Report | Intelligent Investment
A New Delivery Framework for the UK Primary Care Estate 2026
October 1, 2026 5 Minute Read
Overview
The NHS 10 Year Health Plan sets out a clear ambition to relocate care from hospitals into communities through a national network of Neighbourhood Health Centres (NHCs). Delivering this vision will require significant investment in modern primary care infrastructure and new approaches to estate delivery.
This report examines the role of the primary care estate in supporting the NHS transformation agenda. It explores the scale of the infrastructure opportunity, the investment and delivery models available to support it, and the potential for public-private partnerships to help deliver modern, fit-for-purpose healthcare facilities at scale.
Key findings
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The system needs urgent upgrading
Healthcare demand is rising sharply with 9.1 million people projected to have a major illness by 2040. Meanwhile, 83% of GP practices say their premises are unsuitable for future needs and 50% of the GP estate is over 30 years old. The policy direction has been set through the 10 Year Health Plan, relocating care into the community through Neighbourhood Health Centres (NHCs) nationally by 2030. -
Relocating care to the community has system and community benefits
Investment in primary care and shifting services out of hospitals enables earlier intervention, improves population health outcomes, and reduces demand on acute services. NHS England state that 20% of emergency admissions could be prevented with the right community provision in place, which would realise £1.4bn per annum in cost savings. A modern, community-based primary care estate enables greater efficiency, improved productivity, and helps address health inequalities. -
Development has fallen behind primary care infrastructure needs
Post-2010, primary care development has experienced a sharp slowdown due to construction cost inflation, low rental growth, and structurally constrained NHS capital budgets. New development and comprehensive refurbishments have been constrained, which has had a direct negative impact on patient experience and service provision capabilities. -
Capital injection required
A decade of policy initiatives with recurring visions for the primary care estate has resulted in a growing recognition that the financial and approval system must change to support the mobilisation of private capital. To facilitate this, indexed rents, direct landlord-NHS linkages, along with simplified and enhanced reimbursements, will provide the income certainty and continuity institutional investors require. -
New and evolved structures are required
An effective public-private partnership requires a new investment model, one that looks beyond lease length and accounting frameworks, and is instead underwritten by asset fundamentals that support social infrastructure. This approach is consistent with the emerging PPP model being developed by DHSC and NISTA, which places greater emphasis on operational delivery, flexibility, and whole-life asset management than traditional delivery structures.
Why it matters
The gap between what the NHS expects primary care to deliver and the buildings available to deliver it is now as much a private capital opportunity as a public spending challenge. For investors, primary care offers an income profile closer to infrastructure than conventional real estate. For estate owners, refurbishing underutilised NHS buildings could unlock millions of additional appointments within months. For commissioners, the economics are clear: every £1 invested generates £14 in gross value added. The opportunity is real, and the frameworks to act on it are being put in place.
What the full report covers
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Download CBRE's primary care estates report: A New Delivery Framework for the UK Primary Care Estate 2026
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