The NHS Estate and the 10-Year Plan

Health and social care12.08.20257 mins read

Key takeaways

Schools can use isolation as a sanction

The High Court says it’s legal for schools to isolate students if it’s done fairly and follows school rules.

Discipline policies must follow the law

Schools need to make sure their behaviour policies meet legal standards and protect students’ rights.

Courts support fair school decisions

If schools apply their rules reasonably, courts are likely to back their choices.

The NHS Estate and the 10-Year Plan 

On 3 July 2025, the UK government released its long-awaited 10 Year Health Plan for England (“the Plan”), outlining a vision for three seismic shifts – hospital to community, analogue to digital, and sickness to prevention. These reforms carry major estate and infrastructure consequences for NHS estates, property professionals, developers, landlords, and public–private partnerships.

At its core, the Plan aims to transition the health service from a hospital-focussed model to one that prioritises community-based, digitally supported, and preventative care.

Central to the government’s vision is the decentralisation of care, with the expansion of Neighbourhood Health Centres (“NHCs”), also known as NHS Health Hubs. These modern, multi-service facilities aim to reduce reliance on hospitals by offering a more convenient and connected approach to local healthcare.

The NHCs will open for extended hours, and will integrate services such as GP appointments, diagnostics, mental health support, pharmacy access, and social care advice – enhancing accessibility while relieving pressure on acute care settings. The overriding principle being to make health care happen as locally as it can, to end “corridor care”, lower waiting lists and expand same-day emergency care services and co-located urgent treatment centres. 

The Plan commits to deliver 250–300 new NHCs by 2035, 40-50 within this parliament – and redirect outpatient services, including 135 million appointments annually, from hospitals into these integrated hubs .

Achieving this shift from hospital to community demands more than just clinical reform – it calls for a comprehensive transformation of the NHS estate, from acquisition and repurposing of sites to the delivery of entirely new infrastructure at scale. This will require a radical rethink of NHS property assets. We expect there to be an increased demand for new sites, and for outdated, underused or inefficient spaces to be repurposed or replaced for NHCs and co-located services (e.g., pharmacies, dental practices, diagnostics). Property teams will need to have comprehensive data on the extent and suitability of their estate in order to make informed decisions on any transformation. 

To support the scale of change, the Plan also includes a £30 billion investment, with capital redirected from hospital projects into community infrastructure over the next three to four years. More than 250-300 NHCs are planned, underpinned by new GP contracts enabling both single and multi-neighbourhood models. Delivery will involve a combination of public-private partnerships (PPPs) and strategic guidance from ICBs, which will oversee local capital allocation and estate strategy.

The Plan confirmed that the government will develop a business case for the use of PPP for NHCs, ahead of a final decision at the autumn budget. Whilst the government has outlined a potential role for private finance in these projects, it rules out a return to the large-scale Private Finance Initiative (PFI) model (used mostly in the late ‘90s and early ‘00s) and instead the government is aiming for a more flexible, value-driven PPP approach and more detail is expected in the autumn. Key questions remain including which bodies will act as contracting authorities, such as the Trusts, ICBs, or local authorities.

Whilst the Plan is driven by healthcare priorities, the implications for NHS estate teams, property developers, investors, and local authorities are significant. It’s easy to talk about healthcare transformation, but to make it real the NHS needs the right spaces, in the right places, built for modern needs. That’s where the property challenge begins.

Do not hesitate to contact us to discuss what the Plan means for your organisation, and what you need to be doing and thinking about now and ahead of the autumn budget.

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