Which of the following does your organisation need from central government to support access to capital funding? (select all which apply)
Innovation, especially the development of integrated working, requires capital investment in the community sector. This is the funding that pays for new facilities, equipment and digital systems. Yet, highlighting a £27 billion shortfall in capital, Lord Darzi's review stated: "The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending".
Successive governments have failed to release sufficient capital funding, despite the long-term benefits of this type of investment.
When asked about what their organisation needed from government to support access to capital funding, the most common answers were: ability to explore alternative routes to strategic capital funding (78%), access to targeted capital funding for community providers (78%) and longer-term plans to leverage the NHS estate (72%).
Increasing the CDEL was also viewed as a key priority for national government. When interviewed, leaders explained how these rules were limiting their transformation plans, clinical improvements and productivity work. One chief financial officer summed up the experience of trying to transform his trust's estate as 'like wading through treacle'. As previously mentioned, the inflexibility of CDEL accounting also impedes new lease arrangements and further complicates the redevelopment of the community estate. Leaders also noted the challenge that community providers face as a result of the mix of owned and leased properties they work with. They stated it needs to become easier to develop estate strategies with partners, including local authorities, to deliver integrated care.
“There are a couple of important factors to also feed in: the impact and control of leases after IFRS 16; the rising costs and lack of control over NHS Property Services estate; the temporary nature of digital funding... these all hamper the ability to ‘left shift’ to community services.”
Survey respondent