Developing the ICS 10-year infrastructure strategy

The NHS is a significant estate and infrastructure owner, occupying over 29 million m2 at a cost of more than £10 billion per annum.

If the NHS is to deliver its own plan for change, it must invest in the infrastructure and buildings it needs to underpin clinical service provision and demonstrate to government how and where capital investment is required. Therefore, NHS England has asked every integrated care system (ICS) to develop a 10-year system-wide infrastructure strategy that aligns to its clinical vision, delivers the NHS Long Term Plan and sets out how the local estate will be used.

These plans will need to incorporate requirements from the NHS trusts and primary care network (PCN) estates within the ICS. They will also need to support national strategic plans and priorities such as those for the New Hospital Programme.

In developing the infrastructure strategy ICSs need to focus on, but not be limited to, having a clear understanding of the following:

• how the estate, digital, equipment and workforce models contribute to delivery of the overarching system strategy, related clinical pathways and national priorities
• what estate sits in a system, the condition of that estate and how it can best be used
• what the required additional investment is in the short and long term
• what the options and plans are for property or land that is no longer required, or needs repurposing or acquiring
• what needs to be done to deliver against sustainability and net zero ambitions
• how the estate’s cost-effectiveness, productivity and efficiency can be increased and long-term running costs reduced
• what resources are required at the system level and within partners, and how the system collaborates with non-health bodies such as the local authority and voluntary, community and social enterprise (VCSE) sector.

NHS England has published guidance to support ICS’s with the development of the strategy. This guidance is based on learning from pilots and best practice across government and includes a suggested structure, layout and minimum content guidelines. However, it is recognised that the shape and structure of ICS infrastructure strategies may vary by organisation, depending on local context, ICS maturity and local priorities. The guidance can be accessed here.

Additional resources are available for NHS estates teams on the NHS estates collaboration hub on the NHS futures website, including templates, data packs case studies and examples of best practice.

Having the most reliable, up to date data is going to be critical. Data will be a key component of the development of the strategy and further development of the Shape Atlas tool is underway to support the infrastructure strategy process. Following the successful completion of the primary care data gathering (PCDG) exercise, the ICS strategic estate data planning programme has been approved by NHS England. The ICS Shape Atlas programme will support with:

• current status mapping
• demand and capacity modelling
• scenario mapping and
• needs analysis

Further information can be found on the Shape website. All ICBs have free access and the registration link can be accessed on the Shape homepage.

PCC provides a wide range of support with particular expertise in primary care estates and infrastructure. We can also support you to use the Shape Atlas. Contact enquiries@pcc-cic.org.uk to discuss how we can help you.

Helen Simmonds, adviser, PCC