,
13 tweets,
3 min read
Read on Twitter
1/12 Slight sense of deja vu. Another NHS capital announcement, another Twitter, political and media discussion about whether / how much it is real or not. Thread below giving our detailed take, based on the press release that was issued yesterday afternoon and our intell.
2/12 Govt has announced new £2.7bn for 6 new hospitals between 2020-25. These are well known hospitals that need rebuilding/building and already have full business cases. Given amounts involved (avg. £400-500m per hospital), right to assume these are full new schemes.....
3/12 Government say this £2.7 billion will be extra. We see no reason to doubt this. But we need the confirmation of seeing the full NHS 2020-25 capital allocations and all we’ve got at the moment is an existing figure for 2020/21. We also need to see the phasing of the £2.7bn...
4/12 If, for example, the £2.7bn phasing is equal across the years (it won’t be), we’d want to confirm that the 2020/21 total NHS CDEL allocation was at least c£550m more than the current planned figure and the rest of the £2.7 bn was reflected across the period.....
5/12 We’re told these figures will be confirmed at the next capital review. We’re happy to accept this but just want to be sure by actually seeing the figures in a Treasury Red Book type document. Until we see confirmation, it’s possible £2.7bn could come from existing baseline.
6/12 The commitment around the 2025-30 21 trusts/34 hospital schemes seems to us to be less definitive. These schemes haven’t been fully developed yet so we can see why the actual amounts aren’t clear at this point. An indicative £9.7bn (£12.4bn - £2.7bn) seems reasonable....
7/12 Allocating £100m to help the 21 trusts fully develop the schemes and their business cases, so that we can be sure the money is well spent, also makes sense. As does the concept of successive waves of development.
8/12 On the funding required, the Government is calling this “a £13bn plan” but is also saying that “the six are getting the full go-ahead today” and “the 21 are receiving seed funding to kick start their schemes”. Hence why we describe the 21 / 34 as less definitive.....
9/12 Same argument applies here, as with the six. We can only be sure this will be extra capital when we see the 2025-30 NHS capital allocations. This is one of the reasons why we are calling for a clear, definitive, multi year (minimum 5 yr, ideally 10 yr) NHS capital settlement
10/12 Clearly, given these 21/34 schemes are 5 years plus away, there is a much greater chance their funding might disappear / not get allocated. It’s much more difficult to resile from a Treasury Red Book commitment than a press release from party conference time......
11/12 NHS frontline leaders frankly pretty frustrated by not seeing capital announced in past press releases like this actually reach the frontline. So, sorry if this sounds sceptical, but we want to see the commitments clearly set out in a Red Book type document.
12/12 Obvious question the announcement raises is: what about the other NHS capital needs (e.g. mental health, community, ambulance, digital, backlog maintenance) - where / how does this new hospital spend sit alongside these?
@threadreaderapp Unroll
