Location of health facilities closer to the communities they serve, bringing together health and other services and, where possible, through technologies such as telehealth, enabling patients to undergo more treatment in their own homes, are already major talking points among those responsible for future estates planning.
However, as Ian Greggor, project director at international construction and property consultancy Cyril Sweett explains, the Total Place initiative has placed even greater emphasis on ways in which health and other public services can drive such changes, and how the existing estate can best adapt.
The proposition of the Total Place initiative (which is led by the Leadership Centre for Local Government, and supported by Communities and Local Government, the Local Government Association, and the Improvement and Development Agency for local government) is, at first sight, a well-worn path – a desire to improve services, and increase efficiency, by focusing on what our various customers really need, rather than what policy or law say we must do. However a cornerstone of Total Place is that only a co-ordinated approach across public agencies can achieve both aims. It is a seducing message, more intelligent and rounded than many efficiency exercises in the past that expected staff to find a mythical money pit of waste, or to suddenly wake up to an undefined way of “working smarter”. The knee-jerk reaction of looking first to cut support services and facilities does not fit with this, but instead buildings, facilities, and technology, should form a crucial part of the answer, with investment required to ensure they enable, rather than restrict, change. However difficult at a time of retrenchment, investment in these areas may be vital to realise the benefits that are desired. The Total Place initiative was launched in August 2009, principally under the aegis of the (Government’s) Communities and Local Government Department (CLG). It identified 13 pilot areas where budgets would be pooled and an emphasis placed across the public sector on utilising the skills and knowledge of all. Even with the little time so far available, the lessons from pilots are already being used to inform this year’s Budget, a Budget that will undoubtedly signal the start of a longterm and significant squeeze in public sector spending. Total Place, or at least the approach it signals, was given further backing by the Prime Minister at the recent launch of “Putting the Frontline First”, a programme to help find £47 billion of savings over the next four years.
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