Community Healthcare Investment Could Release Up to £6.6bn a Year for the NHS, CBRE Research Finds

• Moving suitable services from hospitals into community settings could release £4.4–£6.6bn annually
• Refurbishment and optimisation of existing NHS estate could support an additional 2.9 million patient appointments per year
• 50% of GP premises are more than 30 years old, while 83% are considered unsuitable for future healthcare delivery

Delivering the NHS 10-Year Health Plan will require significant expansion and modernisation of England's primary care estate, according to new analysis from CBRE.

The NHS 10-Year Health Plan is centred on moving care from hospitals into communities and from sickness to prevention. A national rollout of Neighbourhood Health Centres (NHCs) is expected to play a key role in delivering these ambitions. However, the findings point to a growing mismatch between healthcare demand and the capability of the existing NHS estate.

Community-based care could release billions for the NHS

The research suggests that approximately two-thirds of suitable non-urgent hospital activity could be delivered in community settings, including 62% of outpatient consultations, 89% of diagnostic procedures and 69% of day-case activity.

Enabling this change could release between £4.4 billion and £6.6 billion annually for reinvestment elsewhere across the healthcare system. Realising these benefits will require investment in modern healthcare facilities capable of supporting a greater volume of community-based care.

Existing healthcare estate offers immediate capacity gains

Refurbishment and reconfiguration of an estimated 0.5 million m2 of recoverable NHS estate could support an additional 2.9 million patient appointments annually, helping relieve pressure on hospitals and improve access to local services. These gains are particularly important given the age and condition of the estate.

Half of GP premises are now more than 30 years old and 83% are considered unsuitable for future healthcare delivery. At the same time, GP appointments have increased by 37% and registered patient numbers by 6% since 2020.

Development has not kept pace with demand

Despite growing demand and the need for modern healthcare facilities, primary care development remains close to historic lows. Construction costs have increased by approximately 95% over the past two decades, compared with around 50% nominal growth in primary care rents, creating a widening viability gap for new projects. Addressing these development challenges will be critical to delivering the infrastructure required to support community-based care at scale.

Evolving funding models could unlock investment

The findings also identify a significant investment opportunity linked to the NHS's move towards community-based healthcare. While successive policy initiatives have consistently highlighted the need to modernise the primary care estate, existing funding and approval mechanisms have not evolved at the same pace.

Creating greater income certainty through measures such as indexed rents, more direct NHS-landlord relationships and streamlined reimbursement processes could help unlock institutional capital and accelerate investment into new developments and refurbishments.

Existing delivery models do not currently provide the flexibility, operational integration or scale required to support the NHS's neighbourhood healthcare ambitions. Future models will need to combine capital, development expertise and long-term estate management capability.