The clue is in the name: analysing the L in LIFT
Sewell Advisory Deputy CEO Nikola Idle explores why the local element of the LIFT partnership has made it one of the most successful public-private partnerships of recent times.
Last week, I was at a regional meeting of school leaders. I realise this is an odd place to start an article about LIFT, but please bear with me.
We were discussing the Department for Education’s increasing use of frameworks for procurement. One message came through loud and clear: schools want local suppliers. People who understand their communities, know their challenges and can be at the end of a phone when needed.
That desire for local knowledge and trusted relationships perhaps explains why the local element has always been the secret behind the success of the NHS Local Improvement Finance Trust (LIFT) programme.
Twenty-five years after its launch, LIFT remains one of the most significant public-private partnerships in community healthcare. More than 350 facilities have been delivered across England, many in areas with some of the highest levels of health need.
Yet when people talk about what LIFT is now, they rarely start with buildings, finance models or property transactions. They talk about relationships. Because LIFT succeeds when it is done for a place by a place.
More than buildings
One of the most common misconceptions about LIFT is that it is simply a mechanism for delivering healthcare buildings.
It goes without saying it has achieved this – securing and delivering billions of pounds of investment into communities and replacing outdated premises with modern facilities that support integrated care and bring services closer to home.
But the strongest LIFT partnerships have always offered something more valuable than just a delivery vehicle.
Over time, LIFTCos act as Strategic Estates Partnerships – bringing together voices from across the public sector to solve the challenges a particular place faces. Those involved have developed a deep understanding of the systems they serve: the organisations involved, the pressures they face, the local political environment and the communities behind the statistics. They create a corporate memory that often outlasts restructures, leadership changes and shifting national priorities. Memory and passion are embedded in those who designed the programme, understand its vision and purpose and have been there for the long haul to see it through.
Over the past two decades the NHS has moved from Primary Care Trusts to Clinical Commissioning Groups, and then to Integrated Care Boards. Strategies and structures have changed repeatedly, but in many places the partnerships built through LIFT have remained. And that local knowledge has real value.
That matters. It mattered at the start, it matters throughout the programme, and it matters as these buildings approach End of Term.
Understanding place before property
We all know that successful healthcare infrastructure (or any social infrastructure) starts with people and services, not buildings. The best facilities are shaped around how communities live, access services and interact with the wider public sector, not simply around availability.
Take The Reginald Centre in Leeds. Alongside health services, it provides access to a library, employment support, benefits advice and community activities. It functions as a community hub rather than simply a health centre.
Similarly, Hull’s Jean Bishop Integrated Care Centre brings together health, care and emergency service partners to help older people remain independent and reduce avoidable hospital admissions.
Both work because they were developed (and in the case of the Reginald Centre adapted) in response to local needs rather than imposed through a standardised model. They reflect the priorities of the communities they serve and were shaped by organisations – and sometimes individuals – with genuine “skin in the game”. People with a vested interested in local outcomes, both professionally and often personally – people whose family, friends and loved ones use the facilities they are creating.
The neighbourhood health opportunity
The emergence of NHS England’s Neighbourhood Health Hub Programme represents one of the most significant shifts in community healthcare since LIFT was created.
Its objectives are clear: move care closer to home, strengthen prevention and improve integration between services.
The temptation for some systems will be to start with a blank sheet of paper and a new building. But one of the enduring lessons from LIFT is that the answer is not always new estate.
Across the country, existing health centres are being reconfigured to create flexible clinical space, integrated service hubs and community-focused facilities – diversifying beyond just primary care. Success depends not just on securing increasingly scarce capital, but on understanding how cross-organisation services operate, how communities use buildings and how local needs are changing now and in the future.
That requires trusted partners with long-term knowledge of the place.
Relationships as a strategic asset
It could be said that LIFT’s true legacy will not be the buildings it has created but the partnerships it has sustained.
Creating good partnerships cannot be created through a procurement exercise. They develop through years of collaboration, shared challenges and sometimes failures and a long-term commitment to improving outcomes.
In many areas, LIFT organisations have worked alongside NHS partners for decades, helping them understand utilisation, develop business cases, secure investment and adapt services to changing demands.
That accumulated knowledge becomes a strategic asset in its own right.
When systems begin thinking about primary care transformation, regeneration or neighbourhood health, conversations are inevitably more productive when they involve people who already understand the history, context and ambitions of the place.
Keeping the local in LIFT
As the NHS looks ahead to the next phase of neighbourhood health, the challenge is not simply delivering new facilities. It is preserving the local focus that made so many LIFT schemes successful in the first place.
National programmes often seek consistency and standardisation. There are good reasons for that – value for money being at the front of this list. But communities are not standard.
What works in a big city won’t automatically work in rural areas. The challenges facing an isolated seaside community are not the same as those facing an affluent market town. That’s why lasting change starts with understanding a place – its people, relationships and ambitions – rather than applying a one-size-fits-all solution. Successful neighbourhood health programmes will reflect those differences. They will be shaped by local intelligence, local ambition and local partnerships.
Which brings me back to my conversation with school leaders. Whether we are talking about education, healthcare or local government, people continue to value organisations that understand their communities and remain invested in their success.
The NHS LIFT programme has delivered hundreds of healthcare facilities over the last quarter-century. Its most important legacy may be the lesson that a building programme alone is never enough. Real transformation happens when investment and infrastructure are combined with something much more powerful: a genuine understanding of place. In other words, learning from the local of LIFT.
The Sewell Advisory team has played an integral role in the LIFT programme from the start, and its staff continue to support the running of 84 LIFT properties, worth £1bn – around a third of the LIFT estate across the country.
From directing projects and programmes to improve the LIFT estate, to operational estate management, Sewell Advisory helps ensure our community’s LIFT buildings adapt and change to meet evolving healthcare needs.
Find out more about how we can help you bring your neighbourhood health plans to life.