Capital funding: how to create a winning bid

Context

We are the largest NHS provider of acute, community and specialist mental health services in Greater Manchester. Our estate is vast (over 150 sites), geographically spread and ageing. It takes over three hours to drive from our drug and alcohol services in Cumbria to our inpatient unit in South Manchester! Over the last ten years, we have made significant annual investment in our estate to drive up standards in our existing properties and deliver new developments such as our award-winning inpatient CAMHS unit (‘Junction 17’), our purpose-built low secure unit (Lowry) and our Recovery Academy (‘The Curve’). Service users’ views have been integral to each of these schemes. Park House, which is the largest mental health dormitory accommodation in England, stands out as a particular challenge in this context.
 

Need for investment

We inherited Park House on the North Manchester General Hospital site as part of our acquisition of Manchester Mental Health and Social Care NHS Trust in January 2017. This was at a time when the drive to eradicate dormitory accommodation was beginning to gather momentum nationally.

Park House provides 71 per cent of the total inpatient mental health beds in the City of Manchester but is currently not fit for providing modern mental health care. Environmental challenges include shared bedrooms and bathrooms, dark internal rooms, poor outdoor space and limited access to therapy, activity and family spaces. These factors all increase the physical security required, which can impact on recovery.

The daily challenges we face at Park House are not unique to us. It is the scale of the challenge (the size of the unit, levels of demand and gap between where we are now and where a modern mental health service should be) that marks us out and is why, we believe, our investment plan has received national support.
 

Building a bid – working with others

Our proposal clearly demonstrates the opportunity to improve services and transform care from a clinical-quality and patient-benefit perspective. The new building and vastly improved facilities will have a direct, positive impact on clinical outcomes, staff recruitment and retention and our ability to deliver national targets. In terms of value for money, we know from previous experience that modern, fit for purpose environments result in shorter lengths of stay and reduced need for out of area placements, lower levels of incidents, and reduced expenditure on bank and agency staffing through a redesigned workforce.

Engagement, both internal and external, has been key both to the development of our plans and the achievement of a national funding commitment. From the start, we have worked closely with Manchester City Council, commissioners, acute sector partners, housing providers and our service users to build a bid that reflects our needs and supports delivery of the wider ambitions for North Manchester. Views have been sought on the case for change, critical success factors and build options. Given the obvious and pressing needs presented by Park House, our over-arching plans have received backing at every stage of their development so far. In addition, we have taken time to harness the energy of our highly-skilled workforce at an early stage, recognising that they will be key to driving forward this change, and have commissioned external expert support as required. We are now planning a more comprehensive and structured programme of engagement with these stakeholders, and in particular our service users, for the next phase of the project.

We have also not shied away from welcoming visitors to the Trust, both from regional and national teams and bodies, over the last 12 months. Every visit has been used as an opportunity to highlight the challenges presented by the Park House environment and showcase what our services can achieve. 
 

Learning from Park House

My advice for anyone else seeking capital funding would be:

• Focus on quality: make sure your plan focuses on quality and outcomes as much as, if not more than, simply replacing a building
• Workforce is key: make sure your plan considers workforce both in terms of development opportunities and benefits for staff
• Consider inflation: between submitting your bid and receiving funding, changes to public sector cost indices could mean your capital estimates are far below what you will eventually need
• Plan for the future: test and re-test potential efficiencies being mindful of forecast future growth and population changes
• Go digital: Explore new and emerging digital opportunities to future proof your developments

To hear more from Neil, and our entire panel of experts, be sure to secure your place at the Mental Health Network Annual Conference and Exhibition on 5 March 2020. To view our full programme and book your place, head to www.nhsconfed.org/MHN20

Neil Thwaite is chief executive of Greater Manchester Mental Health NHS Foundation Trust.