NHS leaders urge speeding up of new health centres

NHS leaders have called for urgent action to accelerate delivery of new Neighbourhood Health Centres, highlighting both the scale of the opportunity and the barriers that must be overcome to deliver care closer to communities.

A new report from the NHS Confederation, Accelerating estate solutions for neighbourhood health centre delivery sets out practical recommendations for unlocking progress and scaling delivery across England.

Research by the NHS Confederation has reviewed PFI’s impact and identified lessons for future models with providers seeing private investment as essential for getting new facilities built. With current financial pressures, relying only on public funding would slow progress and could mean the 250 NHCs target is not achieved. While the new PPP model is established, systems and providers can make use of existing autonomous routes to new development.

The report emphasises that neighbourhood health centres are central to the government’s 10 Year Health Plan vision, providing modern, multipurpose facilities that integrate health and social care, improve access, and reduce inequalities. The NHS estate is ageing and fragmented, with a maintenance backlog approaching £16 billion and about 22 per cent of GP premises dating from before the NHS was founded.

A delivery challenge — and an opportunity

The government has committed to delivering 250 Neighbourhood Health Centres overall, including 120 by 2030, and the report stresses that optimising existing estate before commissioning new builds is the fastest route to progress.

Unused or underused NHS space currently costs almost £90 million each year, underlining the financial as well as clinical case for more strategic estate planning.

However, unlocking these opportunities requires tackling structural barriers such as fragmented ownership, complex charging arrangements and misaligned incentives, which have historically slowed estate transformation.

The role of partnerships and PPP models

A clear theme emerging from NHS Confederation members is the importance of collaborative delivery models. Exploring different funding and ownership structures allows providers and partners to pool resources and access development funding, while also supporting regeneration and local economic benefits.

National bodies are already examining funding models for new builds, including a new public-private partnership approach, alongside established mechanisms such as LIFT infrastructure.

The AIIP has already contributed to this debate through our New Models Parameters Report which calls for updated PPP frameworks capable of unlocking large-scale capital investment for public infrastructure. The New Models Report shows investors are ready to deploy significant funding if policy enables new PPP structures and highlights evidence that PPP projects can be delivered faster and more efficiently. A recent European academic study showed the significant long term cost savings related to PPPs.

The New Models report proposes 35 recommendations to improve transparency, reduce complexity and deliver better value for money, drawing on lessons learned from earlier PPP and PFI programmes.

Why speed matters

Delays in estate development increase costs, inflate material prices and risk projects being abandoned altogether. Treating estate as a strategic enabler, combined with flexible funding models and strong partnerships, will therefore be essential if neighbourhood health centres are to be delivered at pace and at scale.

A clear message for policymakers

For infrastructure investors and delivery partners, the message is clear. The policy direction is set, demand is defined, and the health system is actively seeking innovative financing and delivery solutions. With the right frameworks in place, public-private partnerships could play a pivotal role in accelerating delivery and ensuring communities benefit sooner from integrated, modern health facilities.

As the NHS Confederation’s analysis makes clear, the opportunity is not simply to build new buildings but to reshape how care is delivered locally. The pace at which that happens will depend on how quickly systems can unlock capital, collaboration and capability across the public and private sectors.