Significant progress is being made on the Isles of Scilly in the development of a new Integrated Health and Social Care Facility, which is a vital project set to transform local healthcare services. Community 1^st is at the heart of this ambitious project, playing a key role in driving the project forward.

This is one of the most complex and logistically demanding projects ever attempted in such a remote UK location. Transporting over 80 shipping containers of materials to the islands by sea, often in challenging weather conditions, which has required meticulous planning and coordination. With limited access routes and geographical constraints, delivering and installing modular units has been no small feat. Yet, against all odds, what many once thought nearly impossible is now becoming a reality.

A major milestone was achieved in May 2025 with the successful installation of 17 modular units, which will form the new care home component of the facility. These units were carefully craned onto pre-laid concrete foundations in under 12 hours, an impressive display of teamwork, planning, and execution. At peak times, up to 40 people have been working on site to keep the project on track.

Community 1st’s commitment goes well beyond logistics. The organisation has actively involved the local community throughout the development, including engaging students from the Five Islands School. These initiatives highlight the importance placed on community engagement and social value, ensuring that the new facility reflects the unique needs and aspirations of the Isles of Scilly population.

Visitors to the site, including healthcare leaders and local councillors, have consistently praised the quality, speed, and ambition of the work to date. The transformation underway is a powerful testament to the collaborative efforts of all partners and to Community 1st’s leadership in managing such a complex and critical build.

Located on the site of the existing St Mary’s Community Hospital and adjacent land, the new facility will include 12 residential care home beds, NHS inpatient beds, a modern maternity suite, and a range of outpatient services including x-ray, dental, minor injuries, and consulting rooms.

As the project continues to move forward, Community 1st remains committed to ensuring that this state-of-the-art facility not only meets clinical standards but also truly serves the people of the Isles of Scilly, now and into the future.

Ken Jones, Community 1^st General Manager said: “With very little time to plan this project in advance and with little precedence for delivering a project like this on the islands, the whole journey has been a challenge of responding to events that couldn’t really be planned for.

Accommodation, material logistics and the challenges of refurbishing the existing building have created numerous hiccups along the way, but the entire team has pulled together to find solutions and keep things moving.

The hospital team have been very accommodating, and we recognise the difficulties and disruption the works have caused to their daily lives, but like everyone else, they recognise the importance of this significant investment in the Islands’ healthcare infrastructure and the long-term benefits to every islander.

Whilst it’s been a challenge for me to keep everything moving in the same direction as the project leader, I really couldn’t have done it without the partnership working ethos that the entire contracting team have adopted and the trust and free reign the Cornwall Partnership NHS Trust executive and estates team have given me to be able to make decisions on the fly and flex the scope to accommodate the unexpected.

This truly has been an unforgettable project for me, and I suspect for everyone else involved.”

Read more here: https://www.cornwallft.nhs.uk/news/new-isles-of-scilly-care-home-takes-shape-10000

When people come across LIFT, it is often thought that the sole purpose is the delivery of new primary health care facilities. However, this is only one part of the extensive support we have effectively provided over our 20-year partnership with local communities and health economy partners. 

At this time of significant changes and challenges for the NHS and Social Care, our team often reflects on the transformations we have experienced over the years. More importantly, we focus on the future and how we can continue to support our local health economies in delivering high-quality care to their communities. 

Formed in 2004 as a partnership between the private sector and the Secretary of State for Health Community 1st is procurement cleared to provide a wide range of estate services in Oldham, Cornwall and Sheffield. Novel at the time, but at some point, falling out of favour, is it time to re-look at the success and value of a local public private partnership (PPP)? 

With capital funding for public sectors projects stalling, PwC have published a new report, ‘Transforming infrastructure investments: A private finance perspective’, aimed at the government to inform policy development and options for future funding for its upcoming 10-year Infrastructure Plan. The report explores the potential for a renewed Public Private Partnership model for blended financing of UK infrastructure. Read more here.

