Case Study – GMPF & BlackRock Primary Healthcare Health & Wellbeing Assessments

Evolving public health context

The national public health picture in the UK is dominated by an entrenched and widening gap in healthy life expectancy, with individuals in the most deprived areas living nearly two decades fewer in good health than those in affluent areas. Key trends reveal that in the aftermath of the pandemic, rising premature mortality from cardiovascular diseases, and growing NHS waiting lists disproportionately burden disadvantaged communities. At the heart of these issues are structural inequalities, where poor outcomes are driven by wider determinants like substandard housing, poverty, and unequal healthcare access based on geography, socioeconomic background and ethnicity.

The national healthcare strategy responds to this with a radical shift from a reactive “sickness service” model to a proactive model that prioritises early prevention and community-based intervention. This transformation redirects resources from overstretched acute hospitals toward localised care networks, such as Neighbourhood Health Centres, to manage long-term conditions before they escalate. By tackling the wider social and environmental determinants of health directly within communities, this approach aims to reduce emergency admissions and sustainably close the healthy life expectancy gap. The pivotal Marmot Review underpins this preventative shift by demonstrating that tackling the social determinants of health, such as early years development, education, fair employment, poor-quality housing, air pollution and a lack of green spaces, is critical to reducing the steep social gradient in health inequalities.

The government’s 10-Year Health Plan for England establishes a foundational “left shift” to radically relocate the core of healthcare delivery out of overstretched acute hospitals and directly into local communities. By shifting capital and resources toward primary care and multidisciplinary health centres located in the community, the policy aims to manage chronic conditions closer to patients’ homes before they escalate into emergencies. This strategic pivot treats the community as the first line of defence, transforming hospitals from default entry points into specialised treatment centres reserved strictly for acute, complex care.

Role of place-based institutional investment

Institutional capital has a critical role to play in unlocking the “left shift” by helping to provide the vast funding required to develop the primary care hubs, neighbourhood health centres, and supporting community infrastructure that the public sector cannot finance alone. This capital injection is increasingly driven by the rise of place-based investment, where pension funds and institutional investors deploy capital into localised real estate and regeneration projects to generate measurable social impact alongside financial returns. In doing so, place-based investment activities are able to unlock the ‘triple place dividend’, whereby benefits are generated for investors, cities and communities. This momentum is accelerated by the Mansion House Reforms, which unlock billions in domestic pension assets for unlisted equities and productive infrastructure, directly enabling long-term investment into healthier built environments. This represents a particular opportunity for the Local Government Pension Scheme (LGPS) sector, especially in the context of local pension reform where pooling and consolidation is creating “megafunds” with the scale to act as sophisticated domestic investors. LGPS administering authorities are increasingly setting local investment targets, allowing them to deploy capital into place-based investments such as health infrastructure that simultaneously delivers secure, long-term returns and addresses the specific public health needs of their own communities.

The importance of taking an evidence-based approach is central to ensuring that the deployment of institutional capital is delivered in a way that responds to the specific needs of local communities. Investment can be targeted in places with the greatest need, where it can achieve the highest social return on investment by directly narrowing the local healthy life expectancy gap. A successful investment strategy therefore depends on moving beyond generic asset allocation toward highly targeted approaches that respond to the specific demographic and epidemiological profiles of high-need areas. By aligning capital with the granular socioeconomic requirements of local communities, investors can mitigate vacancy risks and ensure long-term social contribution by embedding their assets within the essential public health infrastructure of the most underserved markets.

A place-led approach to wider case making

In March 2026, Greater Manchester Pension Fund (GMPF) launched a joint venture with BlackRock, targeting an initial £1bn portfolio of NHS-backed primary healthcare assets, driving major long-term investment into the real estate underpinning the UK’s frontline healthcare service. The partnership will mobilise private capital to invest in purpose-built GP and primary care facilities across the nation, helping modernise practices, expand capacity and improve access to healthcare services in local communities.

The Hillbreak Place Advisory team recently supported the partnership with an evidence-based socio-economic, health & wellbeing assessment for two proposed primary health centre developments in Manchester. The high need locations sit within a particular strategic and political context in Greater Manchester, requiring a wider approach to case-making that can reach a broader set of stakeholder audiences, both within and outside the NHS.

Hillbreak produced a robust evidence base of local socio-economic, health and wellbeing needs and opportunities for each development opportunity using an overarching set of themes including local healthcare provision, local health outcomes, demographic profile and wider social determinants of health. The assessments provide high level executive summaries suitable for a wide range of audiences, helping to articulate the local and strategic needs for a health care centre in each location.

The reports recognise that Greater Manchester’s population growth and long-standing health inequalities are exacerbating the existing strain on the city region’s hospitals. The subject sites experience localised health and wellbeing challenges making them key locations to address regional and national priorities to improve access to primary care and improve early detection and prevention.

Key findings include:

• Health Outcomes Gap – strained local services in both wards with fewer GPs per patient, exacerbated by long-standing health inequalities and local populations experiencing significantly worse health outcomes, high rates of emergency hospital admissions and an average life expectancy significantly below the national average.
• Diverse & Vulnerable Communities – both locations are areas of longstanding deprivation and have a high proportion of residents from minority communities (including Disabled, BAME, LGBTQ and Gypsy, Roma and Traveller residents), those who do not have English as a first language and residents living in social housing.
• Start Well Mission – high proportions of children and young people with acute health challenges make both sites priority areas to deliver on ambitions to provide the best start in life for Manchester’s children.
• Population Growth – the trend of high population growth over the last 10 years will continue in both areas, spurred on by planned major local developments.

The partnership between GMPF and BlackRock, supported by Hillbreak’s targeted local needs assessments, provides a powerful blueprint for the future of UK healthcare infrastructure. By aligning institutional capital with granular, local socio-economic data, place-based investment ceases to be just about funding real estate; it becomes a precise mechanism for tackling deep-rooted health inequalities and enabling the NHS’s critical “left shift” toward preventative care.

Ultimately, this evidence-based approach helps to link the delivery of resilient financial returns alongside measurable social impact. By investing directly in the health and resilience of underserved communities, institutional investors can secure stable, long-term assets while helping to close the nation’s healthy life expectancy gap. This model serves as a powerful example of how the triple place dividend can be approached in practical terms, delivering benefits for investors, cities and local communities.