexibility reduces the risk of wasted investment and supports more responsive, strategic healthcare planning.
Procurement delays are another challenge, as a lot can change from the time of a tender’s publication through to the moment a contractor is appointed. With so many moving parts, including securing planning permission, it’s rare for construction projects to stay on their initial timescale.
The detrimental impact of project delays on patient care and budgets
All of these factors must be considered when hospitals take on healthcare projects that will deliver additional wards with much needed extra beds to help tackle their backlogs, in order to safeguard patient care. When a project is delayed or cancelled, extra strain is placed on existing facilities, compromising patient care.
Projects that are delivered late also often incur higher costs, putting further strain on tight margins. Material costs rise with inflation and if approval doesn’t come in time, quotes change. This means that the budget a Trust had initially allocated to a project is no longer sufficient by the time it’s been approved, which can have significant knock-on effects.
Key changes needed to fast-track healthcare projects
In order to fast-track healthcare projects, changes must be made. The government should begin by making it easier to build a business case. Currently, Trusts must provide a huge amount of up-front information even before they receive any information about whether they’re eligible for funding. Streamlining this process would remove a barrier and allow healthcare leaders to assess their ability to finance new projects well ahead of time.
Streamlining tendering and bidding processes
Simplifying the tendering and bidding process would also help speed up project delivery. The requirements of tenders vary enormously, with some requiring intricately detailed information, whilst others remain vague about key issues, like scope. This can make it difficult to cost a project accurately, which can cause issues later on when budgets are being allocated. By streamlining the tender process and adding more structure, more healthcare projects would be able to get over the finish line without increased costs.
The value of early collaboration with construction companies
Improved communication between Trusts and construction companies from the outset would also benefit everyone involved. Onboarding contractors early on can have a myriad of benefits when perfecting the design of any new facilities. For example, in offsite construction, where one of the biggest benefits is the flexibility for bespoke design, working with contractors from the start would enable them to advise on matters such as design and specification throughout the projects, helping to not only deliver the best outcomes for patient care, but also making the whole process slicker and more cost effective.
The primary benefit: Improved patient care
Fast-tracking healthcare projects will deliver a range of benefits, the most important being improved patient care. Simply put, if buildings are delivered quicker, then patients can be seen quicker, reducing strain on the existing hospitals’ resources and staff. Bespoke new facilities also have the benefit of extending the range of treatment options that a hospital may be able to offer, for example.
Looking ahead: A more direct route to project progress
Looking ahead, the hope is that a more direct relationship between NHS Trusts and the Department of Health will help drive progress in the construction and delivery of projects. By reducing red tape, providing clearer funding routes, and offering more flexible delivery options, including rental, the approval process can be simplified and project delivery accelerated, helping to tackle hospital backlogs and enhance patient care.