There are many lessons learnt from the LIFT Public Private Partnerships (PPP), which can bring a positive influence into any new PPP Model.  

Community 1st remains a ready-made partnership that has evolved over the last 20 years to respond to each and every reform and structural change the NHS has witnessed.  

We have endeavoured to ensure we can provide a flexible approach to delivering a wide range of services, from direct appointments for specific estate or FM services, supporting NHS backlog maintenance projects, to arranging finance or developing lease arrangements within our LIFT areas. All of this is key to providing tailored support to our partners when needed, often under tight timescales and financial constraints. 

As we anticipate the release of the new 10-Year Health Plan and the upcoming modifications to the NHS and Care structures, we are in the process of strategic and operational planning for services across all our regions. This support encompasses the development of new clinical service strategies across geographic regions and facilitates discussions across sector boundaries to explore the potential for integration and collaboration among service providers. It utilises our LIFT estate as an enabler and also includes the provision of project management support to assist NHS teams in delivering in-house capital works and facilities management on their own estate.  

Establishing multi-skilled locally based teams in all our areas has allowed us to develop and nurture long-term successful partnerships, providing not only expertise and additional resources when needed but also a continuity of knowledge, despite many NHS and Social Care reforms. 

If you want to read more about our recent work outside of our own LIFT estate, you can find recent news stories here, or if you would like to talk to us about how we could support you please get in touch via community1st.co.uk/get-in-touch/ 

 

Jonathan Keegan 

General Manager 

jkeegan@community1st.co.uk  

If you are involved in any part of planning services, estate or delivering FM within the NHS, or even reading the latest news about the current challenges faced, I can almost guarantee there will be a mention of the ongoing and growing backlog maintenance issue. 

The latest ERIC data (which includes the condition of NHS Hospital buildings and equipment) states that the figure to eradicate problems in secondary care now stands at £13.8b, with a 15% increase in the ‘high risk’ backlog in the previous year. Failure to address repairs urgently could lead to serious injury to staff and patients, with potential major disruption to services. 

But this isn’t the whole picture. The same level of detail is not currently collated for the Primary Care estate, which is often pieced together from various surveys and reports. We do know that figures here don’t improve; 20% of practices were built before the establishment of the NHS in 1948, and 53% are over 30 years old. 

As we await the release of the new NHS 10-year health plan, which we already know focuses upon moving care from hospitals to communities (left shift), leveraging technology, and prioritising  prevention over treatment, there’s a feeling of ‘kicking the can down the road’. 

Without doubt, a clinical model that provides patients with timely access to a wider range of services in their local neighbourhoods is the NHS and Social Care system we want to achieve. A system that relieves pressure in acute settings and ensures the right professional sees patients in the right setting. We also want these new models of care to attract a workforce that wants to work in these settings, delivering high-quality care. 

The reality is that to achieve the ‘left shift’, we must closely examine the current capability within the Primary Care estate.  

As Community 1st sponsored a workshop event last week, hosting strategic leaders from the Greater Manchester Integrated Care System, who gathered to discuss how best to shift acute services from traditional hospital settings into community locations, the Government announced a capital fund of £102m, to ‘create additional space’ at 1000 GP surgeries across England.  

The news was well received but sparked considerable discussion about the actual impact this funding would have against a backdrop where much of the Primary Care estate isn’t ‘fit for purpose’. 

Whilst the funding announced will help a small number of GP surgeries, with ‘quick fixes’, we need to consider current opportunities that will enable the transformation of clinical service delivery, be achieved quickly, and maintained in the long term.  

We demonstrate time and time again the opportunities that are presented with the existing LIFT estate – an estate that is fit for purpose, flexible, maintained to day-one standard, and in Community 1st areas, located in local neighbourhoods with high health needs and deprivation, and importantly not yet utilised to its fullest capacity. 

While demonstrating these opportunities to stakeholders, we must address what the system perceives as blockers. The most common theme is that ‘LIFT is expensive’.  

Why is that? 

Hopefully, the answer is clear from the details provided earlier.  

