Master planning – a new way forward?

This paper’s purpose, it should be stressed from the outset, is not to cast doubts on the efficacy or significant contribution that the use of an NHS Estate Strategy (NHS 2004) has made to the NHS in general, and Trusts in particular. Indeed the development of the NHS Estate Strategy in recent years has seen a wider set of values incorporated in an attempt to improve its strategic value. Such developments have, however, increased both its length and complexity, and reduced its readability for Trust boards. This paper’s goal is, instead, to propose a view that, while promoting the “picture of possibilities” for any healthcare site, the current NHS Estate Strategy still falls short of enabling acute Trusts and other users to develop a comprehensive, integrated and dynamic picture of the locality, including the site itself. Trusts are not isolated, insular organisations and, in reaching out to their local population, they (and their planning priorities) should be as integrated with the workings of the local area as with other public services and amenities. Despite a number of additional recommendations regarding local integration of planning, the current NHS Estate Strategy is still insular and, notwithstanding valiant attempts to provide integration via its use, has not substantially changed. It could, in fact, be viewed as a millstone around the neck of Trusts striving to develop strategic planning methods that meet the new integrated world of the NHS. The key question is: has the Estate Strategy, as we have known it, run its course, and should it indeed now be augmented by a more health and social economy-based methodology, a “Master Plan” that has its roots within the Estate Code and the Estate Strategy Framework, but is a more “outward-facing” document?

Current strategy – a guidance millstone?
This paper will examine the basis of the current NHS Estate Strategy and compare this with a view of what constitutes a master planning document, and how such a document can be an integrated pathway to a wider health economy view of development, giving a wider focus to the inward-looking Estate Strategy document. At the heart of the debate, it appears, is the question: “Has the modernisation and integrated care agenda left the Estate Strategy behind?” As NHS modernisation continues, delivered via a number of design, development and procurement avenues, the basic NHS approval methodology and business planning requirements for Foundation Trusts continue to rely, at core level, on the relevant health body having an up-to-date strategic estate document as a foundation for supported development. In itself, the idea of having a strategic document for estate development within the organisation is sound. However, the rapid obsolescence of themes, ideas and principles devalues the document quickly. For the Estate Strategy this applies to the greatest extent in the section related to site development plans which, as a concept, have been rapidly superseded by master planning. If there is one key factor that would go some way to restoring the usability of the Estate Strategy, it is the reformation of its character from one of insular, to one of inclusive, developments. Our development rationale needs to move from the static, and perhaps insular, Strategic Development Plan, to a more dynamic, and relevant, Master Plan.

Methodology
This paper will address (and include):
-The Estate Strategy, (the current working system, its strengths and weaknesses).
-The master planning system, and what constitutes a master plan (and how such plans differ from estates strategies).
-The degree of potential for master plan development in the NHS.
-The next steps on the road to improved planning.
-A conclusion and recommendations.