Published: 06/05/2004, Volume II4, No. 5904 Page 35

Foundation trusts now have the freedom to kick-start new builds quicker than ever before, write Emma Forrest and Peter Taberner

Though many details are still to be ironed out, what is certain is that becoming a foundation hospital will give trusts certain financial freedoms.

Being able to borrow against capital is one.

A snapshot of building programmes at the first wave of 10 foundation trusts shows that a number of facilities are being improved, and many are using their new ability to borrow funds to afford the improvements.

A new cardiac and surgical unit is needed at Stockport foundation trust to replace outdated facilities and increase theatre capacity. Planned for 2006-07, it is hoped that building work will start this year and that borrowing cash against capital will enable work to be carried out quicker than under a private finance initiative deal.

Moving to payment by results a year earlier than other trusts has also freed up funds for a children's eye centre at Moorfields Eye Hospital, London.

'The new financial regime means we can start work on the new building in advance of completing the public appeal, ' says chief executive Ian Balmer.

Elevation to foundation status has made a new build possible at Countess of Chester Hospital foundation trust. It plans to build a new emergency centre, starting in spring or summer 2005.

It is a similar story at London's Homerton University Hospital foundation trust, where work on a perinatal centre, new offices, reconfigured car park and main reception areas will start earlier than expected.

There are hopes at Peterborough Hospitals foundation trust that the new financial arrangements will allow for the modernisation of Stamford and Rutland Hospital.

Plans include a minor-injuries unit, diagnostic and day-care facilities and inpatient beds for elective surgery, rehabilitation and intermediate care.

Other development plans - for an integrated care centre, mental health facility and acute hospital, with all works set for completion by 2011 - packaged under the Greater Peterborough health investment plan, are to be financed under a PFI.

At Royal Devon and Exeter Healthcare foundation trust, a number of developments, including the new£6m Peninsula medical school and a£20m maternity, gynaecology and neonatology centre were planned without the possibility of foundation status-aided funds.

But the future of its Heavitree site, set to be vacated until recent work at the trust saw it used for community-based health and training, is now being considered under a feasibility study, along with the examination of possible funding streams for its redevelopment.

Do you have a new development that you would like to see in a future Buildings special report?

Contact emma. forrest@emap. com