The Naylor Review – a review


, , ,

Major points

1) Establish a powerful new NHS Property Board (NHSPB)

This could be a good idea or a terrible idea depending greatly on structure, governance, and leadership. The Naylor Report (NR) mostly states what powers it should have and little else.  It is designed to solve the problem of lack of strategic estate planning within the NHS.  So there is that.

2) Establish the NHS Property Board in shadow form immediately

I don’t really see the point in this other than to be able to implement the NHSPB with public scrutiny.

3-5) these recommendations largely detail the power the NHSPB should have.  Which are large and extensive.  See point one for opinion.

7) The NHS Property Board should improve transparency and intelligent use of


I’ll believe that when I see it.

8) The NHS Property Board, in partnership with other national bodies, should review processes to ensure they are proportionate and effective.

This is a meaningless statement, simply saying the NHS should be better at stuff, as if Lean and Continuous Improvement philosophies aren’t already in existence within the NHS.   My only real concern is what this says about the writers of the report.

9) STPs should develop affordable estates and infrastructure plans.

STP stands for Sustainability and Transformation Plans.  So this recommendation says, “Plans should develop plans”.   Recommendation has a similar issue.

10) STP estates plans and their delivery should be assessed against targets informed by the benchmarks developed for this review.

STPs and their providers, which fail to develop sufficiently stretching plans, should not be granted access to capital funding either through grants, loans or private finance until they have agreed plans to improve performance against benchmarks.”

This is probably where the claim about forcing the NHS to sell off all its estates from.   Ultimately what this means is, if your local NHS provider disagrees with the NHSPB, or government or whatever (it doesn’t state who decides what a “sufficiently stretching” plan is, your hospital can go rot. This if ever implemented is almost certainly going to result in unnecessary deaths.  It should also be noted that the report uses the reasoning that the backlog of maintenance on some parts of the estate justify its sale, and then goes on to recommend creating a larger backlog of maintenance.

11) A recommendation that money gained from the sales is reinvested locally.

Buried in this proposal is the 2 for 1 offer.  If land is seriously under sold then this will represent a considerable transfer of wealth from the government to capital owners.  The reports gives little justification either economically or morally for such a transfer.


12) A recommendation that different parts of the NHS work together.

13) Land vacated by the NHS should be prioritised for the development of

residential homes for NHS staff, where there is a need.

Sure, however the effectiveness of his depends greatly on the NHSPB.

15) Urgent action should be taken to accelerate the delivery of a large number of small scale and low risk developments to deliver housing.

I would hope Naylor would recommend what action, but least it is a start.

16) All national bodies should work together, sharing intelligence, to develop a robust capital investment plan for the NHS by summer 2017.

Also different bits of the government should work together.

17) Substantial capital investment is needed to deliver service transformation in well evidenced STP plans

This isn’t a recommendation but a fact.

On the 3.5% tax

“NHS providers are not directed to dispose of surplus land or make particular investments. Instead, they are incentivised by the financial performance framework. The key influences are:

  • a 3.5% annual cost of capital charged by the Department of Health on book values;
  • allowing NHS foundation trusts to retain disposal proceeds and a de facto right of NHS trusts when proceeds are reinvested in new facilities;
  • the inclusion of estate costs within the tariff for NHS services so if providers are able to provide care cost effectively they retain the difference”

The 3.5% isn’t a tax, could easily be used to over report the NHS budget. State the budget before the central government claw back.  It should be noted that this already exists and isn’t a new thing.