The LIFT estate was designed to be able to meet the changing needs of local populations for many years. It was also designed to comply with current (and, as far as possible, future) NHS standards (HTM, HBN, IPC), and importantly, the estate is continually maintained to day-one standard. 

With a need to meet stringent criteria within LIFT agreements, our local FM and estate management partners achieve consistently high maintenance, safety and environmental standards across the whole LIFT estate, all via detailed pre-planned maintenance agreements. This ensures the estate will remain fit for purpose, with the ability to expand service provision quickly and efficiently for many years. 

When comparing costs, the LIFT estate versus a poorly maintained, unsuitable estate, it’s clear that the costs will be higher since we’re not comparing like with like.  

So, back to my earlier comment: are we ‘kicking the can down the road’?  

We know the shift from acute to local settings is the right one for those services that can be delivered safely in these settings, whether outreach, outpatient diagnostics, or follow-up care. 

The capital announcement from Primary Care is welcome, but how much will it achieve? Will the estate changes meet the requirements for additional clinical space? Will that allow for an enlarged waiting area and the appropriate support space and staff facilities necessary to comply with HTM and HBN guidelines? Moreover, will these upgrades be maintained in the medium and long term to ensure high-quality care and better environments for staff for years to come?  

I believe we know the answer, and I think we understand that this must change. In our local areas, we are supporting ICB colleagues in planning and delivering transformational change, which extends beyond just the LIFT estate. There is a focus on PLACE, an emphasis on the estate as an enabler rather than a driver, and a commitment to what is best for the patient. 

Our local teams will continue supporting our local health economy partners to address these challenges. We view our LIFT estate as a successful model of long-term partnership and a catalyst for enabling long-term change, one that does not contribute to the existing backlog maintenance issue. 

We will continue to work with our NHS partners and hope to demonstrate the value of long term joint venture partnerships as a model that could help the NHS meet its estate needs.  

 

Kate Edwards 

Health Development Director 

kedwards@community1st.co.uk  

 

#NHSEstate #Workingtogether #Leftshift 

Community 1st sponsored a workshop event this week, hosting strategic leaders from the Greater Manchester Integrated Care System, who gathered to talk about how best to shift acute services from traditional hospital settings into community locations.

Community 1st is a long-term partner of the local NHS. Established in 2004, we operate six ‘core’ healthcare assets across Oldham in accessible community locations.

Delivered through the LIFT model, even years later, these facilities remain fit for purpose, with no backlog maintenance issues and inherently flexible building designs that allow them to adapt to changing health service needs over time.

The day was led by Dr Mohan Kumar, Clinical System Lead for Estates (GMICS), alongside CHP NW Regional Director Jeanette Leach and National Strategic Productivity Partner Mike Simpson and was highly productive for all involved.

Jonathan Keegan, Community 1st General Manager, said, ‘This event was a fantastic opportunity to bring together leaders across the local health economy. There was a lot of discussion around plans for how more health services can be shifted into these core facilities in Oldham. We look forward to working together to support these impactful projects.’

Kate Edwards MIWFM, Health Development Director, said, ‘With over 20 years of successful partnership working with the NHS, we are keen to demonstrate how the LIFT model and facilities can adapt to changing service needs, ensuring our partners’ strategic aims in the upcoming NHS 10-year plan can be met.’

#NHS #CHP #Workinginpartnership #OldhamHealth #NHSConfed #EstatesStrategy #LiftcoSupport

Last week, students from Five Islands School visited our site on the Isles of Scilly, getting hands-on experience in sustainable construction. As part of a student-led design competition, they’ll transform recycled materials from our Integrated Health and Social Care Facility project into a covered walkway and seating area, with guidance from our design team to bring their vision to life.

Stay tuned as the students unveil their designs, we can’t wait to see their creativity in action and announce the winning concept.

