You'll be aware that the government has a programme to improve local healthcare buildings. But did you know that smart developers and councils are using it to catalyse the wholesale regeneration of rundown areas?
"That piece of land is a dog toilet. The council will sell it to us for a pound." Richard Carlowe is pointing at a scruffy green space in St Helens, Merseyside. "At night the junkies move in," he adds. "A four-year-old found a hypodermic needle there recently."

This unpromising patch of land is in the middle of a rundown district centred around Duke Street and St Mary's Lowe House Church. Rubbish-strewn public spaces and neglected buildings form the backdrop for those living in the area. Duke Street used to be a thriving shopping area but most customers have long since abandoned it for the warmth and convenience of nearby malls.

Carlowe, though, is full of enthusiasm about the district he calls the "western gateway" to St Helens. Within five years he predicts the area will be have restaurants, apartment blocks and a hotel. Carlowe is a bid manager for William Pears, a property developer that aims to regenerate urban land using the NHS' Local Improvement Finance Trusts to prime the pump.

The LIFT money has been earmarked by the government to build and refurbish "primary care centres" – local clinics and doctors' surgeries. The idea is to use it to leverage extra funds from the private sector, regional development agencies and the European Union. If the project team pulls it off, the strategy could form the blueprint for LIFT regeneration across the UK (see "Going up", right).

In November last year, the William Pears LIFT Partnership was picked as preferred bidder for the redevelopment of primary care premises in St Helens and three other boroughs in the North-west: Knowsley, Halton and Warrington (there is a more detailed look at the Knowsley scheme over the page). The William Pears team includes EC Harris, which is masterplanning the site, contractor AWG and property consultant King Sturge.

What set apart William Pears' bid from its six rivals was that it had a property developer on board. "Pears had a wider view of what could be generated from a LIFT, and the ability to regenerate is vitally important to St Helens," says Jon Hinchliff, procurement project manager at Hornagold & Hills, the management consultant that helped to pick the winners for St Helens, Knowsley, Halton and Warrington.

The brief for St Helens was to rebuild the primary care facilities at Lingholme, which comprises a jumble of Victorian buildings. Pears said the site was too small and instead suggested a purpose-built health centre 200 yards down the hill in Duke Street.

Howard Forster, partner and head of health at EC Harris, says that there are drawbacks to refurbishing existing health buildings, since they do not comply with the Disability Discrimination Act – due to come into force on 1 October – and are not built to current health standards. By building facilities from scratch, the NHS LIFT will be able to avoid the costly refurbishments necessary to bring the buildings up to the new standards. Forster – who was a health estates manager for 15 years and has a keen understanding of the NHS' primary care requirements – says the larger site will accommodate more GPs, and enable more primary care services to be housed in one place. This tallies nicely with the NHS' current thinking: "The NHS plan is to create a one-stop shop of primary care facilities," says Forster.

The potential of the Duke Street site was quickly apparent. There is an old school on the site, now a nursery and daycare centre, which has a huge unused car park where the William Pears team realised a primary care facility could be built. The team was lucky, as 90% of the 14 ha site was owned by the Archdiocese of Liverpool, which was keen to put the land to better use. William Pears, King Sturge and masterplanner EC Harris decided that a site overlooking St Mary's church garden would be ideal for an apartment block, and that a new hotel on the edge of the site, near shops and restaurants, would help attract visitors.

The LIFT has effectively brought forward the redevelopment of the area by five years

Marc Cole, St Helens council

St Mary's church will also benefit from the scheme. It will share in any uplift in property values through higher rents, or by selling land that has risen in value. And the partnership has promised to redecorate the front of the church and fix its bells.

St Helens council has worked with the partnership to develop a masterplan for the area, and it hopes to pull in funding to improve the public environment around Duke Street. The prime targets for funds are the Northwest Regional Development Agency and the EU Objective 1, a programme that helps Europe's poorest areas to regenerate their economies. Once improvements are in place, Cole hopes to attract restaurants and leisure outlets to Duke Street, and fill the void left by the shrinking retail sector. "The LIFT has effectively brought forward the redevelopment of the area by five years," says Marc Cole, the council's head of regeneration.

