16 September 2014, North

David Jepson looks forward to his new role as Chair of three LIFT Companies

David brings with him a wealth of skills and experience having worked within social housing for nearly 30 years, including time spent as Deputy Chief Executive at one of the largest housing associations in the country, Riverside, and as Chief Executive of The Regenda Group.

David is also currently Chair of “Our Life”, an independent Industrial and Provident Society established for the benefit of the community, campaigning on wellbeing and health issues.

Strong leadership

Christine Winstanley, Eric Wright Partnerships Healthcare Director and Director on the Board of the three LIFT Companies commented on the appointment:

“David will be joining us as Chair at what continues to be a time of challenge and change. David’s leadership will be key in ensuring that the three companies continue to develop and respond to the changing demands placed on the NHS and wider public sector in achieving efficiencies whilst continuing to improve the quality of services."

Excellent mix of skills

Neil Grice, Community Health Partnerships Area Director and Director on the Board of the three LIFT Companies commented:

“We are delighted to appoint David to chair the three Boards. David brings with him a wealth of experience from the housing sector as well as considerable commercial skills and we look forward to working with him.”

Exciting challenge

Reflecting on what has been achieved across the LIFT Programme to date and looking forward to the challenges ahead, David said:

“Becoming chair of three Local Improvement Finance Trust (LIFT) Companies right now is an exciting challenge. Set up to secure private funding for upgrading outdated NHS buildings, LIFTCos have a good track record of helping ensure the primary healthcare and community estate is tailored to the needs of a 21st Century health service, not trapped in a mid 20th Century service with a significant 19th Century property base.

"As very successful public private partnerships they have created some 300+ facilities across the country using a straightforward procurement mechanism that has secured high quality well maintained buildings, which, first and foremost, meet the changing needs of service users. They also provide efficient and attractive environments for health professionals to work in.

"When the LIFT Programme was established, however, it was in a radically different financial environment with significant amounts of direct and additional public investment going into the health service to sustain the programmes of improvement. Since then much has changed. The Great Recession and the advent of the need for austerity have led to a much tighter financial environment.

New institutional environment

"A comprehensive restructuring of the NHS and specifically the process of procurement has created a new institutional landscape and has meant that for three years or so the focus has been on getting the new structure in place.

Responding to the changing scale of demand

"Whilst all this has been going on the demographic structure of the NHS customer base has continued to change. The proportion of older people has increased and is set to continue increasing for decades into the future. This is fundamentally changing the scale of demand as nearly two-thirds of people admitted to hospital are over 65 years old and 70% of hospital emergency bed days are the result of unplanned emergency admissions for those over 65. [1]

"Longevity and improved medical services mean increasing numbers of people have long-term medical conditions, and indeed an increasing number have more than one. These account for some 70% of the money spent on health and care in England. [2]

"All too often these conditions end up being treated in expensive hospital settings when they could be treated just as effectively in local community services which are more accessible for the client and enable them to remain at home.

"This changed environment means that the role of public private partnerships is more important than ever in ensuring that the physical estate of the NHS, in other words the buildings that provide the setting for health and care services, meet the new needs it confronts.

Ensuring maximum estate utilisation 

"Critically, all existing buildings need to be utilised to the maximum. This cannot be the outcome of a one off exercise in the face of a dynamic environment of demand.

"There must be continuous monitoring of the services provided to ensure that expensive buildings are being used to best effect for the local community. Specification of new buildings needs to be carefully thought through to ensure projections of service demand are robust and founded on hard evidence.

Better meeting customer needs

"By doing this areas of under and over provision can be identified and the estate redesigned to better meet the needs of its customers. By more effectively using the buildings that exists, land might be freed up which can be used to support the development of new or more effective services.

"This might be because land can be used with partners to provide accommodation more suited to the needs of older people, enabling them to live in a residential setting for much longer. It might be used to relocate services into the community or, if redundant, then disposed of to secure resources, which can be applied in more appropriate locations.

"Given the tight funding all of the above can only be achieved if there is a really effective partnership engaging the end users (patient); health professionals in acute, primary and community services; and the private sector who can deliver investment and quality buildings.

Strong track record of delivery

"LIFT Companies have a good track record of delivery, the challenge now is greater than ever before and these partnerships need to rise to that challenge, be more creative, work with more partners and look for new and innovative sources of investment.

"I am looking forward to working with colleagues in the NHS and in the commercial world to design new ways to deliver buildings which better meet the needs of a 21st Century health service.”

Challenges that lie ahead

Looking forward, David sights three key challenges for his new role as Chair:

The first key challenge is to make sure an effective partnership is maintained between the various partners within the health service and the commercial sector to ensure all our actions are focused on the needs of service users.

"Secondly, to ensure the existing estate of LIFT properties are effectively utilised as efficiently as possible. Good quality buildings tailored to provide clinical and community services need to be occupied and used as much as possible to get the best value for money out of them.

"Finally, to work with existing and new partners to seek innovative ways to fund much needed additions to the NHS estate to help secure a customer focused service located where it is needed most, in the community.”

[1] Call to Action.  NHS England pp12

[2] Ibid pp13