Exclusive: NHS still waiting for over £1bn capital funding announced five years ago

The government announced almost £3bn  in capital funding to upgrade NHS estates and services in four waves during 2017 and 2018. This was before the pledge to build 40 “new hospitals” by 2030, which has since largely dominated decisions about NHS capital investment.

HSJ  looked at the progress of the 143 schemes, worth a total of £2.7bn, known to have been included in the “sustainability and transformation partnership” capital funding programmes. STPs were the forerunners of integrated care systems.

Only £1.2bn has been given to the organisations involved, and over a fifth of live schemes – which range from emergency department upgrades to new primary care hubs – have not received any allocated funds to date. 

A number of projects have been put “on pause” by the national team, while others have been scrapped. The projects which are still live have all seen projected costs increase significantly. Many projects are waiting to have business cases approved.

Breakdown of progress of 2017 and 2018 capital projects

HSJ obtained the information through trusts or government financial records, covering 139 out of 143 schemes. But even if the four outstanding schemes had received their full allocation, which remains unconfirmed, only 46 per cent of the allocated funding would have been received.

A state of disrepair

Hannah Coffey, the acting chief executive of Mid and South Essex Foundation Trust, which is leading one of the largest “STP” schemes, said: “We are still awaiting £110m from the Department of Health and Social Care.”

She said until this funding is received, the trust cannot carry out some of the capital build works needed to progress expansion and modernisation plans, including expanding Southend Hospital and supporting clinical reconfiguration to provide services as a single team across the region. 

The largest scheme, a much-delayed £300m service overhaul at Shrewsbury and Telford Hospitals Trust, confirmed just £4.5m had been received. However, its plans did secure a key approval last year.

The former head of a pathology merger in Lancashire told HSJ  their scheme had effectively been dropped  due to uncertainties over funding, despite officially still awaiting money.

At least 10 projects allocated STP capital funding were not taken forward. This includes the relocation of child and adolescent mental health services Tier 4 beds at Berkshire Healthcare FT, which was scrapped due to an increased focus on community care.

Several schemes have been scaled back from the initial funding allocation or are under review. 

Leeds and York Partnership FT said its complex rehabilitation programme was among those paused by NHS England and recently given the go ahead. The trust said it was now “exploring options” while taking rising building costs and inflation into consideration. 

The DHSC said a pause on schemes was in place while it reviewed outcomes from the spending review in 2022 and had recently been lifted. It did not answer questions on how many schemes were affected and for how long.

Sarah Walter, director of the ICS Network at the NHS Confederation said: “Over 10 years of underinvestment in capital has seen much NHS estate and equipment crumble into a state of disrepair undermining the ability of healthcare leaders and their staff to work as efficiently as they could.

“The research highlights the problems leaders are facing in accessing capital funding and already agreed projects, this is leading to a domino effect of wider backlog of issues which are not funded yet.”

 A DHSC spokesman said it would be misleading to suggest there are delays to the schemes – saying funding is dependent on the specific project’s business case approval.

They added: “We are committed to all hospital upgrades we’ve previously announced where they continue to show benefit for patients, and currently there are 48 projects in construction with 29 due to begin construction in 2023-24.”

This piece was amended on 17/05/2023 following confirmation from Shrewsbury and Telford Hospital Trust £4.5m - not £0m - had been received.