Capital is a scarce resource in the NHS, yet high in demand. Existing estates are deteriorating, creating a potentially unsafe and uninviting environment for patients and staff. So how does the NHS meet current demands, accommodate changing needs and continue to reduce backlogs in care, whilst providing outstanding patient care?
Exploring innovative solutions to funding improvements to NHS estates was the subject of a recent webinar hosted by the NHS Confederation in partnership with Darwin Group.
The key points and recommendations that resulted from this webinar are summarised here. For more detail, have a look at the long read.
Key points:
• The lack of capital is making it harder to improve NHS productivity and affects both patient care and staff morale. But there are ways in which Trusts and Integrated Care Boards can improve estates, through collaborative working and innovative ways of accessing funding.
• While the pandemic was a difficult time for the NHS in many ways, it had a transformative yet temporary effect on estates planning. The short timescales involved to make major changes in infrastructure led to using frameworks with direct awards or mini competitions.
• An ongoing challenge for the NHS is the Government’s tight control of annual capital spending (CDEL). The limits on this mean that even Trusts with money in the bank cannot spend it on capital projects. While there will always be a place for traditional capital projects, this does mean Trusts are having to look at different ways of delivering much-needed improvements.
Key questions for NHS Trust Boards to consider:
• Are you ensuring you are in the best position to access any capital that suddenly becomes available, perhaps with worked-up plans supported by your ICB?
• Are you working with local authorities to identify potential shared space and talking about whether any section106 money could support health priorities?
• Have you recently audited the use of space in your facilities and looked at whether it could be used more productively?
• Looking forward, have you mapped your clinical strategy against your buildings and considered any changes that might be required, and how more digitally-delivered services might affect the estate you need?
• Do you regularly look at revenue-raising ideas using space within your Trust?
• Are there opportunities to develop projects in a way which does not require capital, such as managed service agreements?
