Backed by a record capital budget for health, rising to £15 billion in 2029/30, the Government's new 10-Year Capital Plan sets out how the government will rebuild, renew and modernise the NHS.
It replaces years of short-term, stop-start investment with a long-term approach, and aims to help the health service deliver major projects that modernise facilities, upgrade technology and deliver better care for patients.
Government investment has already funded almost 800 upgrades to GP surgeries across England, helping practices create space for an estimated 9 million extra appointments. A further £200 million will help more GP surgeries expand and modernise, helping patients get appointments more easily, receive care closer to home and reducing pressure on hospitals.
The plan also sets out how unused NHS land can be turned into affordable homes for healthcare workers. Nurses, porters, healthcare assistants and other NHS staff will be able to rent homes close to the hospitals where they work, helping them spend less time commuting and making it easier for the NHS to recruit and keep staff in areas where housing costs are highest.
Minister of State for Health Karin Smyth said: "NHS patients - and the brilliant staff who care for them - deserve modern buildings, reliable equipment and services fit for the future. Too many NHS buildings are crumbling and outdated. This government is taking the long-term decisions needed to rebuild the health service.
"Our 10 Year Capital Plan backs that ambition with record investment and reforms that will help patients get faster appointments, better facilities, modern technology and more care closer to home for patients across the country."
The investment comes after years of neglect left NHS buildings falling apart. Last year alone, leaking roofs, broken heating systems, electrical faults and other building failures caused more than 4,100 disruptions to patient care, including cancelled appointments and delayed treatment.
To start putting that right, the government is investing at least £6.75 billion over the next nine years to repair hospitals, replace unsafe buildings and tackle the maintenance backlog, reducing the disruptions that can lead to cancelled appointments and delayed treatment.
Hospitals affected by Reinforced Autoclaved Aerated Concrete (RAAC) will benefit from a £2 billion programme to remove RAAC and keep patients and staff safe.
The plan confirms the government will deliver 250 Neighbourhood Health Centres. Bringing together GPs, diagnostic tests, community and other services under one roof, they will make it easier for patients to get the care they need closer to home instead of travelling to hospital.
Alongside improvements to buildings, the plan pledges to invest in better technology across the NHS. This includes improving the NHS App, introducing a Single Patient Record so patients do not have to repeat the same information to different parts of the health service, and replacing outdated systems that keep staff tied up with paperwork, and away from patients.
The government claims it will also make it quicker to get NHS building projects off the ground. Instead of waiting for repeated Treasury sign-off, projects worth up to £300 million will be approved by the Department of Health and Social Care and the NHS. Projects will only need to return to the Treasury if costs rise above £1 billion or their scope changes significantly.
The Government says that, together with long-term funding settlements, the changes will cut red tape, speed up decisions and help hospitals get on with improving buildings, replacing equipment and delivering better care sooner.
Ownership of more NHS buildings and land will be handed from NHS Property Services to local NHS organisations, giving them greater control over how their estates are managed and developed to meet local needs.
Overall, the Government says the reforms will also give construction firms and technology companies a clearer pipeline of future NHS projects, giving them the confidence to invest in people, skills and innovation while helping deliver better value for taxpayers.
Responding to the plan, Siva Anandaciva, Director of Policy, Events and Partnerships at The King’s Fund, commented: "For too long, short-term thinking has shaped NHS capital strategy. Patients and staff have paid the price through crumbling buildings, concrete hospital roofs at risk of collapse, outdated equipment, overheating operating theatres, and stark differences in experience depending on where they live.
"So it is welcome that the government is taking a longer-term, more joined-up view of how health and care buildings, not just NHS-owned estate, can support better health and wellbeing. This is exactly the kind of cross-government thinking the health mission should be aiming for and has been lacking so far.
"It is also positive to see capital investment linked to the wider building blocks of health, including good-quality housing and clean energy. These factors affect the NHS directly and indirectly for example by making services more resilient to energy shocks and helping to prevent children ending up in A&E because they have developed respiratory conditions from living in poor-quality housing.
"One notable commitment is to build affordable housing for NHS staff on unused NHS land. Making it easier for nurses, healthcare assistants, porters and other staff to live near where they work could help make NHS careers more attractive, particularly in areas where housing costs are higher.
"The plan’s local emphasis is also welcome. Where possible, giving local leaders more freedom to invest in the priorities they understand best for their community is the right direction of travel and is similar to previous ‘one public estate’ approaches where locally-led bodies worked together with the prize of more coherent public services that are easier for people to access.
"But while this plan may provide a blueprint for the future, it remains unclear whether there is enough investment to turn the ambitions on paper into bricks-and-mortar improvements. With the NHS maintenance backlog now standing at £15.9 billion, serious questions remain about whether several unfunded commitments add up to one effective and credible capital plan. Those questions are only sharpened by lingering concerns about cuts to capital budgets to fund defence, and whether the level of investment available will come close to matching the scale of need across the health and care estate."
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