Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of imposing an annual capital spending limit for the NHS on the (a) delivery and (b) maintenance of (i) new and (ii) re-developed buildings on the NHS estate.

Each year the Department is allocated a fixed capital budget from HM Treasury, and from that, the capital budget is set for the National Health Service. The NHS budget is divided between operational capital for ongoing service delivery, and capital for national programmes of investment.

To improve the management of operational capital from 2020-21, NHS England and NHS Improvement has set operational capital limits at Sustainability and Transformation Partnership (STP) / Integrated Care System (ICS) level. This is part of the new capital regime published on 2 April 2020, to provide greater clarity on the level of capital resource available and to support system working to agree local capital priorities. This builds on the existing control framework for NHS trusts where Capital Resource Limits are set annually by NHS Improvement, who will monitor the new arrangements.

Maintenance of buildings is one category within operational capital. So, local NHS organisations are expected to work together to better prioritise key maintenance investment within the STP/ICS envelope, along with other projects required to maintain vital services.

Investment for new and redeveloped buildings is primarily through the national programmes of Health Infrastructure Plan and STP transformational schemes, that are allocated to the organisations delivering the investments with ring-fenced budgets separate from the operational capital limits. The Department is providing more support centrally, earlier access to funding, and streamlining the approvals process, to accelerate delivery of these schemes.