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Falling investment in NHS infrastructure ‘puts quality of patient care at risk’

Health Foundation finds 21% reduction in capital funding in England in past eight years

Health Foundation finds 21% reduction in capital funding in England in past eight years


Hospital in Manchester being converted into private property. Picture: Alamy

Care and staff productivity is under threat due to a lack of government investment in new equipment, buildings, IT and other elements of NHS infrastructure, a charity has warned. 

The Health Foundation conducted an analysis of the Department of Health and Social Care’s (DH) capital budget, which funds long-term investment in the NHS, and also pays for maintenance, and research and development.

Transfer of funds

The independent charity’s report warns that the capital budget for NHS trusts in England decreased in real terms from 2010-11 to 2017-18, with a 21% reduction in capital funding over this period.

The decrease is mostly due to the DH transferring money from capital funding to cover the growing day-to-day cost of running the NHS, the Health Foundation said. It added that this amounts to £500 million of cancelled or postponed capital investment in 2018-19 alone.

Negative effects

The charity’s report says low levels of capital spending have the following implications:

  • The UK now has the lowest number of CT and MRI scanners per capita among comparable countries
  • There is a maintenance ‘backlog’ of necessary repairs or replacements needed in NHS trusts, which amounts to £6 billion
  • While sales of NHS property, land and equipment have risen, the government hasn’t always honoured its commitment to re-invest the proceeds into new estates’ projects

Hindering improvement

Health Foundation director of research and economics Anita Charlesworth said: ‘Capital investment is not a nice-to-have – failing to carry out repairs and invest in modern equipment and technology puts the quality of patient care at risk.

‘It will also undermine the NHS’s ability to improve and transform care in line with the NHS Long Term Plan.’

A DH spokesperson said the government had supported the NHS with £3.9 billion to upgrade facilities, which was already delivering improvements, from new emergency departments to diagnostic equipment. 

‘The NHS Long Term Plan sets out ambitions to further modernise and transform the health service over the next ten years,’ the spokesperson said. ‘And we will consider proposals from the NHS for a multi-year capital plan in the spending review later this year.’


Further information

Read the Health Foundation analysis


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