In May 2024, we surveyed trust chief executives and finance directors, asking for their views on a variety of financial and operational challenges in 2024/25. We received responses from 114 different trusts, accounting for over half (55%) of the provider sector (209 trusts), from all regions and trust type in England.

Key findings include:

1. Nine in ten respondents (90%) said that the level of operational capital funding available to their organisation was insufficient, 8% felt it was sufficient and 2% said it was neither sufficient nor insufficient. 

2. 69% of respondents say estate related issues were having either a severe (19%) or significant (50%) impact on their ability to deliver a positive environment for staff, patients and service users. 

3. Over half of respondents also said estate related issues were severely or significantly impacting their ability to deliver:  

a. High quality care – 58% (14% severe, 44% significant);  

b. Improved productivity levels – 57% (9% severe, 48% significant);  

c. Management of demand pressures – 51% (15% severe, 36% significant).  

4. 91% of respondents strongly disagreed (73%) or disagreed (18%) that they had sufficient access to capital funding to invest in the transformation of their estates. 

5. Over half of respondents (53%) also said that their trust’s capital needs were not being sufficiently prioritised within their local system. 

6. 68% of respondents stated that they were unable to explore alternative routes to strategic capital funding effectively.