Press Release - Innovation in the NHS: Local Improvement
Finance Trusts
19 May 2005
Sir John Bourn, head of the National Audit Office, reported
today that the Local Improvement Finance Trust (LIFT) initiative,
launched in 2001, is an effective means of improving primary health
and social care. The LIFT model has a number of strengths: it takes
a long term strategic approach to local health provision which
combines the benefits of national support and local control. There
is more that can be done to measure performance and ensure
accountability but with approximately 50 new buildings expected to
open in 2005, the positive impact of the initiative will soon be
seen.
A LIFTCo is a local joint venture made up of local stakeholders
(typically Primary Care Trusts, Local Authorities and GPs), a
private sector partner and Partnerships for Health, itself a
national joint venture between public and private sectors. The
LIFTCo takes ownership of the premises it builds or refurbishes and
then leases the space to health and social care providers.
As a result of years of under investment in primary care
services, many GPs’ premises are of poor quality. 81% were below
the required size in 2000. LIFT will mean better premises, which in
turn should help in the retention and recruitment of GPs. Patients
will also benefit from different providers being brought together
under the same roof. A wide range of services will be available in
a primary care setting such as minor surgery and scanning. In
particular, there will be better management of chronic diseases
which account for 80 per cent of GP consultations.
LIFT appears to be an effective and flexible procurement
mechanism, capable of producing value for money. Although not
suitable for all areas, LIFT has advantages over alternatives such
as third party development or procurement under the Private Finance
Initiative. Developments are more likely to meet local needs while
benefiting from standardised documentation and LIFT is better
suited to small scale deals than PFI.
The Department of Health, on the whole, managed well the setting
up of the initiative. The initial deals that the NAO examined are
robust. They offer clear long term benefits to both the public and
private sector, with value for money safeguards built into the
contracts.
Inevitably when establishing a new initiative and aiming for
quick results there were some problems. The local use of enabling
funds was not monitored routinely and some schemes did not utilise
funds in a timely manner. The target 12 month timetable for
establishing the LIFTCo and agreeing initial developments was too
ambitious; the quickest, Ashton, Leigh and Wigan, completed in 13
months. Once a LIFTCo is set up, the procurement process for new
projects will be simpler.
On the whole, local LIFT schemes appear to be operating well
although some proposals have faced local opposition. Lessons can be
learned in the light of experience. In particular, local areas,
guided by the Department of Health and Partnerships for Health,
need to ensure accountability and improve the ways they measure
performance. In particular, the Department should develop ways of
evaluating the progress and contribution of LIFT to improvements in
people’s health.
Sir John Bourn said today:
"I welcome LIFT as an attractive new way of improving
primary health and social care facilities. This is an excellent
example of a department doing something different and new to come
up with an effective solution to an established problem. I fully
support this kind of innovation and the department must carefully
evaluate this initiative so that all of government, and especially
Building Schools for the Future, a similar initiative, can benefit
from the lessons that arise."
Notes for Editors:
- Partnerships UK together with the Department for Education and
Skills have established Partnerships for Schools to develop the
Building Schools for the Future initiative – a £25 billion
programme to renew or rebuild England’s secondary school estate.
The initiative is based on a similar procurement model to
LIFT.
- The Department of Health has entered a national joint venture
with Partnerships UK (PUK) to develop and encourage a new market
for investment in primary care and community based facilities and
services. The joint venture company is Partnerships for Health
(PfH). PfH’s specific remit is to gather together a group of
procurement experts dedicated to delivering the NHS LIFT
initiative. PfH is also engaged with the Scottish Executive on
their plans for an NHS LIFT-style primary care initiative in
Scotland.
- Press notices and reports are available from the date of
publication on the NAO website which is at www.nao.org.uk. Hard
copies can be obtained from The Stationery Office on 0845 702
3474.
- The Comptroller and Auditor General, Sir John Bourn, is the
head of the National Audit Office which employs some 800 staff. He
and the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 33/05
All enquiries to Mark Strathdene, NAO Press Office:
Tel: 020 7798 7183
Mobile: 07748 181693