Some examples of development, healthcare and strategic estate planning projects undertaken by Lester Wagman and his associates

1. Strategic Estate Planning
Development & Healthcare
Case Studies
Lester Wagman

2. 2
Primary Healthcare Developments
In 2020 we are advising public and private sector landowner and developer clients on the creation of 5
separate new NHS primary care hubs. The context and brief is different in each case but all projects involve
• Appraisal of development potential
• Negotiation of rental values and support through business case process
• Structuring of lease and development agreements
• Valuation and/or forward sale of completed asset
Croydon, West Sussex, Milton Keynes, Oxfordshire

3. 3
Land option & development agreement
In 2020 we advised three individual co-owners of approx. 1.5 acres of land adjoining a major development
site for 500 homes adjacent to a junction on a major arterial route. However as well as having no rights of
access the land in question had been designated as greenbelt in the local authority’s recent plan review.
With two of the owners being past retirement age they wished to realise the optimum value for their asset.
Having approached a number of promoter-developers none of whom were keen to commit much early
capital we persuaded the owners of the adjoining development to pay a significant fee/premium for a
leasehold development agreement with future value-sharing agreed and final freehold acquisition option.
Working closely with the lawyers the resulting arrangement proved tax efficient for both the vendors’ IHT
planning and the developer's future CGT liability.
Hillingdon, West London

4. 4
Development Consultancy
Context
Barnet Enfield & Haringey Mental Health NHS
Foundation Trust had declared the property
surplus to operational requirements. Haringey
Council wished to acquire the site for a local
public service project.
Challenge
To support local services the Trust wished to
transfer the property to the Council for market
value in a solus transaction without a full
market externalisation process. The agreed
transfer cost needed to be supported by 2
concurring professional valuations. The Council
benefited from an historic title covenant
restricting the use of the property.
Approach
Having undertaken our own valuation we
negotiated with DVS for them to take adequate
account of the effect of the covenant.
Results
Successfully negotiated a substantial capital
receipt for the Trust within tight timescale
Canning Crescent Centre – Wood Green

5. 5
Estate Development Strategy
Context
This busy acute and community Trust in a densely
populated area sought to reconfigure and
modernise its estate to support the vital role it had
carved out for itself in the local health economy.
Challenge
Although residential property values in Croydon are
not as strong as other parts of the capital this site
fronts a main arterial close to a large commercial
centre and main transport connections.
Approach
We worked with master planners to quantify and
optimise development opportunity from parcelling
land for disposal. This work has supported the
development of the Trust’s main site Development
Control Plan which involves the construction of a
multi-storey car park and relocation of its existing
maternity wing as enabling development.
Results
Successfully re-planned site to inform estate
strategy options.
Croydon Health Services NHS Foundation Trust

6. 6
Site Strategy
Context
Following the transfer of some teaching activities
to its new Colindale campus the College was
looking to rationalise its activities at Southgate
with a view to releasing land to generate capital.
Challenge
Site constraints included main access to the site
shared with local public library site (also surplus
for development), a very narrow secondary
access to the site, part shared access with local
Royal Mail depot and sorting office and
underground railway (Piccadilly Line) passing
under part of the site at shallow depth.
Approach
We worked with the College’s master planners to
devise and appraise alternative use development
options for three different parcels of land
including one for high density student housing
Results
Successfully re-planned site to inform estate
strategy options.
Barnet & Southgate College – Southgate Campus

7. 7
Development Consultancy
Context
The College had previously agreed to sell
surplus land from its new campus in
Colindale, London NW9, to a major house
builder. Its original agreement with the
developer included a substantial overage
provision but despite there having been
significant house price growth, the property
market had since stalled/cooled.
Challenge
The developer was looking to crystallise and
make an early settlement of its overage
liability to offset this for tax against large
surpluses it had made in that financial year.
Approach
We undertook a detailed analysis of the
developer's construction programme, plotting
this against projected indices for house price
growth with varying confidence intervals.
Results
Successfully negotiated a substantial capital
payment for the college.
Barnet & Southgate College – Colindale Campus

