Today the Government is publishing the 10 Year Capital Plan for Health and Social Care. Long term capital underinvestment has left the healthcare system starved of resources to function at its fullest, with large parts of the NHS and wider healthcare estate operating in outdated, inefficient and occasionally unsafe infrastructure. This was made clear in Lord Darzi’s report, which estimated a £37 billion shortfall of investment compared to international peers since 2010.

The 10 Year Health Plan set out the long-term vision for healthcare provision with the three shifts of hospital to community, analogue to digital and sickness to prevention as the core components of a new care model based on the NHS’s founding principles. This capital plan will bring together our commitments into a single coherent framework that is aligned with the 10 Year Health Plan, and ensure infrastructure is the enabler for transforming the NHS over the decade ahead.

The government is fully embracing this challenge and has already taken steps to address the root causes affecting healthcare delivery. At Spending Review 2025, the Chancellor provided the largest ever health capital budget, as well as multi-year allocations to 2030 for capital funding streams overall and extended certainty on NHS maintenance budgets to 2035. The priority is now to get on and deliver our priorities within this – making the most of both the budget and the certainty that enables the most strategic investment choices.

We will enable the first shift from hospital to community by reconfiguring the estate so that patients see the appropriate staff in the right place and have already invested £102 million in the Primary Care Utilisation and Modernisation Fund, with a further £200m over 4 years to 2030. In addition to this we will support the development of Neighbourhood Health Centres, as well as ensuring the secondary care estate can deliver the highest quality healthcare for the most complex and specialist cases. Maintenance of the estate will extend beyond the current Spending Review via an investment of £6.75 billion over 9 years to target the most critical building repairs through the Estates Safety Fund.

The second shift from analogue to digital will be enabled through over £4.4 billion of capital investment over this Spending Review period, alongside over £6 billion of revenue funding into technological and digital programmes. This will enable seamless navigation between primary and secondary care such as through the NHS App and Single Patient Record as part of an ambition to make the most digitally accessible healthcare system in the world.

The third shift from sickness to prevention will be achieved through continued investment into research and development as part of DHSC’s non-NHS capital allocation over the course of Spending Review 2025. This will enable earlier identification of illnesses, allowing for earlier intervention and strengthening system resilience to future threats. This is backed by notable investments including a new state-of-the-art health security campus in Harlow, Essex that will create 1,600 extra jobs, and up to £1bn for pandemic preparedness to replenish and expand stockpiles, in line with lessons learned from COVID-19. We are also continuing our investment into genomics, pledging more than £650 million over the next 5 years.

This plan also supports the government’s wider missions set out in the Plan for Change of driving economic growth and productivity, supporting the housing agenda, creating new healthy spaces to live and progressing towards net zero and clean energy. We will continue to commit to the NHS’s existing Net Zero targets and increase its climate resilience through continued setting of standards, showing climate leadership, and working across the system to break down barriers to financing and delivering net zero investments.

The increases in funding will be supported by our capital reforms, to reduce the layers of approval and reduce the time from initial proposal to get spades in the ground. We have already set the additional freedoms and flexibilities through devolving more control over capital budgets to the NHS frontline. Through this plan, we are also placing much greater focus on the outcomes of spend, and on taking steps to continually strengthen our approach to evidence, evaluation and benefits realisation.

The 10 Year Capital Plan provides the clarity needed to do things differently and allow capital to become a true enabler of healthcare reform.

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