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Unlocking Hidden Potential: How Estates Can Contribute to the NHS Productivity Challenge

Sam McCumiskey, Managing Director, gbp consult
Sam McCumiskey, Managing Director, gbp consult

As the NHS faces unprecedented financial pressures, organisations must make difficult decisions to reduce deficits while striving to improve performance and quality.

The challenge can seem insurmountable, but based on my experience, there is an often-overlooked area that holds significant potential: NHS estate.

In my role at gbp consult, I've observed that Trusts and Integrated Care Boards (ICBs) frequently underestimate the potential of estates to deliver substantial savings. This oversight may stem from a belief that improvements in estates yield long-term, rather than short-term, efficiencies.

Over the past several years, my team and I have had the privilege of working with over 100 NHS organisations across England. This extensive experience has provided us with valuable insights into how estates can be optimised to contribute to the NHS productivity challenge.

Ultimately ‘productivity’ is the pursuit of delivering maximum activity or output or health outcome with the resource available. In the NHS this is directly dependent on capacity, and it can be argued that capacity is only available in two forms: Workforce (whole time equivalents) and premises (it’s Net Internal Area or NIA). The two are inextricably linked, and both are reactive to the degree of digital innovation applied in these spaces.

At a simplistic level, to increase productivity three options are available to us:

If we say that the current workforce can deliver more activity by doing things differently, we’re addressing the first point. If we say that we could deliver the same activity from a reduced estate, by doing things differently, we’re addressing the second point. Combined, we would be delivering more activity with less capacity.

Simple, problem solved!

Obviously, it’s not that simple and we can’t merely draw a line between workforce and estate, but it helps to have a simple framework to group initiatives and assess their impact as a whole.

It also helps highlight digital solutions which may solve more than one problem. Rationalising the estate is probably the fundamental lever to enabling how we ‘deliver the same or more activity with less capacity’.

At gbp consult, we are committed to supporting NHS organisations in navigating these challenges and achieving their goals. We hope these insights inspire you to look at your estates with a fresh perspective and recognise the untapped potential they hold.

For more information or to discuss how gbp consult can assist your organization, please feel free to reach out. Email the team:


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