8. 8
Building Utilisation Review
Context
To inform bids under the NHS Estates & Infrastructure
Transformation Fund, CHP commissioned utilisation reviews
of a large number of primary care practices in North Central
London. Working under sub contract from Capita Property &
Infrastructure, Ambercycle undertook the surveys and
analysed the data.
Challenge
To design a generic survey for a variety of premises types
offering a wide range of services that would help identify
underutilisation/capacity and provide useful data to help
inform strategic estate planning. Not all practices were keen
to participate so there were logistical challenges too.
Approach
The survey, undertaken on site but consultatively with
practice staff, examined utilisation by room type and service
from 8am-8pm over a 7-day week in 1-hour sessions.
Results
Successfully surveyed 78 primary care premises over 10 week
period. Undertook analysis of over 10,000 data records and
provided reports at practice, borough/CCG and sub-regional
levels.
Community Health Partnerships

9. 9
Feasibility Study – Bingfield
Context
The CCG commissions a wide range of healthcare
services across one of inner London’s most socially
diverse boroughs, with large areas of deprivation and
some regeneration.
Challenge
Committed to one of the most expensive and
underutilised LIFT assets in a socially deprived area of
inner London, the CCG sought ideas to revitalise the
building and improve recovery of costs.
Approach
Having carried out a detailed utilisation review and
examination of the building layout we identified
opportunities to convert two large offices and a
meeting room into six multi-service, bookable
consulting rooms and entered dialogue with range of
local healthcare service providers to use them.
Results
A detailed report and business case to support the
capital funding application (ETTF) for the works.
Negotiations commenced with landlord and service
providers.
NHS Islington CCG

10. 10
Feasibility Study - Archway
Context
The CCG commissions a wide range of healthcare
services across one of inner London’s most socially
diverse boroughs, with large areas of deprivation and
some regeneration.
Challenge
The CCG, working closely with Islington Council
sought to integrate and replace and a poorly
accessible primary care practice with poor quality
premises together with a new library as part of a
regeneration scheme in a landmark location.
Approach
We led negotiations with the developer and brokered
dialogue with the council to act as lead tenant and
secure a workable building envelope for an integrated
facility with adequate means of access and circulation
and a floor plate that could deliver a flexible model.
Results
Negotiations are ongoing but Stage 1 report
concluded there was positive potential benefit from
such an approach. Next stage will be to finalise the
development agreement and terms of occupation.
NHS Islington CCG

11. 11
Estate Consultancy
Context
The CCG commissions a wide range of healthcare
services across London’s most populous borough,
with one of the highest retired cohorts and some
areas of deprivation and regeneration.
Challenge
The organisation was financially stretched and one
of the greatest challenges it faced was to meet
liabilities for subsidies in expensive [LIFT] buildings
and cover the cost of void areas.
Approach
Working under sub contract from Carter Jonas, we
worked with Community Health Partnerships and
NHS Property Services to renegotiate costs and with
a range of other healthcare providers and
stakeholders to devise a more robust local estate
strategy.
Results
Secured annual recurrent savings of £4m, played a
key role in Barnet Council’s One public Estate 3 bid
[£350m], resolved local estate management issues
and laid foundations for a healthier NHS estate.
NHS Barnet CCG

12. 12
The Forum
Context
Cambridge University Hospital Partners’ 2020 vision
is already becoming reality for the development of
the Addenbrookes site into the Cambridge
Biomedical Park with the arrival of the UK Medical
Research Council and the new Papworth Hospital
due to open in 2016.
Challenge
CUH were seeking an innovative solution for an
integrated commercial hub for the site providing
retail, hotel & conferencing facilities, a learning hub,
private patient centre and car parking.
Approach
Ambercycle played an important part in John Laing’s
bid team for the project, helping to balance the
Trust’s needs and aspirations with those of
prospective commercial funding partners.
Results
A lease structure able to support an institutional
forward funding approach while adapting to mixed-
risk income streams from different elements of the
scheme. John Laing selected as preferred partner.
John Laing Plc & Cambridge University Hospital NHS Foundation Trust

13. Lucille van Geest MH Unit
13
Peterborough & Stamford Hospitals Foundation NHS Trust
Context
Trust had relocated to new PFI at Bretton. Peterborough District
Hospital site mainly surplus and Trust planning development
partnership to optimise value.
Challenge
Cambridgeshire Partnership Trust (MH) occupied LVG day centre
and in-patient unit and other offices on site under separate long-
term leases. Services could not be relocated without consulting
with the Trust, service users and families.
Approach
We worked with the service providers to assess different options
for providing the service in different ways and timescales for site
withdrawal. We also assessed the financial cost of reprovision
and identified ways to mitigate the impact on our client.
Results
We worked with the client to identify part of the Bretton hospital
site, release the Trust from an option agreement and negotiate
access from the PFI provider.

