The Adult Care Services Cabinet Panel of Hertfordshire County Council met on Wednesday, 3 June 2026, to discuss the development of nursing home provision in the county. The panel endorsed a new social investment model to increase nursing care capacity and approved its progression to implementation.

Development of Nursing Home Provision in Hertfordshire

The panel discussed the growing demand for nursing care in Hertfordshire, driven by an ageing population and an increase in complex needs, particularly dementia. It was highlighted that the county faces a projected shortfall of 839 nursing beds by 2032, leading to an £18 million annual cost pressure. To address this, the council has explored various options and identified a social investment model (SIM) as the preferred solution.

This model involves institutional investors funding and developing new nursing homes, with the council entering into long-term lease arrangements and sub-leasing the properties to care operators. This approach aims to attract socially focused investment, reduce the need for upfront public capital, and allow the council to retain strategic oversight of quality and affordability. The proposed programme would deliver between six and eight new nursing homes, creating approximately 600 additional beds, with 150 to 200 beds secured as affordable capacity for council-supported residents. The first homes are expected to open from 2028.

During the discussion, councillors raised questions about the rationale for changing the delivery model, the pace of development, the nature of the bed shortfall, and the design and ownership of the new facilities. Officers explained that the SIM model is a response to increased borrowing costs and construction inflation, making traditional council-led development less viable. They also clarified that the 839-bed shortfall refers to affordable beds that the council would need to fund. The design process will be a partnership, with the council having a strong influence to ensure homes are attractive and sustainable.

Concerns were also raised about the risks associated with the new model, including planning delays and provider failure. It was explained that developers would hold the planning risk, while the council would retain provider risk. The model aims to mitigate risks by allocating them to the party best placed to manage them.

The panel also discussed the importance of prevention and public health initiatives to promote healthier ageing and potentially reduce future demand for nursing care. Officers confirmed that the council is actively engaged in Connect and Prevent initiatives, which include promoting physical activity and supporting people to live independently for longer.

The panel was reassured that the social investment model has been designed to learn from past PFI schemes, particularly regarding maintenance and operational costs, by using straightforward lease agreements with fixed, inflation-linked payments.

Regarding the size of the homes, it was clarified that while the overall programme aims to deliver 600 beds across six to eight homes, individual homes would typically be around 75-80 beds, which is considered optimal for operational efficiency and quality of care, especially for residents with dementia. The 150-200 beds represent the total number of affordable beds the scheme would deliver.

The panel noted the opportunity presented by pension reforms, which are encouraging pension funds to invest in domestic infrastructure with social value.

Finally, the panel recommended to Cabinet that it:

• Agrees the social investment model as the preferred option for delivering additional nursing capacity.
• Approves the progression of the social investment model to implementation, including identifying investors and developers, and entering into necessary contractual and lease arrangements.
• Delegates authority to the Executive Director of Resources, in consultation with relevant executive members, to enter into these arrangements.
• Approves the inclusion of the Hitchin Road, Stevenage scheme in this approach.
• Notes the need to secure external resources for the scheme's delivery.

The next meeting of the Adult Care Services Cabinet Panel was scheduled for Thursday, 2 July 2026.