Case studies

Strategic Estate PlanningHealthcare case studies

Lester WagmanLocation/EventDate

2

The Forum

ContextCambridge University Hospital Partners’ 2020 vision is already becoming reality for the development of the Addenbrookes site into the Cambridge Biomedical Park with the arrival of the UK Medical Research Council and the new Papworth Hospital due to open in 2016.

ChallengeCUH were seeking an innovative solution for an integrated commercial hub for the site providing retail, hotel & conferencing facilities, a learning hub, private patient centre and car parking.

ApproachAmbercycle played an important part in John Laing’s bid team for the project, helping to balance the Trust’s needs and aspirations with those of prospective commercial funding partners.

ResultsA lease structure able to support an institutional forward funding approach while adapting to mixed-risk income streams from different elements of the scheme. John Laing selected as preferred partner.

John Laing Plc & Cambridge University Hospital NHS Foundation Trust

3

Estate Strategy Review (Stage 1)

ContextAcute trust operating from three in-patient hospitals seeking to unlock surplus land to benefit its local partnerships for education, R&D and other complementary uses and secure its position in wider health economy.

ChallengeThwarted by parliamentary commission from closing an outpost hospital and with operations split between two main campuses 1 mile apart, one suffering from poor road access, the trust was seeking ways to rationalise its estate.

ApproachWe parcelled and appraised the land according to complementary alternative use potential, commissioning a traffic management review to unlock inaccessible areas.

ResultsStage 1 report concluded identified significant development potential and the ensuing engagement in UDP consultation has resulted in a flexible development brief.

Oxford Radcliffe Hospitals NHS Trust

4

Estate Solutions Review (Stage 1)

ContextAcute trust, PCT & County Council with diverse and disparate asset holdings (incl. a major hospital PFI) working together to secure provision of locally managed, joined-up services.

ChallengeThe trusts and council wanted to explore ways releasing efficiency savings and optimising capital returns from the estate to fund joint service improvements.

ApproachUndertook first stage investigation and financial modelling of land value potential & profit-sharing from development of trust estate using an asset-backed joint venture structure.

ResultsStage 1 report concluded there was positive potential benefit from such an approach. Next stage review pending advice from Strategic Health Authority on partnership structuring in light of DH guidance on PCT estate.’

Wye Valley NHS Trust & NHS Herefordshire

5

Estate Strategy Review (Stage 1)

ContextAcute trust operating from three in-patient hospitals seeking to unlock surplus land to benefit its local partnerships for education, R&D and other complementary uses and secure its position in wider health economy.

ChallengeThwarted by parliamentary commission from closing an outpost hospital and with operations split between two main campuses 1 mile apart, one suffering from poor road access, the trust was seeking ways to rationalise its estate.

ApproachWe parcelled and appraised the land according to complementary alternative use potential, commissioning a traffic management review to unlock inaccessible areas.

ResultsStage 1 report concluded identified significant development potential and the ensuing engagement in UDP consultation has resulted in a flexible development brief.

Oxford Radcliffe Hospitals NHS Trust

6

Site Strategy Review

ContextMajor educational charity with remote, potentially high value but highly constrained campus and listed building in parkland setting adjacent to golf course and executive housing.

ChallengeSome day facilities on site still appropriate but the organisation’s modus operandi had changed over time and providing institutional residential care no longer met best practice nor it’s clients’ needs. They wanted to explore ways releasing this restrictive asset to reinvest in modern non-residential facilities in more urban settings.

ApproachUndertook a detailed appraisal of campus in parcels considering a range of land use and delivery options that could let RLSB remain in occupation of operational facilities during phased withdrawal.

ResultsIdentified that residential care village development offered best returns, use of listed building and phased implementation. Deal now struck with developer/operator.

Royal London Society for Blind People

7

Project Arkansas (Stage 1)

ContextAcute trust operating from two in-patient hospitals and multiple outpatient sites leading to inefficiency and compromising position in wider health economy.

ChallengeDevise and evaluate options for rationalising estate to help release cost savings and improve operational efficiency.

ApproachUndertook demographic & travel-time studies and engaged with sub-contracted specialist healthcare planners to model clinical activity and assess effects of alternative estate & service-delivery configurations using 15-year financial model.

ResultsStage 1 report considering positive, innovative and radical options alongside more conventional rationalisation plans welcomed by Trust board and being taken forward in Stage 2 as part of ‘Shaping the Future of East Berkshire’

Heatherwood & Wexham Park Hospitals Foundation NHS Trust

Former Greenwich Hospital

8

ContextAcute trust operating from 3 in-patient hospitals. Former hospital replaced by major PFI on alternative site. Site sold for redevelopment subject to overage provisions.

ChallengeMarket had changed since development agreement with HCA and [time-limited] overage provisions in favour now punitive. HCA made cash offer to buy out overage provisions to kick-start development

ApproachLiaised with lawyers to assess implications and reviewed Heart of East Greenwich place-making development plans, appraised site value relative to development agreement and modelled alternative phasing/implementation programmes to increase value.

ResultsDelivered successfully against 3-week timescale to advise Trust board on negotiating strategy.

South London Hospitals Foundation NHS Trust

Lucille van Geest MH Unit

9

Peterborough & Stamford Hospitals Foundation NHS Trust

ContextTrust had relocated to new PFI at Bretton. Peterborough District Hospital site mainly surplus and Trust planning development partnership to optimise value.

ChallengeCambridgeshire Partnership Trust (MH) occupied LVG day centre and in-patient unit and other offices on site under separate long-term leases. Services could not be relocated without consulting with the Trust, service users and families.

ApproachWe worked with the service providers to assess different options for providing the service in different ways and timescales for site withdrawal. We also assessed the financial cost of reprovision and identified ways to mitigate the impact on our client.

ResultsWe worked with the client to identify part of the Bretton hospital site, release the Trust from an option agreement and negotiate access from the PFI provider.