Ownership of Savernake Hospital to change again - what will this mean for its future?
In the early months of 2017 the long history of Savernake Hospital will take another step forward - perhaps a rather shaky step.
In small print at the end of the NHS Sustainability and Transformation Plan (STP) for the area that includes the Marlborough, you can read the county 'Roadmap' for NHS Infrastructure in 2017-2018.
It includes the first public news of a change that will affect the future of Savernake Hospital. It states: "Wiltshire community estate to NHSPS."
NHSPS is the national NHS Property Services Limited - once known as ‘PropCo’ a name that is easier on the eye than a string of letters.
This company "...manages, maintains and improves 3,500 properties, working with NHS organisations to create safe, efficient, sustainable and modern healthcare and working environments."
PropCo will be taking over all ten of Wiltshire's community health buildings. They include Chippenham Hospital (which accounts for a quarter of the county's NHS community assets), Devizes Hospital (which is 70 per cent mothballed) and Marlborough's Savernake Hospital (which is full and very active.)
Wiltshire's NHS community buildings used to be owned by the Primary Care Trust (PCT). When they had to stop providing community health care, the properties - including Savernake Hospital - passed into the ownership of Great Western Hospital as holders of the new contract to provide community services.
When GWH wanted to sell some of the redundant buildings which are costing them large sums of money to keep secure and in good order, the Department of Health said they could not sell them and ordered them to hand the whole community healthcare estate' over to PropCo.
PropCo began operating in April 2013. It was set up as part of the Lansley reorganisation of the NHS. It is a limited company wholly owned by the Health Secretary.
It was designed to become self-sufficient within three years. And, as with everything public that can stand on its own two feet, it was a target for eventual privatisation.
To reach that point, the Treasury decreed that it should charge the NHS 'commercial rents' for its buildings. We understand that some rents on properties in the area taken over by PropCo have been increased by well over 100 per cent - putting further strain on local NHS finances.
This handover has been delayed because PropCo wanted the buildings and grounds put in order (even if they were empty and would soon be sold off.) As GWH's capital budget has already been hit by essential savings, there are still issues to be resolved before the handover can be completed.
It is being said that PropCo are not very interested in the 'soft' parts of the buildings - mainly the shops and cafés some of them contain. This puts the future of Chippenham's popular Grapevine Café and the café and shop at Savernake Hospital in doubt.
This take over seems to go directly against localism. Some of these buildings were built partly by subscription and have over the years had a great deal of community and volunteer input to keep them going. Now their value is being removed from their communities.
There is apparently no reassurance that the money PropCo will make from the properties - in terms of rents and sales - will be re-invested back into Wiltshire communities.
Savernake Hospital opened in 1866 and, like all cottage hospitals that still exist, has evolved greatly over the years. It currently offers a wide variety of clinics and outpatient services, as well as GWH's 30-bed Ailesbury Unit (which has developed from its status as a 'step-down' ward for patients leaving treatment at GWH), the Cotswold House eating disorders unit, and the Prospect Hospice outpatient centre.
Savernake Hospital was redeveloped and modernised under a Private Finance Agreement (PFI) contract in 2004. The PFI contract lasts until 2035 and currently costs GWH one million pounds a year in finance and maintenance charges.
One theory Marlborough.News has heard is that - ironically - Savernake's much criticised PFI contract could be its 'saving grace'. It would be very difficult for PropCo to sell the hospital while it is subject to these large annual PFI payments.
However, it is unclear whether PropCo would renew the 'peppercorn rent' GWH is charging Prospect Hospice for its outpatient centre at Savernake Hospital. 'Peppercorn rents' have to be reviewed after three years.
Wiltshire is not alone in this sort of transfer. This month PropCo completed the transfer of the freeholds of 12 community hospitals in Devon. The PropCo website says of that transfer: "Leases to regularise occupation are currently being finalised".