Ministers consider capital injection to head off winter crisis

HSJ understands a range of capital bids for differing projects were on the agenda to be discussed at health and social care secretary Jeremy Hunt’s Monday meeting this week. It is not yet clear if any have been given the go ahead or how much funding could be made available.

Additional capital could assist trusts in a number of ways, from erecting “modular build” units to cut down on the requirement for corridor care, to converting mothballed wards into ambulatory care or acute medical units, sources told HSJ.

But system leaders face a dilemma because if capital funding was offered without additional revenue, trusts could be stuck with new facilities but insufficient staffing levels to use them optimally, one senior source said.

Trust bosses, many of whom have warned performance could deteriorate further this winter, welcomed the prospect of additional funding.

But they warned system leaders must not issue highly prescriptive spending guidelines, like for last winter’s £100m GP streaming fund, if it were made available.

The wide range of problems faced in different health economies required a more flexible approach without which money would be wasted, they said.

NHS Providers chief executive Chris Hopson told HSJ: “Trusts have told us that they believe this winter will be very difficult, despite best efforts, and they have indicated the sector is unlikely to meet its national targets on either the elective or emergency waiting times. So, extra in year 2018-19 funding – revenue or capital, and preferably both, would be very welcome.

“But we need to learn from last winter, because most of the additional money allocated then simply went into trust bottom lines because it came too late in the year to genuinely increase capacity in the way it could have done if allocated earlier.”

He added: “If there is to be any in year money, then trusts need to know before the parliamentary recess on 20th July. Trusts also told us that they must be allowed to tailor any funding to address their local needs.

“Significant numbers of trusts have told us that the capital spent last year on GP streaming could have been better used if they had been given the freedom to spend it where they thought it was most needed.”

It follows Mr Hopson’s warning last week that NHS England and NHS Improvement’s new target to cut the number of patients spending more than three weeks in hospital will not free up as much capacity as system leaders are banking on.

“We tried [a similar plan] with delayed discharges last year. Effectively, we got some of the way there. I think the same will happen with this target, and we will end up some way short,” he said.

Both the Department for Health and Social Care and NHSI declined to comment.