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In the UK healthcare sector, funding and provision of public care facilities has been primarily the responsibility of government through the National Health Service (NHS). After decades of under-investment and consequent effects on the quality of care, new procurement routes are currently being used to improve the standards of facilities to meet the requirements of modern care services. This paper critically reviews these new procurement routes in terms of concepts and suitable areas of application, and examines how the principal procurement methods have evolved into the forms used for UK healthcare facilities. The paper outlines recommendations for further research in assessing the suitability or otherwise of these new procurement methods, both for construction projects generally and specifically for healthcare facilities.

The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public‐private partnership to address the historical under‐investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices – ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public‐private partnerships is managed at the local level.

The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level.

Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured.

As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care.

To the authors’ knowledge this is the first study of the role of culture in mediating LIFT partnerships and the findings add to the evidence on public‐private partnerships in the NHS.

The purpose of this paper is to explore some of the challenges in putting government policy on the development of a new generation of primary health care centres into practice, at a time when a growing number of property companies are moving into the primary health care market.

The paper begins by outlining the government policy issues driving the development of primary health care centres, it describes the ways in which these centres are being developed and discusses some of the issues involved in putting government policy into practice.

The paper reveals that the government's plans to develop a new generation of primary health care centres have provoked considerable controversy and it explores five sets of issues, namely the quality of health care; location and accessibility; economies of scale and cost savings; the changing balance of public and private sector provision; and impacts within the wider urban environment.

The paper provides an accessible review of the debate surrounding the development of primary health care centres and as such it will be of interest to those working in, engaging with, and studying the primary health care property market.

The purpose of this paper is to examine the accounting and governance of public private partnerships (PPPs) that are structured as joint venture partnerships. Drawing on Giddens’ structuration theory, the paper examines how human agents interact with these joint venture structures and analyses the effects on financial disclosures and public accountability for taxpayers’ investments.

The authors adopt a cross-case analysis to investigate two such PPP schemes, which form part of the UK’s programme of investment in primary healthcare, known as the Local Improvement Finance Trust (LIFT) policy. The authors employ a combination of interviews and analysis of financial statements and publicly available official documents.

The corporate structure of these LIFT schemes is very complicated so that the financial accounting is opaque. The implication is that the joint venture mechanism cannot be relied upon to deliver transparency of reporting. The paper argues that the LIFT structures are deliberately constructed by human agents to act as barriers to transparency about public expenditure.

The financial reporting undermines public accountability and transparency as both are necessarily restricted. Policy makers should pay attention to not only the private sector technologies but also the manner in which structures are used to reduce transparency and consequently undermine public accountability.

The paper provides detailed analysis from the perspective of structuration theory to show how human agents use structures to impact on financial reporting and public accountability.

This paper aims to examine whether the UK Local Improvement Finance Trust (LIFT) procurement strategy supports the delivery of facilities for improved primary and social care services that meet local needs while providing value for money.

The research employed a qualitative approach (case study), involving semi‐structured interviews with senior managers involved in three LIFT schemes.

The investigations revealed significant differences in the maturity levels of the schemes evaluated in terms of systems, processes and structures used in the planning and implementation of the schemes. Although there is potential for further improvements, the pattern of progress made generally confirmed an evolving system, with considerable evidence of performance improvement from project‐to‐project.

This evaluation involved only three LIFT schemes and thus utmost caution should be taken in generalising the results. In addition, the evaluations were limited to project management perspectives related to the built environment component and did not delve into clinical aspects.

The paper identified both good practices (that could be transferred across schemes and between projects) and poor practices (that require improvements) from the schemes evaluated.

Although potential ways for securing further long‐term improvements and sustained value for money were highlighted, this paper provides prima facie evidence that the LIFT initiative is delivering the expected economies of scale in providing modern facilities for the provision of integrated primary and social care services.

Public–private joint ventures (PPJVs) have a stronger partnership element than standard public–private partnerships (PPPs) but PPJVs are under-researched despite this important partnership element. This article derives knowledge of incentives and barriers to goal alignment in healthcare PPJVs.

An in-depth case study of the UK’s Local Improvement Finance Trust (LIFT) model including three PPJVs and 34 individual projects was conducted.

The main economic incentives are future opportunities creating a strong shadow of the future. This is supplemented by social incentives such as the ability to have a social impact. Enlarging the shadow of the future can encourage both parties to think long-term, avoiding short-term opportunism.

PPJV is a promising model for partnership. However, complexity through fragmented public sector partners and the financial structure can create barriers for goal alignment.

This study challenges earlier research studies based on PPJV by providing evidence that the long-term nature of PPJV, especially the potential of new projects, enables the public sector to get more engagement from the private sector.

The purpose of this paper is to evaluate the addition of a “resilience-focused” Cognitive Behavioural Therapy (CBT)-based psycho-educational course for asylum seekers within a primary care Increasing Access to Psychological Therapy (IAPT) service.

Eight asylum seekers who attended the “Healthy Minds” psycho-educational course took part in semi-structured interviews. Interviews were transcribed verbatim and analysed using thematic analysis to gain insight into participants’ experiences of attending the course.

Five main themes emerged: factors promoting engagement; acquiring coping skills; connecting with personal strengths; connecting with others; and future support. Overall, positive feedback from the course participants suggests that the intervention was effective and well received.

The sample’s heterogeneity and size, as well as potential biases, limit the generalisability of the findings. Future research is therefore needed to confirm these findings and additional areas for further enquiry are considered.

The group-based intervention provided a cost-effective and culturally relevant means of promoting social inclusion, whilst disseminating psycho-educational material.

Good practice in this area is important and timely. The success of this intervention indicates that future collaborations between IAPT services and community organisations which support people seeking asylum, should be explored.

This study is valuable as it demonstrates that a non-specialist IAPT service has the ability to provide an effective low intensity psycho-educational intervention for people seeking asylum.

The UK Government has now adopted Private Finance Initiative (PFI) as a major vehicle for the delivery of additional resources to the health sector in order to achieve a greater investment in healthcare facilities. The purpose of this paper is to examine the trends and risk assessment of the PFI in the healthcare sector.

The paper employed secondary data and interviews of key participants in two hospital PFI projects to highlight developments in healthcare PFI and the risk management of hospital projects.

The results show that the use of PFI in the provision of healthcare is increasing in terms of number, capital value and size of projects. What emerged in the healthcare PFI project was a usage of a plethora of risk management techniques, albeit to varying degrees. Experience appeared to be the prime risk assessment technique employed, while risk avoidance was first explored before pricing and allocating any residual risks. “Risk prompts”, such as using checklists and risk registers were also useful in the identification of risks. Among all participants, insurance cover and sub‐contracting appear to be the most prominent strategies employed for managing out the risks.

The negotiations that precede the signing of a healthcare PFI project contract had an impact on the final choice of facilities or their specifications. The two contracting parties sought a balance between an optimal allocation of risks, choice of facilities and project price. Although the risk management techniques being used are generic in nature, there is still no evidence at the moment to show that these are appropriate for PFI projects. It is important that further investigation is undertaken to assess the level of current skills in risk management techniques to deal with PFI projects and the extent to which these techniques are appropriate to tackle complex healthcare PFI projects.