The regional Darzi plans will at last prompt foundation trusts to spend their surpluses, Monitor's executive chair has predicted.

Speaking to HSJ ahead of the publication today of the regulator's Review of Foundation Trusts' Annual Plans for 2008-09, Bill Moyes said trusts' plans included significant capital investment. "What we are seeing is they are beginning to get a sense of where investment is justified and starting to make serious plans," he said.

"My prediction is that this time next year, when the [strategic health authority] local visions are in place, this will have developed more."

In June a joint report by the Audit Commission and Healthcare Commission criticised growing foundation trust surpluses. Mr Moyes said: "We are very keen that they [spend the surpluses], but that they do it in discussion with their commissioners."

The total capital spend planned for the year is£1.4bn, compared with£1.2bn planned for 2007-08. The actual total capital expenditure in 2007-08 was£945m. Birmingham's Heart of England foundation trust has published a 10-year investment strategy for its three main sites, with particular work at Good Hope Hospital which it acquired in April last year.

Chief executive Mark Goldman said: "People have been questioning foundation trusts that have been stashing away lots of money. This is the response to that - we are going to spend it all."

Lancashire Care foundation trust plans to invest£150m over 10 years to replace each of its inpatient units.

Chief executive Finlay Robertson said: "We understood the buildings we had were not fit for purpose at an early stage."

Trusts are also prioritising plans to improve progress towards MRSA and C difficile targets. Eighteen have identified breaching their MRSA target as a risk for the year and five said they may not meet C difficile performance standards.

Mr Moyes said achieving the targets was "not straightforward".

"They are being cautious in that respect, but I don't mind that."