This briefing, prepared in partnership with the Nuffield Trust, sets out considerations for policymakers on capital spending in the NHS in England. It has been produced ahead of the Autumn Statement on 17 November.

Capital spending is used to construct facilities and buildings such as new hospitals or GP surgeries, to purchase and maintain equipment and IT, and to fund research and development. It is an essential route to increasing productivity and improving patient services across the NHS.

The UK has historically underinvested in capital as a proportion of total healthcare spending. We call for this balance to be redressed, whilst examining the options for accelerating delivery against the Government’s 2019 manifesto pledge to build 48 new hospitals by 2030. We explore what a strategic approach to capital would look like, setting out a series of priorities in areas with the greatest possible benefit. With a renewed emphasis on fiscal responsibility across Government, the briefing considers options for alternative sources of finance, including greater emphasis on the disposal of surplus NHS land.