Department of Health

Website of the Department of Health

Please note that this website has a UK government access keys system.

NHS logo

NHS LIFT FAQ

  • Last modified date:
    8 February 2007

Frequently asked questions about the aims and origins of the NHS LIFT public private partnership.

Key points

  • NHS LIFT will help improve the primary care estate. A large element of the current primary care estate is not suitable for the provision of modern healthcare
  • Local LIFT will own and lease premises to GPs (as well as dentists, chemists, etc)
  • NHS LIFT will empower and assist the regeneration of local communities by providing better healthcare facilities, involving local businesses to deliver local solutions
  • NHS LIFT will
    -supplement current investment in the primary care estate
    -be inclusive: all GPs- including single handed GPs will be welcome to be involved in the NHS LIFT initiative
    -be delivered using common approaches across the country, to avoid re-inventing the wheel

What are the investment targets within the NHS Plan?

  • the NHS Plan stated that NHS LIFT and public capital will lever £1 billion into reinvigorating the primary care estate
  • this level of investment will deliver substantial upgrades or replace up to 3,000 primary care premises
  • the investment will also fund development of 500 one stop primary care centres
  • these new buildings will enable the co-location of GP and community services, and wherever possible the location of social care agencies

What exactly is NHS LIFT?

  • NHS LIFT stands for NHS Local Improvement Finance Trust
  • A local LIFT will build and refurbish primary care premises which it will own
  • it will rent accommodation to GPs on a lease basis (as well as other parties such as chemists, opticians, dentists etc)

How will NHS LIFT be set up?

  • A new PPP has been established, Partnerships for Health, between Department of Health and Partnerships UK. PfH will invest money into NHS LIFT and also help attract additional private funding
  • A local LIFT will be a public private partnership (PPP). It will be set up as a limited company with the local NHS (potentially including individual practitioners) PfH and the private sector as share-holders
  • as a shareholder the NHS will be better placed to direct investment to the areas of greatest need

Why as a company (limited by share capital)?

  • a company is relatively simple and efficient way to structure a Public Private Partnership
  • it offers the potential for GPs or groups of GPs to become part-owners
  • the NHS (and GPs) will have the key role in determining where investments are made (and will share in any profits - which it can then reinvest in healthcare)
  • we can sell our shares. This is not a long-term investment - it is a catalyst for change

Why do we need NHS LIFT?

  • to help address the legacy of under investment in the NHS (for example many primary care premises are over 30 years old)
  • current private sector investment is piecemeal and not concentrated in the areas of greatest need (particularly in the inner-cities)
  • a large number of the current premises are too small and cramped to provide modern primary care

Where will NHS LIFTs be developed?

  • The Department has approved the development of 42 LIFTs
  • 6 first wave schemes: Newcastle and North Tyneside; Barnsley; Manchester, Salford & Trafford; Sandwell; Camden & Islington and East London and City. These were announced in February 2001.
  • 12 second wave schemes : Barking and Havering; Birmingham and Solihull; Bradford; Cornwall and Isles of Scilly; Coventry; East Lancashire; Hull; Leicester; Liverpool and Sefton; West Kent (Medway); North Staffordshire; Redbridge and Waltham Forest. These schemes were announced in February 2002.
  • 24 third wave schemes were announced in August 2002.

Why were these specific areas chosen?

  • The intention was to focus initially on deprived inner city areas
  • these are the areas where health need is greatest
  • these areas have a disproportionately high number of sub-standard premises

What about traditional public capital?

  • public capital funding will be available for areas where NHS Lift will not operate
  • in addition improvement grants, cost rent, notional rent and other PMS mechanisms for small scale redevelopment and improvements continue to be available

What is the condition of existing primary care premises?

  • only just over 40% of premises are purpose built
  • almost half are based in either
    (a) adapted residential buildings or
    (b) converted shops
  • many GPs work in converted residential buildings, which have poor access for patients

How many premises will be built as a result of NHS LIFT?

  • NHS LIFT aims to invest a total of up to £1billion in the primary care estate
  • existing arrangements (eg. badged capital and unified allocations) will deliver the rest

What are the additional benefits of the "NHS LIFT" approach?

  • flexibility : NHS LIFTs will offer GPs flexible lease arrangements (currently GPs are often tied into long leases). This should help attract more GPs to work in inner city areas
  • scale and speed: NHS LIFTs will help deliver a significant number of new premises in a short period of time
  • integration of services : Patients expect to find as many of the services they need in one place as possible. NHS LIFTs will actively seek to co-locate additional services and facilities (for example space can be used by a range of related health care professionals as well as social services)
  • common approach: avoiding individual GP practices or local teams having to develop an approach and all the documentation for each scheme, PfH is establishing a common approach that LIFT schemes across the country can adopt

Will NHS LIFT force GPs to move/sell-up?

  • No GP will be forced to be part of a LIFT scheme if they don't want to. Improvement grants and other arrangements which enable GPs to improve current premises - will continue to be available, and GPs who want to stay as owner occupiers, or rent premises from other landlords can do so
  • NHS LIFT is about providing improved primary care facilities - not - about determining where GPs are located
  • NHS LIFT will provide incentives to GPs wishing to relocate. For example, many GPs are tied into long-term leases that they cannot easily terminate. NHS LIFT will be able to "buy-out" these leases enabling GPs to move out

Will this initiative ignore single-handed GPs?

  • all GPs -including single-handed GPs- will be welcome to participate in the NHS LIFT initiative

Is this initiative linked to the introduction on the PMS scheme?

  • the objective of NHS LIFT is to improve the quality of the physical primary care estate
  • it is not linked to other developments, such as the PMS scheme

What is wrong with the current investment process within primary care?

  • it can be both fragmented and piecemeal
  • it sometimes does not concentrate on those areas with the greatest need
  • it is also inflexible, particularly for those GPs who do not wish to own their practice property

What happens next?

  • first wave schemes are currently finalising their service and investment plans. They will shortly sign commercial agreements after which building will commence.

Who will run local LIFTs?

  • at a local level, a management board comprising private sector partners, local NHS nominees and PfH will work together to agree and develop investment programmes

Is this simply "privatising the NHS"?

  • No. NHS LIFT is an additional PPP to provide primary care facilities to GPs and other primary care professionals, (chemists, opticians, dentists, etc)
  • primary care premises are provided under a range of ownership models. Most are privately owned by individual GPs (63%), some are rented from private sector landlords (21%), and the remainder are provided by the NHS (16%) in health centres

Who are Partnerships UK (PUK)?

  • PUK was established by Treasury, as a successor to the Treasury Taskforce
  • PUK is a PPP itself. This reflects the fact that HMT will continue to own 44% of PUK, Scottish ministers own 5% so the total public sector is 49%. The range of private sector companies/institutions collectively owns the remaining 51%
  • PUK has a corporate objective to help the Government deliver PPPs better and faster to facilitate the development of new forms of PPPs

How do we currently provide primary care facilities?

  • a mixed economy approach with public and private ownership of premises
  • most GPs own their own premises
  • some GPs - especially in inner cities - rent

Access keys