14. 14
Estate Solutions Review (Stage 1)
Context
Acute trust, PCT & County Council with diverse and
disparate asset holdings (incl. a major hospital PFI)
working together to secure provision of locally
managed, joined-up services.
Challenge
The trusts and council wanted to explore ways
releasing efficiency savings and optimising capital
returns from the estate to fund joint service
improvements.
Approach
Undertook first stage investigation and financial
modelling of land value potential & profit-sharing
from development of trust estate using an asset-
backed joint venture structure.
Results
Stage 1 report concluded there was positive potential
benefit from such an approach. Next stage review
pending advice from Strategic Health Authority on
partnership structuring in light of DH guidance on PCT
estate.’
Wye Valley NHS Trust & NHS Herefordshire

15. 15
Project Arkansas (Stage 1)
Context
Acute trust operating from two in-patient hospitals and
multiple outpatient sites leading to inefficiency and
compromising position in wider health economy.
Challenge
Devise and evaluate options for rationalising estate to
help release cost savings and improve operational
efficiency.
Approach
Undertook demographic & travel-time studies and
engaged with sub-contracted specialist healthcare
planners to model clinical activity and assess effects of
alternative estate & service-delivery configurations
using 15-year financial model.
Results
Stage 1 report considering positive, innovative and
radical options alongside more conventional
rationalisation plans welcomed by Trust board and
being taken forward in Stage 2 as part of ‘Shaping the
Future of East Berkshire’
Heatherwood & Wexham Park Hospitals Foundation NHS Trust

16. 16
Estate Strategy Review (Stage 1)
Context
Acute trust operating from three in-patient hospitals
seeking to unlock surplus land to benefit its local
partnerships for education, R&D and other
complementary uses and secure its position in wider
health economy.
Challenge
Thwarted by parliamentary commission from closing an
outpost hospital and with operations split between two
main campuses 1 mile apart, one suffering from poor
road access, the trust was seeking ways to rationalise
its estate.
Approach
We parcelled and appraised the land according to
complementary alternative use potential,
commissioning a traffic management review to unlock
inaccessible areas.
Results
Stage 1 report concluded identified significant
development potential and the ensuing engagement in
UDP consultation has resulted in a flexible development
brief.
Oxford Radcliffe Hospitals NHS Trust

17. [Heart of East] Greenwich Square
17
Context
Acute trust operating from 3 in-patient hospitals.
Former hospital replaced by major PFI on alternative
site. Site sold for redevelopment subject to overage
provisions.
Challenge
Market had changed since development agreement
with HCA and [time-limited] overage provisions in
favour now punitive. HCA made cash offer to buy out
overage provisions to kick-start development
Approach
Liaised with lawyers to assess implications and
reviewed Heart of East Greenwich place-making
development plans, appraised site value relative to
development agreement and modelled alternative
phasing/implementation programmes to increase value.
Results
Delivered successfully against 3-week timescale to
advise Trust board on negotiating strategy.
South London Hospitals Foundation NHS Trust

18. 18
Site Strategy Review
Context
Major educational charity with remote, potentially high
value but highly constrained campus and listed building in
parkland setting adjacent to golf course and executive
housing.
Challenge
Some day facilities on site still appropriate but the
organisation’s modus operandi had changed over time and
providing institutional residential care no longer met best
practice nor it’s clients’ needs. They wanted to explore
ways releasing this restrictive asset to reinvest in modern
non-residential facilities in more urban settings.
Approach
Undertook a detailed appraisal of campus in parcels
considering a range of land use and delivery options that
could let RLSB remain in occupation of operational
facilities during phased withdrawal.
Results
Identified that residential care village development offered
best returns, use of listed building and phased
implementation. Deal now struck with developer/operator.
Royal London Society for Blind People