• Capital expenditure is the money used to invest in goods and services that will be used for more than one year, such as buildings, equipment, vehicles and IT.
• Over the last few years, the NHS has been unable to make substantial capital investments.
• According to the Health Foundation, capital spending in NHS providers fell 21% between 2010/11 and 2017/18. It has now become a very significant, immediate, issue at the top of current concerns for NHS provider leaders.
• Every government department is delegated expenditure limits for both revenue and capital. For health spending, the Department of Health and Social Care is responsible for managing the overall capital limit.
  
  

The chief executive of NHS Providers, Chris Hopson, said:

“England’s 226 hospital, mental health, community and ambulance trusts fear patients’ safety is at risk because they’ve been told to cut their 2019/20 capital spending to comply with Treasury spending rules and all NHS frontline capital spending has been paused until this cut is delivered.

“Over many years of austerity, trusts have had to hold back from buying new scanners, replacing ageing wards, repairing leaking roofs and purchasing new ambulances. They’ve scrimped, saved, patched up and made do. But we’ve now reached a crisis point.

Over many years of austerity, trusts have had to hold back from buying new scanners, replacing ageing wards, repairing leaking roofs and purchasing new ambulances. They’ve scrimped, saved, patched up and made do. But we’ve now reached a crisis point.

“In the last year I’ve visited a trust that has had multiple floods because of crumbling pipework. A trust that’s had to close its intensive care unit within an hour and move it to the other end of the hospital due to torrents of water running down the walls all because it couldn’t get the capital to repair a leaking roof. A trust that’s had to cancel vital cancer diagnostic appointments because they’re trying to extend the life of their oldest scanner. A mental health trust that was looking after seriously ill patients on wards built in the 40s - the 1840s.

“A number of trusts have told me that they are worried they are running an unacceptable fire hazard risk. And several have said they don’t have the capital to comply with the terms of formal Care Quality Commission enforcement notices.

What’s worse is that some of these trusts have the cash in the bank to pay for this work. They’re ready to sign contracts to get this vital work started right now.

“What’s worse is that some of these trusts have the cash in the bank to pay for this work. They’re ready to sign contracts to get this vital work started right now. But they’re now being told they have to pause this work and cut their plans by 20% so that the Department of Health and Social Care can meet its arbitrary Treasury capital spending target.

The money is there to be spent. Patient safety is clearly at risk. But everything’s on hold.

“The money is there to be spent. Patient safety is clearly at risk. But everything’s on hold. Politicians need to focus on and sort the very real problems facing the NHS today - this can’t wait. Quickly increasing the 2019/20 NHS’s capital spending limit is the obvious answer”.