INDEPENDENT HEALTHCARE
PPPs, with a focus on an expansion of independent sector led services to tackle waiting times for elective care and diagnostics.
The Government should collaborate with the independent healthcare sector to develop a dedicated Neighbourhood Health Capital Fund.
Speeding up capital programme processes is one of the aims of the 10-Year Health Plan. A focus on tracking the delivery of capital projects could help identify organisations that are struggling with capital builds, and work on solutions.
Health commiting to establish up to 300 new Neighbourhood Health Centres ‘in every community’, IHPN is also calling for the Government to explore the creation of a Neighbourhood Health Capital Fund which would enable the NHS to raise private capital investment to develop neighbourhood health services across the country, with support from the independent sector. The report makes the following recommendations:
HM Treasury should update Green Book guidance, to clarify the off–balance sheet capital investment mechanisms available to senior NHS leadership to stimulate public/private partnerships – particularly those which enable the independent sector to provide finance and deliver services on an ongoing basis.
Updated guidance should refer to schemes, encompassing primary and
community as well as secondary care where NHS providers have already entered effective, ongoing partnership with the independent healthcare sector to work within the current accounting rules.
To create a forum for leadership and enable ongoing partnership between Government, the NHS and the independent healthcare sector, a National Strategic Council for Healthcare Infrastructure should be established. Its membership should include representatives from HM Treasury, DHSC, the NHS and the independent healthcare sector to enhance collaboration on the enablers of public-private partnerships (PPPs). Its work should align to the Government’s stated priorities in the 10-Year Health Plan. In conjunction, DHSC should publish a dedicated set of guidelines for how the NHS will use
To avoid the usual difficulties in the existing capital system and to move at pace, a separate and dedicated Neighbourhood Health Capital Fund should be established. Such a fund would allow the Government to set out the strategic objectives, requirements and levels of investment needed from capital investment into neighbourhood health. The primary aim of the fund would be to raise private capital investment, but it could also be supplemented by central funds to support the overall capital requirements of the neighbourhood health programme. The development of the fund will also create opportunities for independent sector delivery of some clinical services within these new neighbourhood health facilities, which can be delivered within the bounds of the Provider Selection Regime. Alongside this, the National Health Service (General Medical Services Premises Costs) Directions 2024 should be amended in tandem, so that they are supportive of private capital investment into the NHS primary care estate and to enable alignment to the Government’s vision.
Enhancing accountability for delivering on NHS capital priorities.
The Government will need to follow through on its 10-Year Health Plan aims of speeding up capital programme processes. As part of this it should introduce a new indicator in the NHS Oversight Framework that tracks the performance of NHS organisations on their delivery of capital projects. Such transparency can be used to identify organisations that are struggling with capital builds, identify blocks to progress and work on solutions to these challenges.
Given the squeeze on public finances,
we believe that private investment is one of the only options for raising the capital funding the NHS needs to develop the 21st century facilities that patients expect
Matthew Taylor, Chief Executive of the NHS Confederation 40
WWW.PATHOLOGYINPRACTICE.COM October 2026
Increasing PPPs to support elective recovery.
NHS England should publish a set of guidelines for how the Government’s commitments in the 10-Year Infrastructure Strategy for more PPPs will be translated into building more capacity to deliver elective recovery. Learning should be taken from those NHS and independent sector organisations who have already been able to make such arrangements work within the current accounting rules.
AdobeStock / Tom
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