• when preparing business cases for LIFT projects, Primary Care Trusts should compare the cost of LIFT to the costs of alternative procurement routes, and make explicit the implications for spending on other primary care facilities;
• where Primary Care Trusts are paying substantial subsidies to make LIFT affordable to other organisations, there should be a business case to support the value of the subsidy; the expected benefits should also be made transparent;
• the department and Partnerships for Health should work quickly and publicise the underlying mechanism and methods so that a meaningful quantitative evaluation of the value for money of LIFT and its schemes can be made;
• in light of the experience in the local LIFT area, strategic partnering boards in consultation with the LIFTCo should set cost reduction targets for new projects, and there should be an annual review of progress against targets once buildings are operational;
• since there is no threshold level for minor building alterations in the standard LIFT contract, some tenants are frustrated that they cannot procure minor alterations without prior consent and without going through a time consuming and bureaucratic process. Partnerships for Health should consult with the private sector partners and agree on reasonable threshold levels;
• location and access issues should be given priority by Primary Care Trusts who should liaise with other relevant parties; and
• Partnerships for Health should help Primary Care Trusts and local authorities (where relevant) develop a framework for appraising the effectiveness of boards.