How the NHS estate can help reduce health inequalities

The NHS is one of the largest landowners in England. As well as providing essential sites for the NHS to deliver services to patients, the NHS has an opportunity to intentionally manage its land and buildings in a way that has a positive social, economic and environmental impact. Simon Corben, Director and Head of Profession – Estates and Facilities explains how in this blog.

The way NHS estates are designed, used and disposed of provides opportunities to improve the health and wellbeing of communities and reduce health inequalities.

NHS England has developed new practical information for estates and facilities managers to help them understand their role in reducing health inequalities and inspire action in 10 key areas that were identified with stakeholders. We are calling these 10 areas ‘building blocks for health’.

The 10 building blocks for building for health are:

  1. Supporting community development
  2. Improving location and access
  3. Supporting healthier communities
  4. Facilitating economic development
  5. Enabling access to green space
  6. Access to good inclusive employment and training in estates
  7. Improved design
  8. Access to quality and affordable housing
  9. Reducing negative environmental impact
  10. Social value in procurement

You can find out more about each building block and download a pdf summary on our new webpage. It also includes examples of how these building blocks have already been applied.

Back in October 2022, I was lucky enough to be able to visit St Basil’s Live and Work project in Sandwell, Birmingham, an excellent example of building block 8: access to quality and affordable housing.

The scheme provides accommodation for young workers for less than £43 per week, inclusive of all bills, and is open to 16 to 24 year olds in the West Midlands.

The scheme is totally “benefit free” which means that young people get the opportunity to live and to work without having to rely on welfare benefits.

The accommodation, a former nurses block, is now home to 32 young people and is comprised of eight flats. Each flat has four bedrooms, with shared kitchen, dining and bathroom facilities. It’s located only 20 minutes away from Birmingham City Centre with reliable transport links and good local amenities.

Sandwell and West Birmingham NHS Trust made the former nurses block available to the scheme in 2014, at which point it had stood unused for 16 years. The trust now offers apprenticeships to live and work on site. An apprenticeship at the trust lasts for 12 months and provides an opportunity for young people to experience work in several areas including finance, healthcare support, business administration and physiotherapy support.

So far, the scheme has helped over 130 young people through apprenticeships. More than 100 of these have gone on to secure full time work at the trust or other local organisations.

I met two former live and work apprentices on my visit: Siani, a newly qualified nurse and Jack, an administrator at the start of his NHS career. It was both hugely moving and rewarding to hear how the scheme had transformed Jack and Siani’s lives and about their ambitions for a continued career in the NHS. I also met some of the team, led by Assistant Director of Strategic Development, James Pollitt, whose tenacity makes this programme possible and uses what was otherwise dormant estate for the good of the wider community. You can watch a short film of my visit featuring James, Siani and Jack below:

The building that houses these young people is now owned by the local NHS trust, repurposing part of the NHS estate into something truly special to vastly improve the opportunities for those individuals that have had a difficult start in life.

Three key partners – the NHS, the charity and a local building contractor – have come together, through a common desire to support vulnerable communities, bring homeless young people into safe and secure accommodation and provide a pathway to employment. As well as that, the project also supports the economy through financial and social return on investment (£14 gained from every £1 spent).

I hope all my estates colleagues will read through the 10 building blocks and apply what they can in the management of their own land and services. Reducing health inequalities really is everybody’s business – and estates colleagues have a key role to play.

Photo of Simon Corben

Simon Corben is Director and Head of Profession for NHS Estates and Facilities at NHS England.
Simon joined the NHS in May 2017, after 16 years in the private sector, to lead the estates and facilities function which includes both primary and secondary care estate. Building on the Carter Implementation Programme and Naylor Review, Simon leads on work including the Model Hospital, sustainability and ICS Infrastructure Strategies, ProCure23, and delivery of the Health Infrastructure Programmes announced by the Prime Minister in 2019. Simon also led the NHS Estates response to the COVID-19 pandemic including the delivery of the Nightingale hospitals with over 3,500 critical care beds in a matter of weeks.