Scottish Government’s 2-year freeze on NHS builds: How all 14 NHS regional health boards are affected

By Lina Kurdi | Published: 18-Apr-2024

A look at how all 14 NHS Scotland regional health boards have been affected by the Scottish Government’s decision to pause NHS builds for two years

It was previously announced that the Scottish Government decided to delay the construction of NHS builds for two years.

A Scottish Government spokesperson reiterated to Building Better Healthcare that this decision was due to a cut in its capital budget.

“The UK Government did not inflation-proof its capital budget which has resulted in nearly a 10% real-terms cut in the Scottish Government’s capital funding over the medium-term between 2023-24 and 2027-28,” the spokesperson said.

Building Better Healthcare reached out to all 14 NHS regional health boards to find out how the construction of NHS builds has been affected by this decision in each region to date. The following is in alphabetical order:

NHS Ayrshire & Arran

A National Treatment Centre planned for Carrick Glen Hospital in Ayr has been put on hold.

The National Treatment Centre (NTC) Programme is an investment by the Scottish Government to support elective care across Scotland.

The delayed National Treatment Centre at Carrick Glen Hospital was one of 11 National Treatment Centres planned to open across Scotland.

The centre at Carrick Glen Hospital was going to specialise in orthopaedics. 

In the first instance, the goal of the centre was to cater to patients who needed hip or knee replacements, a day-case orthopaedic procedure or minor procedures requiring local anaesthetic. 

A National Treatment Centre planned for Carrick Glen Hospital in Ayr has been put on hold

However, NHS Ayrshire & Arran was one of the health boards told by the Scottish Government that money was no longer available for construction projects.

Nicola Graham, Director of Infrastructure and Support Services, said: “We have been advised and can confirm that capital budgets remain at 2023/24 level and no new capital projects will be funded by Scottish Government over the next two years at least.”

“This means that the National Treatment Centre planned for Carrick Glen Hospital will not progress over the next two years,” Graham concluded. 

NHS Ayrshire and Arran bought The Carrick Glen Hospital from Circle Health, a private healthcare provider, for £1.8m in 2022. 

As well as the centre, the health board planned to remodel and extend the hospital with two theatres, an enhanced treatment room, as well as 11 inpatient beds before it opened its door to patients.

NHS Grampian

NHS Grampian paused the construction of The National Treatment Centre – Grampian (NTC-G) and a national treatment centre in Aberdeen. 

The National Treatment Centre – Grampian (NTC-G) aimed to improve patient experience, the care pathway and treatment waiting times. The services and facilities in the new Centre would have included:

  • Day Case surgery
  • Endoscopy
  • Diagnostics – MRI (including MRI at Dr Gray’s Hospital in Elgin), CT and X-Ray
  • Urology, Respiratory and Dermatology Clinics

We had not broken ground on either of these projects and a contractor had not been appointed

An NHS Grampian spokesperson told Building Better Healthcare: “We had not broken ground on either of these projects and a contractor had not been appointed.”

NHS Grampian also intended to refurbish Ward 4, a mental health ward at Dr Gray's Hospital during the MRI works, “which will now be considered alongside our wider infrastructure plans,” the spokesperson said.

“We expect any capital funds received to go into maintenance of existing buildings and replacement of equipment,” the spokesperson concluded. 

NHS Highland

NHS Highland confirmed to Building Better Healthcare that the following builds have been affected by the pause in capital spending: 

  • Caithness redesign (two community hubs)
  • Lochaber redesign (replacement Belford Hospital in Fort William)
  • Raigmore Hospital maternity upgrade
  • Cowal Community Hospital reconfiguration

An NHS Highland spokesperson, said: “ Following the Scottish Government budget announcement in December 2023, all NHS boards have been advised to stop any project development spend.”

“Instead funds available should be focused on the maintenance of the estate and essential equipment and digital replacement. As a result, NHS Highland is assessing its capital projects,” the spokesperson concluded. 

NHS Tayside 

The National Treatment Centre – Tayside (NTC-T) at Perth Royal Infirmary (PRI) has been paused.

The goal of the Centre was to become “a centre of excellence for planned surgery.”

The specialist centre would have offered a range of routine procedures in:

  • Breast surgery
  • General surgery
  • Gynaecology
  • Neurosurgery
  • Oral maxillofacial surgery
  • Orthopaedics
  • Ophthalmology
  • Plastic surgery
  • Urology
  • Dermatology
  • Ear, nose and throat (ENT)

The proposal for NTC-T included a purpose-built unit with five new theatres to be built next to the current theatre suite on the PRI site to supplement the five existing theatres there.

Tayside (NTC-T) at Perth Royal Infirmary (PRI), alongside projects in the early planning stages in Tayside have been paused

The proposal also included plans for two enhanced treatment rooms for ophthalmology and day procedures patient rooms for all pre and post-operative checks and a short stay unit for patients who would have needed a short period of care after their procedure.

A spokesperson for NHS Tayside said: “Following the announcement by the Scottish Government that it would not be directly funding development costs for any new projects over the next two years, the National Treatment Centre -Tayside (NTC-T) at Perth Royal Infirmary (PRI), alongside projects in the early planning stages in Tayside have been paused.”

“The outline business case for the NTC-T was submitted to the Scottish Government last year, but it has not yet been approved,” the spokesperson explained.  

