Just 3% of the £2.5bn capital funding announced and allocated by the government for the NHS since 2017 has actually been released to the service, an analysis suggests.
HSJ calculated that less than £100m has been distributed to local providers over the last two years.
The announcement of a “first wave” of funding in July 2017 was headlined “£325m invested in NHS transformation projects”. Two years on, only around £48m of that money has so far been received by the bidders, with more than half the organisations still waiting for the money to be released, the analysis shows.
Out of 145 schemes approved through all four “waves” of the £2.5bn, just 25 have started receiving the funding.
Some of the projects would not have expected to have received funding by this point, particularly in the latter tranches. But multiple sources in and around the NHS have expressed concern and frustration over the difficulties providers have faced in securing the money.
Sir Robert Naylor, the government’s own adviser on NHS estates, told the HSJ he was “disappointed more money hasn’t got to the front line”.
In 2017, the Department of Health and Social Care set up a new process in which trusts have to submit capital bids through their “sustainability and transformation partnership”.
Although some trusts are able to generate their own cash for capital projects, by saving up budget surpluses, many have to apply for central funding. When money is allocated, the recipient organisations must submit two business cases to the centre, which then require approval from all the national bodies – NHS England, DHSC and the Treasury.
The projects have typically been held up by delays in sign off and requests for further information from these agencies and, in some cases, local problems.
Sir Robert, the former University College London Hospitals FT chief executive who led a government review of capital in 2017, told HSJ: “Backlog maintenance is spiralling out of control and we have to really focus now on improving the quality of the estate. Obviously the spending limit needs to be increased, and the whole question of how it works needs to be very urgently revisited and taken up with the Treasury.”
In a statement, the DHSC said it has committed to invest £3.9bn of “new” capital by 2022-23. Its capital budget has increased by 30% in the three years since 2016-17, which equates to £1.3bn in cash terms and £1bn in real terms. The current budget is lower in real terms than it was in 2010-11.