NHS leaders have made an impassioned plea for vital capital investment in the health service as negotiations on October's comprehensive spending review (CSR) reach their final, critical stage.

Trust leaders welcomed recent financial commitments by the government to invest an extra £5.4bn in the NHS for the second half of this financial year, including £500m of additional capital, to support elective care this winter. This is alongside a further £15.8bn over the next three years via the new health and care levy to support running costs and get waiting lists down.

This is much needed and welcome extra funding at a time when wider public finances are under significant strain. However there is a risk this funding will not deliver the desired improvements without a longer-term capital settlement for the service, which would provide crucial investment in areas such as the NHS estate, ambulances, and digital technology.

While the government has previously earmarked £5.4bn funding for hospital building and upgrades, the NHS needs wide ranging investment across its estates and facilities to tackle the alarming maintenance backlog and to respond to the record care backlog across acute, mental health and community services, and unprecedented pressure on urgent and emergency care.

With just over a month to go until the CSR on 27 October 2021, NHS Providers is calling for annual real terms funding increases to the Department of Health and Social Care's capital budget.

   

With just over a month to go until the CSR on 27 October 2021, NHS Providers is calling for annual real terms funding increases to the Department of Health and Social Care's capital budget – an extra £1.5bn by 2024/25 as an absolute minimum – as part of a new capital settlement to ensure the NHS has the day-to-day funds it needs to transform services and improve access to care in the wake of the COVID-19 pandemic.

In a new briefing Rebuilding our NHS: The case for capital funding, NHS Providers says capital investment would allow the NHS to increase physical capacity, create a new network of community diagnostic hubs, reconfigure hospitals to deal with future waves of COVID-19 and winter pressures, create safe therapeutic environments for mental health services as well as investing in new ways of treating patients.

Looking to the future, trust leaders say that with the right level of capital investment, the NHS could also take greater strides towards supporting an array of government ambitions, including reaching 'net-zero' by 2050 and the 'levelling up' agenda, as recently highlighted by the secretary of state for health and social care.

Capital investment would put these within the NHS' reach. Greater use of zero-emission ambulances and the implementation of wider energy efficiency measures would become a reality rather than an ambition. Similarly, additional investment would allow the health service to better support local community health and wellbeing through better use of NHS land and buildings.

The deputy chief executive of NHS Providers, Saffron Cordery said:

"The benefits of capital investment in the NHS are substantial. From fixing leaking roofs and broken boilers, to removing ligature points in mental health facilities and replacing outdated technology, capital investment has the potential to transform the NHS.

"With the right level of investment, the NHS could play an even bigger role in turning the government's ambitions for net zero and "levelling up" from ambition to reality.

"Trust leaders know the NHS has received significant sums in recent weeks to help it deal with COVID-19 pandemic and to deliver services over the next three years. This funding is, of course, incredibly welcome at a time when the public purse strings are being tightened.

To deliver the benefits we all want, that investment must be underpinned by appropriate capital funding.

Saffron Cordery    Interim Chief Executive

"But to deliver the benefits we all want, that investment must be underpinned by appropriate capital funding – a critical piece of the jigsaw – to help bring long neglected parts of the NHS estate into the 21^st century.

"This must be alongside a multi-year capital settlement for the NHS. The NHS cannot go from year to year not knowing how much capital it is going to get. This is far from ideal for a service that needs to plan for the future so it can best meet a complex array of patients' needs.

"Protecting and enhancing patient care, supporting recovery from the pandemic and ensuring staff work in safe environments is a price worth paying. That's why we're calling for a strong capital settlement for the NHS in next month's CSR."