Having reached a peak of £5.9bn in 2008, health sector
construction output has subsequently declined by 48%. Cuts to the capital
budget initiated by the Government since April 2011 have had a significant
impact on health sector output and the outlook remains one of moderate improvement
at best to 2019.
However, despite this decline, it’s worth emphasising
that healthcare still represents a major area for construction work. In recent
years, the mix between public and private sector output has changed, with the
public sector share having experienced significant fluctuations due to budget
cuts and changing attitudes towards the use of PFI and other private funding
sources.
With more healthcare services being driven out of the
acute setting and into the primary sector, GPs are very firmly at the core of
the NHS and the emphasis is now upon the upgrading and refurbishment of the GP
estate. Investment in the primary care estate has generally lagged behind the
secondary or acute sector, but in the 2014 Autumn Statement, the Chancellor announced
a £1bn funding package for investment into GP facilities which will help
upgrade current premises to deliver additional services and care outside
hospitals.
Established methods of delivery of new capital
developments, such as PFI, LIFT, Procure 21+ and Express LIFT are now
undergoing change under NHS organisational reforms. The broader policies of
developing GP-led commissioning have undoubtedly led to greater co-operation
between the private and public sectors, and more work with private providers
and their construction teams, as financial constraints continue and public
sector capital becomes more difficult to obtain.
Health sector construction output is forecast to pick up
slightly in 2015 with value growth of around 4%, though forecasts indicate
moderate annual rates of growth to 2019 when output is forecast to reach
£3.6bn. Although the latest trend for new orders has been upwards this is
unlikely to result in a rapid upturn in output in the medium-term, particularly
while budgets remain under pressure.
A slight increase in the NHS capital expenditure budget
in 2015-16 to £4.7bn may help to sustain output growth in 2016 and beyond as
financial pressures on trusts to commission new facilities and upgrade existing
ones begin to ease. However, the medium-term prospects for health sector output
are still severely constrained by continuing low levels of investment, though
medium term prospects are subject to the outcome of the Election.
“Whilst health
spending for 2016-17 and 2017-18 has not yet been announced, the health budget
continues to be under pressure. A change of government could also alter the
focus of health sector capital expenditure” said Andrew Hartley, Director of AMA
Research. “Key to the future performance
of the health sector is the changing focus from larger-scale regional provision
to smaller, locally based services based on LIFT/P21+ procurement programmes.
This is set to continue as health and social care services are increasingly
integrated at a community level.“
The ‘Healthcare
Construction Market Report – UK 2015-2019 Analysis’ report is published by
AMA Research, a leading provider of market research and consultancy services
within the construction and home improvement markets. The report is available
now and can be ordered online at www.amaresearch.co.uk or by calling 01242
235724.
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