• Several large transformation schemes miss out on capital funding
  • Chief executive bemoans lack of investment in primary and community care estates
  • No more STP capital allocations before next year’s spending review

An £84m urgent and emergency care transformation in Middlesbrough, system wide cancer reconfiguration in South Yorkshire, and a large elective care centre in Norfolk were among projects which missed out on recent government funding.

HSJ’s analysis of bids submitted to NHS England via sustainability and transformation partnerships show several trusts failed to secure tens of millions of pounds to deliver projects considered vital for their performance and sustainability.

Eight STPs, including two which have integrated care system status (South Yorkshire and Bassetlaw, and Gloucestershire), were given no money.

Meanwhile, one trust chief executive said he was “hugely fed up” with the fact that less than 10 per cent of the £963m package was allocated to primary and community care providers. The sectors are thought to account for roughly 20 per cent of all spending.

The Department of Health and Social Care said funding was allocated on the “strength of bids received from local NHS teams”.

According to a briefing paper issued by the DHSC and NHS Improvement last month, there were a total of 314 bids submitted which combined would require £8.6bn of public funding.  

Bids were rated against criteria such as deliverability, service and demand management, transformation and patient benefit, financial sustainability, and value for money.

The money was allocated from a £2.9bn capital pot established for STPs in the government’s 2017 spring and autumn budgets. 

Sixty per cent of the funding announced last week (£584.8m) went to acute trusts, while 22.1 per cent (£213.1m) was allocated to mental health trusts.

Three community trusts received a combined total of £35.6m, but the total amount allocated to the primary and community care sector (mainly via clinical commissioning groups) was £97.6m (9.8 per cent of the funds available).

Matthew Winn, chief executive of Cambridgeshire Community Services, said on Twitter he was “hugely fed up” that “little or no funding” had been allocated to primary and community health infrastructure.

“Really is time that the rhetoric about supporting [people] to live healthy lives at home and use less secondary care is matched by revenue AND capital allocations – hospitals are great but most care is provided in the community,” he said.

Mr Winn added in his tweet he was “very pleased for my NHS colleagues around the country getting capital for their buildings”.

However, several trusts and STPs were left disappointed after their bids were unsuccessful.

These included plans for:

  • An £84m urgent and emergency care reconfiguration at James Cook Hospital in Middlesbrough to create sustainable services; 
  • The reconfiguration of cancer services across South Yorkshire and Bassetlaw;
  • An ambulatory care centre key to increasing capacity for elective care at the Norfolk and Norwich University Hospital;
  • A £90m ambulatory care and diagnostics hub at Heartlands Hospital in Birmingham;
  • The transformation of community hospital infrastructure (costing £11.5m) in the Forest of Dean; 
  • A £31.5m expansion of the emergency department at University Hospital Coventry; and
  • A £260m reconfiguration of NHS services in north west London.

A small number of STPs also submitted bids for IT projects. Only Dorset was successful and was allocated £5.1m for a pan county pathology laboratory IT system.

Examples of STPs missing out on funds for IT projects include Bristol, North Somerset and South Gloucestershire, which wanted a new STP wide IT system for children’s community and mental health services (costing £1.3m), and Northamptonshire, which wanted funding for an “STP wide IT project”.

Chris Hopson, chief executive of NHS Providers which is the trade association for NHS trusts, said on Twitter he was “very struck” by the delight of those trusts which received capital, but also “how incredibly disappointed those that missed out are”.

HSJ understands there are no more planned capital allocations for STPs before the next spending review, which is due in spring 2019. Around £530m remains to be allocated from the government’s 2017 budgets.  

A DHSC spokesman said: “As part of the ongoing work to develop the NHS long-term plan, the government has been clear that it will consider proposals from the NHS for a multiyear capital plan to support transformation, which will feed into the next spending review.”

Meanwhile, two ambulance trusts (East of England and South East Coast) were awarded £37m in total.

Two specialist trusts (Alder Hey and Moorfields) were awarded £25.2m in total.

Two bids, worth £7.4m, have not been included in the totals as there was not enough information available to categorise them. 

Details of more than 30 STPs’ bids for funding are available at https://www.hsjintelligence.co.uk/

The STPs which missed out on funding were:

South Yorkshire and Bassetlaw;

Birmingham and Solihull (combined bid value of £102m);

Coventry and Warwickshire (combined bid value of £86.8m);

Norfolk and Waveney;


Shropshire and Telford and Wrekin;

North East London; and

Gloucestershire (combined bid value of £68.3m).

Mid and South Essex did not submit bids.