A new briefing from NHS Providers reveals that 62% of the Trusts with completion dates for projects within the New Hospital Programme (NHP) that are behind schedule said the delays will affect the Trust’s ability to deliver safe and effective patient care.
With backlog maintenance standing at record levels (£9.2bn, ERIC 2020/21), without appropriate investment, issues like leaking roofs, broken boilers and outdated technology cannot be fully rectified, compromising both quality fo care and patient safety.
NHS Providers reports that Trusts are concerned that delays to projects will exacerbate capital maintenance backlogs, the levels of which will exceed available sources of capital across local systems, or nationally.
This briefing was published just days after it was revealed the National Audit Office will launch a review into the NHP. The survey that underpins the briefing was carried out by NHS Providers with all Trusts currently included within the NHP invited to answer questions around funding, delays and the value of the programme.
Funding concerns & additional pressures
Responses were received from 26 Trusts, representing 74% of all Trusts (35) in the programme. All cohort groups were represented, and those in cohort 1 were most confident that their funding allocation was sufficient to deliver their project. Overall, however, half of Trusts admitted they were ‘not confident’ or ‘not at all confident’ that their funding allocation would be sufficient and only 20% of Trusts are confident that their funding allocation (at the current stage of business case development) is sufficient to deliver their project.
In addition, 96% of Trusts either ‘strongly agreed’ or ‘agreed’ that the government should confirm the funding envelope for the NHP beyond the current spending review period. There is also concern that the capital envelope of £3.7bn for the current spending review period is insufficient to fund the cohorts currently included in the scheme. Delays to projects as a result of delays to business case development, funding allocation, as well as capacity and capability issues across the construction sector are increasing costs, especially given current inflationary pressures. Completion dates are behind schedule for 39% of Trusts. One year behind schedule was the minimum reported, with other respondents admitting projects are between two and four years behind, with others saying no date has been formally agreed.
The briefing also highlights wider challenges surrounding capital investment, with backlog maintenance continuing to be a major concern for Trusts. There are concerns about the adequacy of system capital envelopes to address key operational repairs and enable Trusts to manage risks to staff and patient safety. “Trusts are telling us that the limited headroom within system capital envelopes means they carry high levels of risk related to their infrastructure on a day-to-day basis,” the report states.
Interim Chief Executive of NHS Providers, Saffron Cordery, says: "Delays nationally and mounting concern about funding mean what was billed as the biggest hospital building programme in a generation is on shaky ground.
"Hopes and expectations have been raised. Now it's time for the government to deliver on the prime minister's pledge.
"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.
"This is about much more than bricks and mortar. 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.
"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."