• £270m of deferred spending identified, much of which relates to projects such as building maintenance, IT infrastructure and the purchase of new equipment.
  • Twenty biggest transfers listed. Download full details of the capital-to-revenue transfers identified
  • Sources told HSJ they are seriously concerned that key capital projects could be jeopardised in 2016-17, due to increasingly tight restrictions on funds. 

HSJ has obtained details of dozens of NHS capital schemes that were deferred from 2015-16, as part of a bid to stop the Department of Health breaching its budget.

The investigation reveals that, across 84 trusts which provided information, more than £270m of deferred spending was identified in response to national officials’ plea for “capital to revenue transfers”, to help boost day-to-day spending budgets.

Much of the deferred spending relates to projects such as building maintenance, IT infrastructure and the purchase of new equipment.

In their formal responses to HSJ, most trusts said the capital projects covered had already been delayed for other reasons – regardless of the plea for transfers – so timescales for delivery had not been impacted.

Where projects were delayed because of the policy, trusts said patient care was not affected.

However, some trust executive directors speaking anonymously told HSJ they were concerned that trusts may struggle to get the capital funds back in 2016-17, due to increasingly tight restrictions on capital funds. They warned this could put key projects in jeopardy.

One executive added: “This has been an undignified scramble from the DH and regulators to hit the departmental expenditure limit.

“It would be highly embarrassing for the centre if we didn’t get the money back this year, because I know people have received guarantees on that.”

The 20 largest capital to revenue transfers identified by HSJ

TrustAmount (£m)
Royal Liverpool And Broadgreen University Hospitals NHS Trust 25
University College London NHS Foundation Trust 25
Heart Of England NHS Foundation Trust 18.6
Lewisham And Greenwich NHS Trust 15.5
Barts Health NHS Trust 15
University Hospitals Coventry And Warwickshire NHS Trust 12.85
Guy’s And St Thomas’ NHS Foundation Trust 9.3
Walsall Healthcare NHS Trust 8
Moorfields Eye Hospital NHS Foundation Trust 6.9
Plymouth Hospitals NHS Trust 6
Oxford University Hospitals NHS Foundation Trust 6
Mid Yorkshire Hospitals NHS Trust 5
Staffordshire And Stoke On Trent Partnership NHS Trust 4.7
St George’s University Hospitals NHS Foundation Trust 4.6
Bolton Hospital NHS Foundation Trust 4.1
United Lincolnshire Hospitals NHS Trust 4
Mid Essex Hospital Services NHS Trust 3.8
South West London And St George’s Mental Health NHS Trust 3.8
George Eliot Hospital NHS Trust 3.8
Derby Teaching Hospitals NHS Foundation Trust 3.7

About 40 trusts did not respond to enquiries, while 106 trusts confirmed they did not complete/agree a transfer.

The largest transfers, of £25m, have been agreed by Royal Liverpool and Broadgreen University Hospitals Trust and University College London Foundation Trust.

Both relate to major building projects, which the trusts said were not delayed as a result of the transfers.

In February, NHS Improvement reported that £320m of capital to revenue transfers had been agreed at a local level, with another £24m yet to be confirmed.

More than £900m has also been transferred at a national level, as previously reported by HSJ.

There is a severe risk that the health service has breached its revenue spending limit for 2015-16, which Jim Mackey, the chief executive of NHS Improvement, has said would be “fatal for a lot of people”. The final accounts will be produced in the coming months.

HSJ asked NHS Improvement if trusts which agreed a capital-to-revenue transfer in 2015-16 would get the capital funding back this year. This was not answered directly, but the regulator said these trusts “will not be disadvantaged”.