Trusts call for funding certainty for hospital building programme

A survey by NHS Providers of trusts in the programme found that half of the trusts polled were not confident that the funding they’ve been allocated is sufficient to deliver their project. And almost two in five hospitals said their completion date was behind schedule, with almost half of these having publicly reset their timescales.

Interim chief executive of NHS Providers, Saffron Cordery (pictured), said the hospital building programme – billed as the biggest in a generation – was on shaky ground. ‘Trust leaders are deeply frustrated that the benefits they expected to be able to deliver for patients and their communities are increasingly in doubt, in some cases getting further out of reach with every day that goes by,’ she said.

The government made a manifesto commitment to build 40 new hospitals by 2030 and subsequently added a further eight hospitals to the programme. Currently endorsed schemes involve 35 trusts and £3.7bn of capital funding was confirmed in the 2021 spending review to cover the programme’s capital requirements in the period from 2022/23 to 2024/25.

The survey, which included responses from 26 trusts – three quarters of those in the programme – raised questions about the adequacy of this funding. The eight trusts in the first cohort of the programme – where projects were already underway when the programme was announced – were most confident about funding, with 80% believing their allocation would be sufficient.

However, 66% of cohort 3 trusts and 55% of cohort 4 trusts (where planned start dates are yet to be confirmed) said they weren’t confident that their funding would enable them to deliver their projects. Outturn costs for some trusts’ schemes in this period are already above initial forecasts, NHS Providers said.

Trusts said that costs were rising due to delays and inflationary pressures within the construction industry. Insufficient funding would mean more delays and higher costs.

Building will carry on well beyond the current spending review period and nearly all respondents called for the Treasury to clarify the funding profiles of the new hospital programme budget up to 2030. While this would be out of step with usual government funding commitments, the representative body said that the lifespan of these projects demanded ‘extended, multi-year financial allocations to give organisations the certainty and stability to underpin their planning and delivery processes’.

Cohorts 3 and 4 are facing particularly significant delays compared with their initial timetables. One-year was the minimum delay reported by those experiencing delays – with others reporting hold-ups of up to four years. Delays to the programme business case and insufficient funding to meet the fees of the outline business case and to pursue the necessary enabling work were key reasons given for the delays.

This week it was announced that the National Audit Office will carry out a value-for-money review of the building programme amid growing concerns that the promised 40 hospitals will not be built by 2030 (see our Top story).

Ms Cordery said the programme was about more than bricks and mortar and that trust leaders had underlined the potential benefits of the programme if funded and delivered properly. Schemes would improve patient experiences and outcomes and boost efficiency as well as helping with treatment backlogs in some cases.

‘The new hospital programme is a fantastic opportunity to rebuild the fabric of the NHS, providing badly needed renewal for acute, mental health, community and ambulance services,’ she said. ‘Failure to create a modern, comfortable and safe environment for patients where staff can provide first-class care reliably, effectively and efficiently is a missed opportunity, which will cost the NHS dear for years to come.’