Failing to capitalise

Capital spending in the NHS

The capital budget of the Department of Health and Social Care is used to finance long-term investments in the NHS in England. This includes spending on new buildings, equipment and IT, improvements to and some maintenance of NHS trusts, and research and development.

Read the full list of key points

Watch: capital spending on health care in England explained

In this briefing, we analyse trends in the capital budget, comparing the UK with international averages. Using annual data from all NHS trusts in England, we then focus on trends in the capital spending of NHS trusts to analyse where money has been spent and where there are areas of need.

We also analyse the implications of recent capital spending, with a specific focus on NHS trusts’ maintenance backlog, and conclude with a discussion of the trends in capital spending and capital levels, and implications and recommendations for future health care.

This report was updated on 3 April 2019 to correct the key in Figure 5.

Related research

Health Foundation-funded research by Health Services Management Centre (HSMC) at the University of Birmingham, referenced in the report, interviewed directors and managers at NHS trusts, revealing serious concerns that spending restrictions are impacting service efficiency, and in several cases, the quality of patient care. The research highlights the impact of equipment shortages and failures, and reliance on ageing diagnostic equipment.