“NHS Tayside remains committed to delivering the NTC-T in the future if funding becomes available,” the spokesperson concluded.

NHS Lothian

An NHS Lothian spokesperson told Building Better Healthcare that following the announcement, “NHS Lothian sought and received clarification around the development projects which would cease.”

The development projects put on hold are:

  •  Primary Care – Various projects
  •  National Treatment Centre
  •  Reprovision of Eye Services (PAEP)
  •  South East of Scotland Cancer Centre
  •  HSDU Reprovision
  •  RIDU Reprovision
  •  Royal Edinburgh Hospital
  •  Western General Critical Care
  •  Western General Energy Infrastructure

Craig Marriott, Finance Director, NHS Lothian, said: “Following the Budget announcement in December 2023, the Scottish Government advised NHS boards to immediately stop any new project development spend and that only major projects already in construction were to be completed.

“We provided updates to our staff and partners immediately and will continue to provide any more information as we receive it,” Marriott concluded.

NHS Lanarkshire

NHS Lanarkshire told Building Better Healthcare that it remains committed to its largest project, The £700m University Hospital Monklands.

A new state-of-the-art University Hospital Monklands was set to replace the existing Monklands Hospital on a new site. 

NHS Lanarkshire remains fully committed to the Monklands Replacement Project

Colin Lauder, Director of Planning, Property and Performance, said:  “NHS Lanarkshire remains fully committed to the Monklands Replacement Project; with Outline Planning Permission given last year and Laing O’Rourke appointed as our preferred construction partner.”

“We continue to work on developing the Full Business Case (FBC). Part of this process is having ongoing discussions with the Scottish Government regarding the budget for the project, which will be finalised as part of the FBC process. We are aiming to have the FBC complete during 2025,” Lauder concluded.

NHS regional health boards not impacted

The NHS regional health boards not affected by the Scottish Government's decision to halt NHS builds for two years have sent Building Better Healthcare a comment 

NHS Borders

"We have not had to suspend or pause any existing building projects due to Scottish Governments spending pause."

NHS Dumfries and Galloway

"We have had no approved projects paused."

NHS Fife 

"NHS Fife was not in the process of building any new hospitals at the time of the pause on capital projects. Plans were underway to build new health centres in Kincardine and Lochgelly and it was confirmed last summer that these projects would be delayed."

NHS Forth Valley 

"There are no hospitals in NHS Forth Valley affected by the Scottish Government’s suspension of funding for capital projects."

NHS Greater Glasgow & Clyde

"NHSGGC’s financial plans are yet to be finalised, however, we can confirm a number of key projects already under construction will continue through to completion."

NHS Orkney

"NHS Orkney is not affected by the Scottish Governments freeze on hospital builds. Works on our hospital was completed in 2019 and we have no other new builds planned.”

NHS Shetland

NHS Shetland told Building Better Healthcare that the Scottish Government supported it to develop a strategic assessment and a subsequent precursor business case commonly known as the Programme Initial Agreement (PIA) for the replacement of the Gilbert Bain Hospital.

The Scottish Government also supported NHS Shetland to set out a 20 year property asset plan for all NHS premises that reflects the aims of its services as set out in the Clinical and Care Strategy. 

As a small board that does not have a capital project management and healthcare planning professionals on its team, NHS Shetland used the funding it received to bring in technical experts to help it develop the PIA.

Following the announcement by the Scottish Government that business cases for capital projects would be paused, NHS Shetland had already completed 70% of the PIA, putting them in a good position to aim to complete it in 2025-26.  

In the interim, NHS Shetland are focusing on developing business continuity plans to ensure that it can prioritise the risks that it knows about in respect of the Hospital and other facilities and how best to mitigate them e.g. maintenance, improving functional use etc within our capital budgets.

Whilst there are challenges with the Gilbert Bain Hospital, we are committed to ensuring that the Hospital remains fit for purpose

This will be submitted to Scottish Government, late Summer 2024, according to Professor Kathleen Carolan, Director of Nursing and Acute Services.

Carolan, said: “The work that has been undertaken to date, particularly in respect of building our understanding of where and how services will be delivered in the future, has been invaluable and the information gathered from patients, communities and our staff will be reflected in future service delivery plans and the Sustainability Strategy for the Board.” 

“We have received significant capital investment to support and improve the functional use of the Hospital since the pandemic which includes funding to replace the CT scanner, implement the Bereavement Suite, redesign the Day Surgical Unit, replace our decontamination systems and improve infection control compliance,” Carolan explained.  

“As well as support to provide MRI in Shetland with a mobile service soon to be replaced by a permanent MRI scanner and facilities. So whilst there are challenges with the Gilbert Bain Hospital, we are committed to ensuring that the Hospital remains fit for purpose and a safe and welcoming environment for patients and visitors, as is the case for all of our other NHS premises,” Carolan concluded.

NHS Western Isles

"We don’t have any hospital developments affected by this."

The future of the paused NHS builds

A Scottish Government spokesperson further reiterated to Building Better Healthcare that following the decision to pause capital projects, “all due consideration will be given to what projects can be included within that revised plan to ensure it is affordable and deliverable, while providing the best value for money. In the interim, boards have also been advised to pause any new capital projects.”

“A revised pipeline of infrastructure investment will be published in Spring 2024,” according to the spokesperson.

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