Background to the report

The NHS capital budget is for the construction of new buildings and the replacement of medical and other equipment. Capital investment is essential for modernising and improving the quality of care and for achieving the changes that will make the NHS sustainable in the longer term.

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The Department of Health & Social Care (DHSC) sets an annual NHS capital budget based on local spending trends and central initiatives. Many organisations share responsibility for the planning, allocation, approval and management of NHS capital. Overall, DHSC is responsible for ensuring that the capital limit is not exceeded, and NHSE&I (NHS England and NHS Improvement) works with NHS trusts and NHS foundation trusts (NHS providers), who set out what they need for capital spending in business plans.

Content and scope of the report

This report sets out the facts on capital investment in the NHS. It draws on and expands on issues we cover in our annual report on NHS financial sustainability.

It includes:

  • the age of the NHS estate and rising maintenance costs;
  • the allocation of the capital investment budget;
  • sources of capital funding;
  • challenges to planning and delivering an effective capital strategy.


Publication details

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