Johnson urged to build 100 new hospitals

A new report has outlined the scale of the task required to rebuild and equip the NHS to make it fit for the 21st century.

Rebuilding our NHS: why it’s time to invest, published by NHS Providers, says many of the buildings in the NHS that now need replacing date from the last and only major national infrastructure programme of the 1960s, which delivered 95 major schemes in its first three years.

The next biggest infrastructure programme was delivered under the Private Finance Initiative (PFI) between 1997 and 2015. There are more than 100 PFI projects still being paid for that were built under these arrangements.

Hospital leaders have welcomed the government’s recent recognition of the need to refurbish and replace NHS buildings and facilities, including Prime Minister Boris Johnson's announcements to upgrade and rebuild hospitals and invest in new scanners.

However, the new report claims that, even taking into account the second wave of the planned infrastructure spending, set to cover 40 projects, this is a much more modest ambition than what was achieved under those previous initiatives.

The report, which includes findings from a survey of NHS leaders carried out last summer, emphasises the need for capital funding for mental health, community and ambulance services as well as the acute hospital sector. It found that 97 per cent were worried that their organisation’s requirement for capital investment would not be met, whilst 82 per cent said there was a medium or high risk to patient safety.

The survey further found that: 99 per cent of respondents said their boards were concerned about the impact that capital was having on their duties and liabilities to both patients and staff; 94 per cent of trust leaders said restricted funding posed a high or medium risk to patient experience; 97 per cent reported high or medium risks to transformation programmes; 95 per cent said there was a high or medium risk to productivity and efficiency initiatives; and 90 per cent of the finance directors said that the capital regime was not fit for purpose. 

The report sets out the three fundamental changes needed to support the implementation of the NHS long term plan: securing a multiyear capital settlement, ideally lasting ten years and extended annually; aligning the capital budget with comparable economies, meaning funding available to trusts should roughly double; and establishing an efficient and effective mechanism for prioritising, accessing and spending NHS capital based on need. 

Saffron Cordery, deputy chief executive of NHS Providers, said: “NHS trusts are suffering from years of under-investment in facilities across the English NHS. The situation is now critical for the great majority of organisations and is directly impacting on patients and staff. The system for allocating capital funding to the frontline is not fit for purpose. This year’s expected comprehensive spending review represents the best opportunity for many years to improve resourcing and reset the rules governing capital in the NHS.

“There is a growing bill for essential maintenance across the NHS and this needs to be urgently addressed. However, to see the rebuilding and replacing of outdated facilities and infrastructure required, a major national building programme is needed on a scale comparable with the 1960s Hospital Plan. It’s time for the biggest building programme in the NHS since the Beatles.

“This will support the delivery of the long term plan and provide the opportunity to see tangible improvements to patient safety and staff and patient experience. These include reduced treatment delays due to equipment failure, increased inpatient capacity, expanded diagnostics services, transformed care pathways, more efficient services, and bringing about a fully digitised, technologically-enabled service.”