While local authorities 20 years ago understood that their vast property estate, which in some cases they were not even aware of, had a value, the penny has been slower to drop at NHS providers. Yet the running cost of the NHS-owned and occupied estate is its third largest cost after staff and medicines. As local authorities have already discovered, efficient use of property delivers both capital receipts and revenue. Better use of its estate means the NHS can reduce running costs, reconfigure property to better meet commissioning needs, share property with the wider public sector, especially local government, and generate capital receipts.

To kickstart understanding by hospital trusts about the value of the multi-billion pound NHS estate they occupy and maximising revenue, the Government created NHS Property Services (NHSPS) as a limited company in 2013, absorbing all the £3bn estate and 3,500 properties formerly owned by the primary care trusts in England which did not pass to hospitals and which represents 10% of the entire NHS estate. In its first two years the NHSPS, with an annual budget of £766m and controlling some 1,700 GP surgeries, claimed already to have saved £80m in property running costs, sold 160 surplus properties and released land for 2,000 homes.