With the church and council being the only major landowners, site assembly was relatively straightforward. In more complex circumstances, Carlowe says that the 12-week bid time in the LIFT would make it difficult to be innovative.

"The bid time inhibits thinking outside the envelope," he says.

According to EC Harris' Forster, the building and masterplanning of a LIFT can trigger a wider reorganisation of public facilities. "It's an unprecedented opportunity to bring services together," he says. "The public sector bodies will get their Ordnance Survey maps out to align property and services strategies, which will create synergies. It gives the local authority a chance to think about its existing stock."

In St Helens, the LIFT process has led to a rethinking of the position of the Mersey Regional Ambulance Service NHS Trust. Non-executive director Sylvia Hikins says that old ambulance stations are no longer situated where they should be, such as near motorways. "This is why you see ambulances in McDonald's car parks," she says.

By including the Ambulance Service in the strategic overview of assets, EC Harris will be able to identify the most appropriate sites for ambulance stations and make the most of the assets they no longer need.

Forster thinks the partnership between the public and private sector is ideally suited to maximising benefit from blighted land. The inclusion of a property developer on the LIFT means the project is also more likely to have a long-term value. "William Pears' real interest is in the residual value of property, and this means looking beyond the 25 years of the LIFT," he says.

Going up: How Local Improvement Finance Trusts work

LIFTs are public–private partnerships set up by the government to allow NHS Primary Care Trusts and their local partner organisations to redevelop their primary care facilities through PPPs. LIFT hopes to spend £1bn on health facilities, with the most spending focused on inner city areas, which have a disproportionately high number of sub-standard premises.

The 42 LIFTs established will own the primary care facilities and rent accommodation to GPs and other health bodies such as dentists and opticians on a lease basis. One of the goals of LIFT is to provide as many services in one place as possible, which means building new purpose-built centres.

At the moment nearly half of all primary care facilities in the UK are situated in converted homes or shops – only 40% are purpose built.

The St Helens, Knowsley, Halton and Warrington LIFT will invest £125m in primary care estates over the next 20 years. This LIFT is particularly complex because of the large number of partners involved, which include four PCTs, four local councils, and the Merseyside Regional Ambulance Service NHS Trust.

The first two schemes will be the development of the Widnes Health Care Resource Centre in Halton and the Tower Hill Primary Care Resource Centre in Knowsley. Work on the Duke Street scheme in St Helens will start in May, and is expected to be completed within 18 months.

Under siege: A primary care centre in Knowsley

The repositioning of the Tower Hill Primary Care Resource Centre in Knowsley is a good example of how LIFT prompts wider regeneration. The existing GP centre lies in the middle of a scrub of desolate parkland where three tower blocks once stood. A sorry-looking pub is now its only neighbour, and barbed wire fortifications make the centre look uninviting.

EC Harris’ first instinct was to relocate the centre closer to the Knowsley community.

The William Pears team soon found the site they wanted at nearby Ravenscroft School. “Ravenscroft has a fantastic ownership of the local community,” says EC Harris’ Howard Forster, who was keen to tap into the school’s positive reputation.

The project team’s design, by jmarchitects is for a new primary care centre linked to the school by a piazza (shown as CAD images in the pictures to the right). In addition to GP surgeries, it is likely to include a minor treatment centre, pharmacy and community centre. A Surestart nursery will also be incorporated into the main school building.

The site assembly was complex and involved a close liaison with the community and the local authority leisure services and education authority. The project will also involve the relocation of an existing playing field, where the centre will be built, and the provision of an all-weather football pitch. As a result, Sport England was brought into the process.

“We are bringing the concept of partnership to site assembly, with the goal of creating a campus that will enhance services for the school and local community,” says Forster.

The integrated approach to planning means that “the end result is greater than the sum of its parts”.