Is the local improvement finance trust (LIFT) procurement initiative delivering the expected economies of scale? Results from three case studies

The UK Department of Health (DoH) introduced the Local Improvement Finance Trust (LIFT) initiative in 2000 to reverse the declining state of primary healthcare facilities. The initiative involves partnerships between diverse organisations from public and private sectors working together to deliver improvements in facilities that will be suitable for modern primary and social care services. However, recent evaluations of the performance of some schemes under the initiative show mixed results. This paper examines three LIFT case studies to investigate whether the LIFT procurement strategy supports the delivery of facilities for improved primary and social care services that meet local needs whilst providing value for money. The investigations, which involved senior managers, revealed significant differences in the maturity levels of the schemes evaluated in terms of appropriate systems, processes and structures in the planning and implementation of the schemes. Although there is potential for more improvements, the pattern of progress made generally confirmed an evolving system, with considerable evidence of performance improvement from project-to-project. Whilst suggesting some potential ways for securing long-term improvements and sustained value for money, this paper concludes that there is considerable 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.