HFMA evidence to the PAC’s inquiry into capital expenditure in the NHS

Emma Knowles

21 May 2020


The Public Accounts Committee launched an inquiry on NHS capital expenditure and financial management on 5 May 2020 asking for written evidence to be submitted by 15 May. The inquiry is in response to the NAO’s report on capital expenditure in the NHS that concluded that the current system of allocating funds for capital Is not strategic or transparent. Also, that the current capital regime is pushed to the limit of its effectiveness. 

Our key points are: 
  • our members have consistently identified capital as an area of concern 
  • the recent changes made to the capital regime mean that the NAO’s findings should be considered only to the extent that they allow for the lessons learned from the previous arrangements to be implemented 
  • the challenge of dealing with the Covid-19 pandemic and the changes that have been made at pace should be used to allow the NHS to consider how funding, both revenue and capital, should be best spent to deliver integrated health and social care in the right place at the right time 
  • the delivery of system wide capital schemes will need the legislative change set out in the proposed NHS Bill as well as good financial management on a system wide basis 
  • without a longer-term financial settlement, it is difficult to make any plans. The deferral of the Spending Review, while understandable, is frustrating 
  • we remain concerned about the affordability of capital programmes as well as the process of approval and management. The agility of the arrangements put in place to address the Covid-19 crisis should be retained where possible 
  • nationally announced, large scale capital projects should be tracked from the initial announcement to the opening of the facility to ensure complete transparency.

HFMA evidence to the PAC’s inquiry into capital expenditure in the NHS

May 2020 (PDF 251KB)

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