The document discusses several options for how the NHS can make creative use of surplus land assets: 1. Selling land through a public land registry or marketing agent to the highest bidder. 2. Exchanging surplus land for new facilities through partnerships with developers. This provides financial certainty but the NHS loses equity and control. 3. Forming consortiums or joint ventures with partners to develop surplus land in phases, which shares financial risks and workload while maintaining some control over the whole development.

1. Making creative use of NHS estate
Peter Molyneux
Common Cause Consulting
4 June 2014

2. • Land surplus to requirements
• Lodge with public land registry for 50 days
• If NHS or other public body interested then transferred or
sold at NPV.
• If not marketing agent instructed and sealed bids sought.
• Bids assessed and received by District Valuer
• Highest bid accepted.
NHS land disposal process

3. • Land surplus to requirements
• Foundation Trusts must operate within risk assessment
framework.
• Decision may require approval from the Board and Council
of Governors.
• NHS Trusts are entitled to keep proceeds up to £5m.
• Over £10m a business case is required.
• Up to £50m a business case for investment must receive
NHS TDA approval.
• Over £50m DH and Treasury approval is required.
Rules on assets

5. • Low financial risk
• Raises fixed capital sum quickly – for investment in new
facilities
• Overage partly recoups uplift from development
• Trust loses equity in perpetuity
• Trust loses control over development and development of
community infrastructure is difficult
• Early sale may reduce income and cost control needs to be
robust to limit risk of overrun.
Release value of land at outset

7. • Surplus land is exchanged for new mental health facilities.
• Financial certainty is delivered early – design certainty also
needs to be delivered early.
• Trust is not distracted from core purpose.
• Financial failure of selected purchaser.
• Trust is very dependent on purchaser delivering on
obligations
Cross-subsidy with single partner

9. • Selection of right partner will share burden of optimised
delivery of the whole
• Control maintained over timing and sequencing of the
whole development and community development.
• Sales values maximised.
• JV structure could be used to incentivise the delivery of
holistic best value.
• Income at risk from market fluctuations.
Single flexible partner, release in phases
using open supply chain

11. • Selection of right partner will share burden of optimised
delivery of the whole
• Financial risks and workload are shared.
• Opportunity to engage or involve community partners in
the consortium – which can also hide / reduce value of
cross subsidy.
• Risk share may reduce outturn value to the Trust for cross
subsidy.
• Delivery of best value in discrete elements may not deliver
best value overall.
Consortium approach to whole of planning consent

12. • Housing associations should have a clear service offer that
is measurable, tradeable and marketable.
• Understand service transformation and CIP programmes
and how they can help with them.
• Understand land disposal plans of local Trusts and appetite
for disposals or JVs
• Understand proposals of local authority.
Making an approach