“Britain’s high street is set to be hit by more closures tomorrow as major retailers shut branches for good.”
This has become commonplace headline news. Last year 50 shops a day closed their doors permanently (almost 50% more than in 2021). Retailers are struggling with soaring energy bills, inflationary pressures and the continued growth of online shopping. Decreased footfall on high streets leads to decline for other businesses, leaving large empty spaces on once thriving streets.
In contrast, the NHS is suffering from demand far outstripping capacity. The pressures of delivering care during the pandemic have led to significant backlogs and longer waits for patients. Before the pandemic there were 4.43 million people on a waiting list for care. In January this year around 7.21 million people were waiting for treatment. This is the visible backlog. Added to this are the ‘hidden backlog’ of patients who for various reasons have not yet found their way into the healthcare system. Clearing the waiting lists could take some considerable time.
Reducing pressure on acute hospitals
Without strategic action, the backlogs could result in even greater demands on the NHS. New ways of thinking are essential. Bold and deliverable plans are needed. There is a pioneering but simple solution which could help solve some of the challenges faced both by health services and high streets. Health on the High Street initiatives aim to transform empty retail units into local health hubs, delivering much needed healthcare for local communities.
The concept was first outlined in an NHS Confederation Paper in 2020. Now Health Spaces is turning this futuristic vision into reality; strategically supporting NHS Trusts across the UK to create clinical spaces in vacant buildings in the heart of local communities. We offer NHS Trusts an operating lease of fully fitted, fully compliant, multi-purpose clinical spaces in high street locations throughout the UK. This is a fast-track and cost-effective way of upscaling capacity and tackling waiting lists. Besides alleviating pressure on hospitals, it also brings increased footfall and much needed life back to local high streets.
Treat more conditions in the community
Health on the High Street is very much aligned with the Health Secretary Steve Barclay’s intention ‘to treat more conditions in the community’ away from already over-stretched hospitals (January 2023). It’s estimated that up to 20% of hospital admissions are avoidable with the right care in place.
There are already tangible signs of healthcare moving into communities: 160 Community Diagnostic Centres (CDCs ) are planned by 2025, giving local people faster access to tests, checks and scans; the latest one being located on the site of a redeveloped shopping centre in Stockton-on-Tees.
CDCs will offer a variety of diagnostic checks, scans, and tests closer to patients’ homes. Patients can receive a potentially life-saving diagnosis for a range of conditions, such as cancer, heart and lung disease, in a shorter time frame following a GP referral. By diverting patients away from hospitals, CDCs reduce the number of hospital visits and waiting times, allowing hospitals to focus on treating urgent cases while diagnostic centres address the backlog for tests and checks. CDCs are also more convenient and efficient for patients, reducing the likelihood of test cancellations. To date, 92 CDCs have been opened in diverse settings, such as football stadiums and shopping centres, and have performed over 1.7 million tests.
There are also Government plans to improve the provision of mental health services more locally. These include mental health assessment and care centres, as well as crisis cafes and safe havens to provide a supportive space for people experiencing a mental health crisis. Town centre locations are being considered to improve accessibility to these services.
Situating health services in the heart of the community has many benefits. Easy access to care, increased town centre footfall and often better public transport links than out of town hospitals, to name but a few. We also know that by strategically separating acute and elective diagnostics within the system significantly reduces pressure on the acute hospital setting.
So what are the potential drawbacks of Health on the High Street?
Staffing, planning permission and costs need to be carefully considered.
Staffing community healthcare facilities may be seen as a constraining factor. However, our own analysis indicates that staff retention could be improved. Public transport links are usually better and more convenient in town centres than out of town hospitals. Local high street facilities offer more variety to the working environment. There could even be the option of splitting time between the hospital and high street. All of which could be appealing to staff and help attract employees.
Planning permission to convert a retail space into a healthcare space may be considered a challenge, but the introduction of “Class E” Planning Use in the Town and Country Planning Regulations in September 2020 has removed a considerable hurdle to this. It aims to simplify the planning process and encourage mixed use high streets.
Cost is always a factor when looking at already over-stretched NHS budgets. Health on the High Street gives NHS Trusts a low-cost option to rapidly create extra capacity. Repurposing existing buildings can also reduce waste and cut carbon emissions. It also offers significant cost saving per square metre compared to new builds.
Vacant retail units are already close to community settings and could be rapidly and cost-effectively converted into excellent healthcare facilities, bringing patients closer to the care they need.
Rethinking the delivery of healthcare
In the post pandemic era, it is time to radically rethink the delivery of healthcare. Services need to be sustainably integrated into local communities to reduce reliance on hospitals and bring care closer to patients.
Health on the High Street has the potential to deliver this visionary transformation. Read more about the Health on the High Street model offered by Health Spaces.
