The Spending Review 2025 (SR25) and the government’s 10 Year Health Plan for England together set out some of the most significant reforms of NHS capital in recent history.
The NHS has a 4-year capital settlement, extending to 2029/30, and a further 5 years of certainty for estates maintenance. This stability is designed to provide the confidence needed for long-term investment decisions and to support delivery of the 10 Year Health Plan’s radical vision for care.
This guidance sets out a capital framework that is more transparent, devolved and integrated than before. The SR25 settlement provides the NHS with over £44 billion of capital over the 4-year Spending Review period, including real terms protection of operational capital, £750 million annually for estates safety, and dedicated programmes for technology, return to constitutional standards (covering diagnostics, electives and urgent care), reinforced autoclaved aerated concrete (RAAC), community, mental health, learning disability and autism (MHLDA) and the New Hospital Programme (NHP).
This provides the platform for the NHS to move decisively from short-term response towards more strategic investment.
Date: 24 November