The safety of patients and staff is at the core of everything the NHS does. That's why the government's manifesto pledge to build 40 new hospitals in England by 2030, is so important.
The Conservatives' promise was back in the media spotlight recently when a broadcaster exposed the cost of delays to the programme, revealing that seven of the 40 don't yet have a completion date. This confirmed our own earlier findings. Our July survey of leaders of trusts involved in the scheme showed that the government's promise is on shaky ground.
Billed as the biggest hospital building programme in a generation, the New Hospital Programme (NHP) would mean urgently needed renewal for trusts. Large chunks of the NHS estate are in very poor condition. Old buildings and out-of-date facilities are costing the NHS dear. There is a huge 'money pit' of a maintenance backlog right across the NHS, and for some trusts bulldozing buildings and putting up new ones is the only feasible way ahead. Without proper funding, the leaky roofs and ceilings, broken down boilers and ageing IT won't get fixed or replaced, compromising the quality of care and patients' safety. The £3.7bn announced by Boris Johnson in October 2020 for trusts to make progress on the 40 NHP schemes isn't enough for every trust in the programme to make their preferred options a reality during the current government Spending Review period.
One trust leader told us that operating '21st century healthcare from 19th century buildings' was 'increasingly unsustainable'.Deputy Chief Executive
Our assertion that the government's pledge is on shaky ground is based on the evidence of our survey. Nearly two in three leaders who responded said delays to the programme affected their ability to deliver safe and effective patient care, with all those facing delays reporting cost implications. Half of the trusts surveyed were not confident (or not at all confident) that the funding they've been allocated is sufficient to deliver their project. Almost two in five said their schemes were behind schedule. One trust leader told us that operating "21st century healthcare from 19th century buildings" was "increasingly unsustainable".
The recent heatwave showed how creaking infrastructure puts pressure on hard pressed NHS staff and services. In the extreme temperatures some operating theatres had to shut down because they got too hot and IT systems were under strain with trusts having to install industrial cooling units and fans to try to prevent equipment from overheating. It just underlined why the government has to deliver on its new hospitals pledge and invest more in NHS capital. Especially as at the height of a summer the demands on the NHS are making it feel like the middle of winter already with services working flat out and at full capacity.
Almost all (96%) of the trusts we surveyed agreed that, if appropriately funded, their schemes would improve patient care and experiences, improve clinical outcomes, and enable them to increase productivity. The NHP would not only mean long overdue improvements to patient safety and service capacity but would help to recruit and retain staff who need suitable, modern environments and brand new, state-of-the-art facilities to provide first-class care. And the NHP can play a big part in 'levelling up' by helping to reduce deep-rooted health inequalities across England.
Trusts in the NHP agree that with the right amount of government support their planned schemes will mean better care, experiences, and outcomes for patients.Deputy Chief Executive
But those frustrating delays are pushing up costs all the time and sapping staff morale. Trusts in the NHP agree that with the right amount of government support their planned schemes will mean better care, experiences, and outcomes for patients. It is vital, therefore, that the government funds the work properly and lets trusts get on with it as quickly as possible. Trust leaders are worried that the big improvements they planned for patients and their communities are more and more vulnerable with every uncertain day that goes by. They are poised and ready to begin construction but are waiting for confirmation of funding. Those forced to pause now face inflation driving up the cost of building materials.
The NHP is a golden opportunity to give the fabric of the NHS a massive makeover and boost healthcare with badly needed renewal for acute, mental health, community, and ambulance services. Trusts need clarity and commitment from the government about the progress and funding of the NHP. Almost all (96%) of the NHP trusts we surveyed agreed that the government should confirm funding for the NHP beyond the current Spending Review period (2022/23-2024/25).
The NHP is being looked at too by the National Audit Office, the public spending watchdog. It will conduct a "value for money review". Whole communities are counting on these schemes but as deadlines slip and construction sites lie quiet, public confidence that plans will get past the drawing board stage is being dented.
Having raised people's expectations, the government must now produce the goods and live up to its pledge.
This blog was first published by the National Health Executive.