Designing better mental healthcare facilities

Over eighty per cent of NHS leaders say lack of investment’ is ‘putting patients at risk of harm’

A new survey released today by NHS Providers has found that 82% (161) of NHS Trust leaders think the current climate of restricted capital funding ‘poses a medium or high risk to patient safety’, and could undermine plans to transform the NHS.

NHS Providers says that ‘despite the Prime Minister’s welcome commitment to allow the NHS to spend an additional £1.8bn, the survey reveals the scale of the challenge of NHS capital funding that still exists, and the direct impact this has on everyone who relies on the health service’.

Eighty-two per cent (161) of NHS Trust leaders think the current climate of restricted capital funding poses a medium or high risk to patient safety.

The survey also reveals that:

  • 97% of respondents are worried about their Trust’s requirement for capital investment.
  • 94% are concerned that it is affecting patients’ experience of care.
  • 92% think the restricted capital environment is impacting on staff wellbeing and recruitment.

The findings also highlight what NHS Providers says are ‘deep and widespread concerns’ over the impact of capital constraints on the ability of the NHS – along with local partners - to transform and modernise the way services are delivered, as set out in the recent Long Term Plan. Ninety-seven per cent of Trust leaders said these programmes were at risk. The NHS’s annual capital budget is now less than its £6 bn backlog maintenance bill – which is growing by 10% per year.

The survey results were revealed launched as part of a new NHS Providers campaign calling on the government to address the challenge of NHS capital funding in the forthcoming spending round. It will seek to highlight that the PM’s recent capital announcement ‘can only be considered a first down payment’ on the NHS’s needs. As a nation, we are now spending less than half the amount on health capital than comparable countries.

NHS Providers said: “With the NHS’s annual capital budget now less than its backlog maintenance bill, issues like leaking roofs and broken boilers, ligature points in mental health facilities, and outdated technology cannot be fully addressed – even before any investment can be made in new buildings and services. Per head of population, we have fewer CT scanners than Slovenia, the Russian Federation, Turkey, and the Czech and Slovak Republics, and under half the number in Latvia, Greece, and Iceland.

Specific examples of the impact of the capital shortfall, according to NHS Providers include:

  • The emergency department at Kettering General Hospital is now seeing three times as many patients per day as it was built to treat safely. The care of children, adults and elderly people is currently ‘being compromised by the cramped and crowded facilities’.  The Trust needs up to £50m to build an up-to-date urgent care hub. However, it has no access to capital from either public or private funding sources.
  • At University Hospitals of Leicester NHS Trust, currently a three hospital site Trust, there are plans to consolidate acute clinical services onto two acute sites; re-purposing the third site to provide community-based NHS facilities. This includes the urgent requirement to invest in a newly combined maternity and neonatal hospital offering midwifery and obstetric-led care.
  • A ‘substandard’ layout at the Abraham Cowley Unit in Chertsey, run by Surrey and Borders Partnership NHS Foundation Trust, means the Trust has to implement more restrictive practices to maintain safety. The Trust has been unable to eliminate antiquated dormitory wards and patients, some of whom may be detained against their wishes, and may still have to sleep in a room with strangers who may also be agitated or suicidal.

NHS Providers CEO, Chris Hopson, said: “We need to rebuild our NHS, and give our doctors and nurses the tools to create the 21st century health service that patients expect and that we can all be proud of.”

NHS Providers is calling for the Government to take three specific steps:

  • Setting a multi-year NHS capital funding settlement.
  • Committing to bringing the NHS’ capital budget into line with comparable countries
  • Establishing ‘an efficient and effective mechanism for prioritising, accessing, and spending NHS capital based on need’.




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