This report has highlighted the significant and wide-ranging benefits of investment in health infrastructure. However, many parts of the NHS estate are in extremely poor condition. Trusts need major operational capital investment to drive substantial and long overdue improvements to service capacity, increase productivity, improve the safety and experience of patients and staff, and to prevent the further deterioration of the NHS estate.

Strategic investment is also needed to transform the delivery of healthcare and modernise the estate. Giving trusts access to adequate strategic capital will deliver the transformation needed to improve patient flow and deliver integrated, high-quality care across the whole system. This requires full consideration of the needs across the acute, ambulance, mental health and community sectors.

As the Public Accounts Committee has recently recommended, the Department of Health and Social Care must publish a long-term capital strategy to meet the needs of a 21st century health and care estate. The government should outline how systems are expected to sustainably reduce the capital maintenance backlog, and map out routes for trusts to access capital for strategic transformation of their estate outside of the New Hospitals Programme.