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NHS capital budgets 'must double' to £14.1bn

A new report has stressed the need to up investment in the estate

NHS capital budgets must double to £14.1bn if is to clear the building repairs backlog and overhaul the estate to enable greater productivity and faster patient care, according to a new report.

The report, Investing to save: The capital requirement for a more sustainable NHS in England,  - carried out by the NHS Confederation - looks at where the NHS is using capital investment to drive productivity, and makes the case for greater funding if the NHS is to meet stretching productivity targets of 2 per cent by 2030.

The report also outlines examples of capital projects which have been transformational for patient care and productivity, along with numerous case studies of proposed cost-effective, forward-thinking developments which have been delayed, hindered or scrapped due to the lack of initial funding needed to get them off the ground.

NHS leaders said “that increasing capital funding is their top financial priority ahead of the next election, alongside reform of how the capital regime operates.”

This amounts to 6.4bn in all three years of the next Spending Review to help the NHS address its £10.2 billion maintenance backlog, refurbish dilapidated buildings, upgrade equipment and turbocharge staff productivity. That would take annual NHS capital spending to £14.1 billion per year, compared to the current level of £7.7 billion.

The consequence otherwise will be long waiting lists and delayed care for patients, the report revealed.

Matthew Taylor, chief executive of the NHS Confederation said: “Some of our members have parts of their estate that are barely fit for the 19th century, let alone the 21st, so any future Secretary of State for Health and Social Care must make the physical and digital condition of the NHS a priority, if the health service is to reduce backlogs and get productivity levels to where the government want them to be.

“Lack of capital across different care settings, covering digital and physical infrastructure and mental and physical health, is clearly not just leading to missed opportunities to improve productivity, but actively undermining it and causing patient safety issues. Health leaders across England have endless ideas about how capital funding could drive large productivity increases.

“Equipping staff with the right tools, and allowing them to operate in safe, modern, optimised environments will improve efficiency, meaning that an increase to the capital budget will help limit the need for growth in revenue spend, relieve pressure on wider NHS finances and services, and put the NHS on the path to longer-term financial sustainability.

“This will require a significant increase to the NHS capital budget to make up for years of under-resourcing and repeated raids on capital that has left much of the estate broken. Based on the assessment of health leaders, this will need to be an increase of £6.4bn to take the capital budget to £14.1bn for each year of the next spending review in order to fully address the repairs backlog and realise some of the innovative transformation projects which have previously fallen by the wayside. The next government must grasp the nettle.”

Leaders across the country have many ideas to transform care and increase productivity should funding allow. However, issues in accessing capital funding, with processes often labyrinthine in nature, and lack of funds are delaying innovative plans for transformation.

But the NHS still doesn’t have a capital strategy and the next government must boost capital funding if the health service is to meet stretching productivity targets and become more financially sustainable, according to the report.

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