Published date: 03 January 2025
The King’s Fund Webinar: Funding the NHS estate of the future
79% of attendees said they were more likely to explore new funding sources after watching the webinar. So what did we learn?
Our recent webinar with The King’s Fund saw NHS experts come together - with almost 400 attendees - for a rounded discussion about the current and future landscape of NHS estate funding.
The webinar featured experts from across the NHS:
- Kieran Kinsella: Executive Director of Advisory Services, NHS Property Services.
- Fiona Daly: Director of Sustainability and Workforce and National Deputy Director for Estates, NHS England.
- Nicola Theron: Director of Estates, North Central London Integrated Care System.
- Lucy Gardner: Chief Strategy and Partnerships Officer, Warrington and Halton Teaching Hospitals NHS Foundation Trust.
Drawing from their own experiences and struggles with accessing NHS estate funding, the panel exchanged ideas, offering valuable advice and innovative solutions.
Click 'watch the recording' below and then 'get tickets' on the landing page to watch the webinar.
What are the main funding challenges for the NHS?
Lack of capital
Fiona kicked off the discussion by addressing the recent Lord Darzi review identifying a £37 billion shortfall in NHS capital investment. The impact of this underinvestment poses a great challenge for all:
“The underspend in capital funding over a period of time, is playing out in backlog maintenance bill for the NHS of just under 14 billion pounds…there’s still a lot to do in addressing the backlog maintenance bill…we’re still in very short-term planning cycles in terms of capital and revenue spends.”
Nicola talked about the main challenges facing ICBs. With there being such a huge shortage in funding, ICBs are often faced with very difficult decisions:
“How do we allocate capital?...Whatever goes into local care does not go into the acute sector.”
Revenue affordability
Kieran also highlighted lack of capital as a barrier, from a backlog maintenance point of view. But then shed light on the revenue challenges too – highlighting the true extent of the difficult funding landscape:
“We spent an average of about £66 million a year on backlog maintenance, but that’s still about £25 million short of investment to move our estate to a condition... when we do secure funding for transformational customer projects…we then need to deliver that project in an envelope that is affordable from a revenue and an operational cost perspective.”
Approvals
Adding a Trust’s perspective to the discussion, Lucy spoke about the challenge of getting approval on their funding requests:
“We’ve been in every phase of the new hospitals program and been unsuccessful yet have Victorian buildings. So that kind of underinvestment is a real challenge.”
Timeframes
Lucy called out another key funding barrier for NHS colleagues: the lack of flexibility to plan capital spend over multiple years:
“The inability to plan capital spend across multiple years also prevents us from being able to take that really strategic view. when there is funding available, it often has to be spent really quickly…often means that as NHS providers we don’t necessarily get the best deal in terms of construction.”
This was a hot topic for attendees. Throughout the webinar, they could add questions and comments, with the top rated comment stating:
“The timeframe to actually spend available funding often doesn’t take into account lengthy application processes or the amount of upfront technical consultant input/cost to get to a completed design stage."
So what are the solutions?
45% of webinar attendees said that ‘knowing/understanding the options available’ was their biggest challenge in accessing funding.
Indeed, while the challenges in NHS estate funding are clear, there are also some great funding opportunities within the system that are not being fully maximised.
Watch the full webinar to hear the panel’s discussion about practical solutions to these challenges. Including new ways to access capital and successful examples of creative approaches that have helped unlock huge pots of funding like developer contributions from the Town Planning system.
And get your copy of our guide to NHS Estate Funding to help you access eight different sources of funding, with practical, step-by-step advice and information on timings and approvals processes.
Don’t miss the chance to learn more about innovative solutions to these funding barriers.