We are almost at the end of February already! Having just reached the huge milestone of the module installation for the new Integrated Health and Social Care facility on the Isles of Scilly and knowing what a huge impact this development will have for islanders, it’s hard not to be disappointed by the Government announcement for the revised timetable for the New Hospital Programme. But whilst I and many others are disappointed, I am sure I am not alone when I say I am not surprised. 

I could add to the commentary from my colleagues across the sector regarding the impact of this announcement, but the issues are well documented and glaringly obvious. Especially for NHS colleagues (currently still in the throes of dealing with ‘Winter Pressures’) who are now facing the prospect of continuing to provide and, be expected to improve service delivery from a crumbling NHS estate that does not match the vision of a Health Care system that is supposedly being ‘rebuilt’. 

Instead, I want to reflect on our achievements over the last 12 months to ensure the successful delivery of this much needed facility for the Isles of Scilly. Not only will this deliver new and improved inpatient and outpatient facilities, but will also provide access to a wider range of services not only for health but social care too.  

One of the main successes of this project is how it demonstrates that if all key stakeholders are aligned, then progress can be very rapid.  

In a little over 12 months with the collaborative efforts and hard work of the project team, Health and Social Care system partners, along with the wider design team we have achieved NHSE business case approval, planning permission, commenced works on site, along with the the first module install completed this month, all which will result in the delivery of a new model of care for the island, all delivered from the new Integrated Health and Social Care facility.  

The enhanced outpatient facilities will include digital consulting capability, whilst the inpatient facilities will have a new palliative care room, and adjacent quiet space for relatives. Other accommodation improvements will include a new and more appropriately located birthing suite, and an improved operational layout for the MIU facilities along with ambulance service accommodation. 

To enable the move to this new model of care the existing St Mary’s Hospital will be extended to provide new residential care accommodation. This allows the only care home on the island to relocate from a facility with a challenging layout that is not suitable for the delivery of modern social care services to the new facility providing 12 residential, ensuite bedrooms and associated support spaces. 

The design of this single site facility recognizes the quite different accommodation requirements between Health and Social care, but at the same time it will act as an enabler for staff teams to work collaboratively to provide seamless health and social care services for the benefit of patients, residents and staff. 

The benefits will be many, less travel to the mainland for island residents, improved fit for purpose facilities with new point of care testing, and diagnostic capabilities, improved staff facilities and operational layout that will enable and facilitate collaboration between teams. 

As a long-term partner for the NHS, we contemplate what the delay in the New Hospital Programme means for the NHS Teams up and down the country. These very teams who have worked so hard on developing new models of care, business cases and proposals that will now be pushed into the long grass, not seeing the benefits that the Local Health Economy will see in Cornwall and the Isles of Scilly, for many years, if at all. 

So, whilst disappointed with the announcement of the delay, and in part magnified by seeing and realizing the benefits of such projects like the one on the Isles of Scilly, it is very much part of what drives us to look for innovative and novel solutions to bridge the gap and continue to support our NHS Partners. 

The NHS Confederations recent report on capital efficiency (read here) puts a focus the current NHS capital regime and calls for urgent reform to enhance productivity and support economic growth. The report advocates for enabling systems to raise private investment to support the NHS estate needs. Whilst new funding models are being considered by the Government, Community 1st will continue to champion the benefits of the LIFT model as a successful public private partnership model, which has proven over the last 20+ years to deliver high quality facilities. Facilities all deemed as ‘Core NHS Estate’ with no back log maintenance issues , inherently flexible in design, enabling facilities to be easily adapted when needed to support changing health service needs.  

With the success of this model as a showcase, Community 1st is an invested long-term partner, committed to provide alternative solutions to achieve strategic estate priorities that will ignite long term meaningful change for our NHS and Social Care partners. 

Community 1st LIFT company is an existing Joint Venture partnership structure that is tried and tested and has access to capital funding ready to support minor to major estate improvement projects.  

It’s not broken, so why fix it! We could instead evolve the LIFT model and use this procurement cleared entities to support rapid project investment and delivery.  

Kate Edwards 

Health Development Director