A new survey released today by NHS Providers found that 82% (161) of NHS trust leaders think the current climate of restricted capital funding poses a medium or high risk to patient safety, and could undermine plans to transform the NHS.

Despite the prime minister’s welcome commitment to allow the NHS to spend an additional £1.8bn, the survey reveals the scale of the challenge of NHS capital funding that still exists, and the direct impact this has on everyone who relies on the health service.

82% (161) of NHS trust leaders think that the current climate of restricted capital funding poses a medium or high risk to patient safety.

   

The survey also reveals: 

• 97% of respondents are worried about their trust’s requirement for capital investment
• 94% are concerned that it is affecting patients’ experience of care
• 92% think that the restricted capital environment is impacting on staff wellbeing and recruitment.

The findings also highlight deep and widespread concerns over the impact of capital constraints on the ability of the NHS – along with local partners - to transform and modernise the way services are delivered, as set out in the recent long term plan. 97% of trust leaders said these programmes were at risk.

The NHS’ annual capital budget is now less than its £6bn backlog maintenance bill -which is growing by 10% a year.

   

The survey is launched as part of a new campaign by NHS Providers calling on the government to address the challenge of NHS capital funding in the forthcoming spending round. The campaign will seek to highlight that the PM’s recent capital announcement can only be considered a first down payment on the NHS’s needs. As a nation, we are now spending less than half the amount on health capital than comparable countries.

The NHS’ annual capital budget is now less than its £6bn backlog maintenance bill (which is growing by 10% a year), meaning that issues like leaking roofs and broken boilers, ligature points in mental health facilities and outdated technology cannot be fully addressed – even before any investment can be made in new buildings and services. Per head of population, we have fewer CT scanners than Slovenia, the Russian Federation, Turkey, and the Czech and Slovak Republics, and less than half the number you will find in Latvia, Greece and Iceland.

Specific examples of the impact of the capital shortfall include: 

• The emergency department at Kettering General Hospital NHS Foundation Trust is now seeing three times as many patients per day as it was built to treat safely. The care of children, adults and elderly people is currently being compromised by the cramped and crowded facilities.  The trust needs up to £50m to build an up-to-date urgent care hub. However, it has no access to capital from either public or private funding sources.

• At University Hospitals of Leicester NHS Trust, currently a three hospital site trust, they plan to consolidate  acute clinical  services onto two acute sites; re-purposing the third site to provide community based NHS facilities. This includes the urgent requirement to invest in a newly combined  maternity and neo-natal hospital offering midwifery and obstetric-led care. This will allow UHL to provide safe high quality care for mothers and babies by creating a sustainable staffing model, negating the need for staff to work across two sites. Patient experience will be substantially improved as care will be delivered in modern fit for purpose facilities that have been designed with privacy and dignity in mind. The new single site configuration will remove the need for mothers and babies to be transferred and cared for across two sites.
• A substandard layout at the Abraham Cowley Unit in Chertsey, run by Surrey and Borders Partnership NHS Foundation Trust, means the Trust has to implement more restrictive practices to maintain safety. The Trust has been unable to eliminate antiquated dormitory wards and patients, some of whom may be detained against their wishes, still have to sleep in a room with strangers who may also be agitated or suicidal.

Commenting, our chief executive Chris Hopson said: “We need to rebuild our NHS, and give our doctors and nurses the tools to create the 21st century health service that patients expect and that we can all be proud of.”

NHS Providers calls for three steps to be taken by the government:

1. Set a multiyear NHS capital funding settlement
2. Commit to bringing the NHS’ capital budget into line with comparable countries
3. Establish an efficient and effective mechanism for prioritising, accessing and spending NHS capital based on need

We need to rebuild our NHS, and give our doctors and nurses the tools to create the 21st century health service that patients expect and that we can all be proud of.

Commenting further, Chris Hopson said: “We know the Government shares our aim of a properly-funded and well-designed system of capital funding, but this support now needs to be translated into urgent action, because the risk to patients is rising every day.”

Read an article from NHS Providers chief executive Chris Hopson setting out why it's time to rebuild the NHS and create a modern health service.