Delivering the Neighbourhood Health Service: Estates

Status / emerging findings

• NHS Property Services identified 160 properties that could become neighbourhood health centres with low capital cost; 11 conversions planned by March 2026, but pace is far slower than new-build capacity (13–14 months vs. 6–7 years for existing projects)
• 438,000 square metres of NHS space is underutilised due to siloed occupancy, lease restrictions, and no cross-organisational incentive to share facilities
• Government definition of 'neighbourhood health service' remains vague—spanning emergency reduction, prevention, and population health—leaving Integrated Care Boards uncertain on implementation priorities
• Linear decision-making, consultation delays, and unclear procurement pathways are major blockers to estate transformation, creating misalignment between policy intent and on-the-ground delivery

Why it matters

The NHS estate is worth tens of billions and currently underused; fixing how it's shared and deployed could free capital for care without new spending, or waste years if barriers aren't addressed.

Tone arc

Opening hearing set a cooperative tone, with witnesses identifying concrete opportunities (160 convertible sites) but immediately flagging systemic friction (7-year project timelines, siloed occupancy, definitional ambiguity). Framing shifted from 'what's possible' to 'why it hasn't happened yet'.

Key witnesses

NHS Property Services, NHS Alliance, King's Fund