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Over the past decade, many NHS organisations have had to make do with their infrastructure because capital has been severely constrained and funding routes, such as Private Finance Initiatives (PFI), have been removed.

As a result, the cost of backlog maintenance has reached an all-time high, tipping the scales at £6 billion. The second half of 2019 saw the first glimpse of change, with the announcement of a new NHS infrastructure in the summer and again with the Health Infrastructure Plan in the autumn. We know the approval bar for capital projects will be set high, so you must make sure that your business cases and underlying assumptions can really withstand scrutiny. Moreover, there's still a limited pot of funds, meaning you will have to carefully plan where to invest every pound.

Infrastructure advisory that supports the future of healthcare

Delivering an infrastructure project is one of the most important decisions an NHS organisation can make; it affects operations for years to come and will probably be your single largest investment. Get it right and it allows you to deliver excellent healthcare; get it wrong and you may miss an opportunity. We work with you to help you navigate every stage in the process, from building an indisputable case for change, to procurement and structuring delivery vehicles. Our partners, directors and senior managers in healthcare have over 15 years' experience working on NHS estates transactions, from tertiary, whole hospital builds to mental health and primary care facilities.

Our healthcare advisory capital services:

  • Benefit and risk assessment
  • Business cases – SOC, OBC and FBC
  • Contract review and optimisation
    • Conventional government funding
  • Estates strategy
    • ETTF
  • Identifying and selecting funding options:
    • Leasing
  • Modelling
  • Options appraisal, including the CIAM
    • Private funding sources such as debt, bond and equity
  • Procurement
  • Selecting the delivery vehicle
  • Value-for-money appraisals


Matt Custance

+44 (0)77 3987 5320

Find out more

Five steps for a successful NHS business case

Matt Custance outlines the key steps to creating a successful NHS business case.