The government owned company set up to manage thousands of primary care premises and other NHS buildings spent only around half of its planned capital budget last year.

  • Capital budgets for primary care facilities nearly 50 per cent unspent against original estimates.
  • This is despite “crying need” for investment, says BMA leader.
  • NHS Property Services says “only stongest” business cases will be approved.

In its working estimates for 2014-15, NHS Property Services set an overall forecast for capital spending of £150m. Actual spending for the year was £81m.

The company, formed in 2013 and owned by the health secretary, delivers strategic estates management for about 4,000 buildings, such as GP surgeries, health centres and community hospitals.

Its capital budget is primarily meant to be used to develop these facilities. It is generally accepted that there is a need for major development of primary and community care facilities.

An NHS Property Services spokeswoman said the main reason for the underspending was that some schemes that had previously been in its pipeline had become “outdated” due to NHS structure changes, while new quality criteria meant “only the strongest” business cases could proceed.

The bulk of the actual spending related to day to day maintenance, while £13m was spent on more significant work, such as refurbishments or new buildings. This was against an estimated spend of £34m. These budgets were previously controlled locally, by the now disbanded primary care trusts.

Vautrey

The new system is ‘bureaucratic and slow’, Richard Vautrey said

Richard Vautrey, deputy chair of the British Medical Association’s general practitioners committee, said doctors and clinical commissioning groups had found the new system difficult to navigate, which could explain the large
underspends. He added: “The process is bureaucratic and slow. PCTs had a clear understanding and resource to invest in their area, but with this more remote organisation there are significant delays.

“There’s a crying need for investment in the estate but there are so many barriers in place and caveats attached.”

The NHS Property Services spokeswoman said: “Timescales can be affected by factors such as changing service requirements, planning processes or customer amendments to building specifications, and these have an effect on the flow of capital through the pipeline - sometimes moving spending into the following year.

“Because of the reformed NHS and its revised outlook, many of our customers are revising their design plans from those originally conceived during the [PCT/strategic health authority] era. We are receiving the expected number of capital requests from CCGs.

“NHS Property Services brings for the first time an holistic approach to managing the NHS primary care estate and ensures every scheme benefits from professional expertise.

“One of the reasons we were set up in April 2013 was to ensure whole system thinking, rather than a localised and piecemeal approach, as was previously the case.”

She added that capital spending increased by 47 per cent last year, compared with £55m in 2013-14. The Primary Care Infrastructure Fund, which was announced in January and worth £250m per year, is managed separately by NHS England, the spokeswoman said.