More than 90% of contact with the National Health Service occurs in the primary sector, in GPs’ or dentists’ surgeries, pharmacies and other local facilities. The primary sector is a sprawling estate, with, for example, more than 9000 GPs’ surgeries. In terms of fitness for purpose, the building stock is poor. Only 40% of GPs’ surgeries are purpose built and 80% are under-size. This is a significant barrier to health service reform, and the NHS plan has targeted 3000 upgrades and the construction of 500 new one-stop shops in the primary sector. The NHS is also keen to transfer services from the acute hospitals to the local primary sector.

The Local Improvement Finance Trust initiative has been designed to carry out this change in local healthcare delivery by levering in private funding for the construction and maintenance of modern, integrated facilities, to provide an extended range of healthcare services in more accessible locations.