Requesting transfers of NHS property – What NHS trusts and ICBs need to know

Why the transfer opportunity matters

The 2026 guidance emphasises that enabling local providers to hold the estate from which they deliver care can support:

• Local decision‑making and delivery, aligning estate ownership with service need
• Productivity and efficiency, placing assets with the organisation best positioned to invest and use them effectively
• The government’s 10‑Year Health Plan, which encourages neighbourhood‑level, integrated, preventative care
• Value for money, ensuring surplus or short‑life assets can be released appropriately

By aligning ownership more closely with clinical delivery organisations, ICBs can strengthen system planning and ensure the NHS estate is used as a strategic enabler for modernised, integrated care.

Scope of the policy

The guidance clarifies that:

• Only NHS trusts and foundation trusts may receive transfers
• Subsidiaries of trusts are not eligible as transferees, although a receiving trust may subsequently transfer assets to a wholly owned subsidiary in line with NHS England rules
• Transfers apply only to property currently owned by NHS Property Services (NHSPS)

This keeps the process focused on property inherited from the former Primary Care Trust (PCT) estate following the 2013 reforms.

Principles underpinning transfer decisions

The updated policy reaffirms the core principles originally set out during the 2013 reforms. These principles guide assessments of any request:

Protecting assets & maintaining flexibility: Ownership must:

• Keep estate available for NHS service provision
• Allow flexibility for future service model or provider changes

Ensuring efficiency: Properties should be held by the organisation with the strongest incentive to:

• Use them effectively
• Invest in their development

Safe, fit‑for‑purpose estate: The estate must remain safe, secure and compliant, supporting high‑quality care environments.

Value for money: Organisations must identify surplus or short‑life assets and make them available for disposal when appropriate.

Effective estate management: This includes:

• Meeting statutory inspection obligations
• Proper management of third‑party occupiers
• Responsible cost management
• Using the estate as an enabler for modern service delivery

These principles ensure that transfers support wider system strategy and do not undermine long‑term estate flexibility.

The process for requesting a transfer

The guidance introduces a structured process for ICBs and trusts:

Local system alignment through ICBs: ICBs play a central role in ensuring that:

• Transfer requests are aligned with system‑wide estate strategies
• Decisions reflect long‑term service planning, clinical strategies, and productivity goals.

Trust‑led application: Eligible trusts can initiate a request by:

• Preparing a clear strategic case for transfer
• Demonstrating how ownership would improve estate utilisation, service delivery, or system value for money
• Confirming alignment with the ICB’s integrated care strategy and local estates plan

Assessment criteria: Applications will be reviewed against:

• Contribution to strategic estates planning
• Capacity to maintain and invest in the asset
• Compliance with the principles of safe, effective, flexible estate management
• The system‑wide impact across the ICB footprint

Transfer arrangement and legal process: Once approved, the policy sets out expectations for:

• Transfer mechanisms (typically freehold or long lease)
• Required legal documentation
• Alignment with NHS England guidance on subsidiaries (where relevant)

Although detail sits within the full DHSC guidance, the overriding intent is to ensure transfers proceed smoothly while safeguarding public value.

What this means for ICBs and trusts

The guidance presents a meaningful opportunity for systems to:

• Strengthen local autonomy over critical estate assets
• Improve estate optimisation by placing assets with those best positioned to use them
• Accelerate neighbourhood‑level integration, supporting modernised models of care
• Unlock investment, where local providers are better able to commit capital than a national landlord
• Enhance long‑term estate sustainability, aligned to service transformation ambitions

Given the significant operational and strategic implications of estate ownership, ICBs should ensure that transfer opportunities are evaluated as part of broader system estate planning.

Conclusion

The 2026 guidance provides a clearer, more strategic route for NHS trusts to request the transfer of property from NHSPS, underpinned by consistent national principles and local ICB oversight. For trusts and ICBs seeking to modernise estates, integrate services, and deliver more productive care environments, the transfer policy represents a timely and supportive opportunity.

If you would like to discuss what is likely to be required for a particular site (or portfolio) and the likely “pinch points” (for example, title, occupiers, compliance, liabilities), we can provide an initial scoping call and a checklist aligned to the DHSC approach.