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1/10 Great roundtable this morning on NHS capital with 16 member Chairs, CEOs and FDs and 6 senior colleagues from @NHSEngland and @NHSImprovement. Agreement that we now have a significant problem here...and strong view that we must quickly work together to solve it.
2/10 Member roundtable agreed we've now reached "NHS capital tipping point". After years of capital restraint / constraint, trusts very clear they must now make significant capital investment in 2019/20 to address patient safety / care quality concerns they can defer no longer...
3/10 Provider 2019/20 capital spending plans currently exceed allocated limit in DHSC capital budget by some way. Problem bigger than previous years. Compounded by mismatch between where need likely to be greatest and where funds (eg prior year PSF/STF funds) currently sitting...
4/10 Agreement at member roundtable that many aspects of current NHS capital regime in desperate need of reform - absence of clear strategy matched to need and LTP ambitions; prioritisation and allocation process unclear/opaque; length of time and burden of approvals process.
5/10 Member roundtable on capital agreed some key principles on how to solve current NHS capital problems. Much greater transparency needed throughout. Problem is a shared one, requiring DHSC, ALBs and front line boards to work together, so any solutions must be co-created...
6/10 Key principles for solving current NHS capital problems pt 2...Need fair immediate 2019/20 'rationing' fix. Work in parallel on longer term system. Avoid creating over complex solutions. Need solutions that work for different types eg FTs with cash & cash strapped trusts.
7/10 Key principles for solving current NHS capital problems pt3...Prioritisation and allocation will require providers to act collegiately. One way - use STP/ICS footprint with NHSE/I regional support. But need to recognise STP/ICS footprint working & regions still developing.
8/10 Recognition at member roundtable that capital becoming a very tricky issue. Provider boards rightly feel strongly they must have freedom to spend capital and get proper access to it, to ensure they can provide the safe, quality, care they are accountable for delivering.
9/10 Important NHS makes powerful & effective case for capital spending as part of forthcoming spending review. Need to show NHS has good system to prioritise/allocate capital; that NHS investment provides wider economic benefit & that NHS can stick to capital limit allocated.
10/10 V strong feeling at member roundtable today that capital now become a key NHS issue. Reasons: urgent spending need; challenge to keep within 2019/20 limit; broken, opaque, allocation/prioritisation system; key element of spending review. Key @NHSProviders forward priority.
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