A new national delivery mechanism for Primary Health Care

In July 2000 the Government published the NHS Plan which included a major commitment to a new programme of investment in primary and community healthcare facilities, to be known as NHS LIFT (Local Improvement Finance Trust). Primary Care had seen extremely low levels of investment for many years, and the NHS Plan committed to delivering 500 new one-stop centres; and substantially improve 3000 GP surgeries.

Whilst this represented a major step change in the level of investment activity that would reverse the historic under-investment in primary care, it was not yet clear how this was to be delivered.

The LIFT initiative had very clear objectives: immediate investment to meet the NHS Plan targets; and an approach that could deliver investment over a protracted period, on the basis of agreed strategic planning at a local level.

Partnerships UK (PUK) started working with the Department of Health (DH), to set up a delivery mechanism for the NHS LIFT programme. After many months of evaluation of options and development of potential models, a new national delivery vehicle, Partnerships for Health (PfH), was set up as a joint venture between DH and PUK. A programme of investment, in 42 localities, over three phases, would be delivered in each area by a new form of Public Private Partnership - a LiftCo. Each LiftCo is a joint venture between the local Primary Care Trusts, PfH and a private sector partner selected out of open competition.

Local LiftCos enter a long-term strategic partnership with Primary CareTrusts (PCTs), giving them exclusivity to develop and deliver future schemes in response to local health priorities and strategies. The exclusivity is conditional on showing value for money on each scheme, with the PCTs having the right to go elsewhere if value for money was not shown.

A key challenge was to develop a new market of potential suppliers to meet the LIFT investment requirements. A managed programme, comprising small deals that aggregated to a very substantial investment opportunity, enabled PfH to attract and develop sufficient private sector capacity to deliver the programme.

By Spring 2005, the establishment of the LiftCos and the procurement for the three phases of projects was substantially complete. The success of NHS LIFT and PfH was recognised by the Government and a fourth phase of further investment was announced.

PfH, still backed by the original shareholders of DH and PUK, is increasingly becoming an investment business, supporting over 40 local LiftCos as they deliver much needed investment in local primary healthcare facilities.