Five steps every capital programme can take to embed transformational change

Investment and need for change 

The government has increased funding for digital and capital investment in healthcare, raising the NHS capital budget by 10.9% to £13.6bn by 2025/26. Our healthcare system faces a “curve of doom” demand that current workforce and funding models can’t meet. Acute programs must support shifts from; analogue to digital, treatment to prevention, and hospital to community, to avoid outdated facilities. The New Hospital Programme aims to transform healthcare by reducing length of stay and the need for acute beds. Success requires transforming services years before a facility opens.

Examples like the My Care My Way model in West London, which provides holistic care to over 65s and has shown a 11.5% reduction in acute admissions. This helps keep people healthy at home, reducing the demand for acute beds. 

There are five key steps to de-risk transformation assumptions by embedding transformation in programmes: 

1: Co-produced, patient–centred care 

Patient–centred design puts citizen needs at their heart, designing care models that are holistic, address a range of needs, and empower patients to manage their own care. Programmes should embed this in their model of care and engagement approaches, ensuring meaningful listening and production with local people. 

Key questions: 

• Is there meaningful co-production and a citizen voice in your programme? 

• Are holistic citizen needs considered, or just parts of the pathway/ –illness? 

2: Empowered health and care professionals 

Transformational capital programmes need to be locally led. This means building ownership and recognition by clinicians, nurses, allied health, social care, and third sector professionals. It avoids the risks of nationally mandated planning assumptions being disconnected from local population needs, systems, or programme delivery.  

Key questions: 

• Are a range of disciplines included: clinical, nursing, and other allied health and care professionals? 

• Do clinical voices have the time, skills and learning opportunities to meaningfully engage and lead? 

3: Data driven, population health approach  

A population health approach shifts the focus from individual patient care to the overall wellness of the community. It integrates clinical care with public health efforts, emphasising prevention, health promotion, and addressing social determinants of health. A data–led approach stratifies population risk to identify opportunities where intervention can avoid deterioration or crisis.  

Key questions: 

• What is your readiness as system for a risk stratified, population health approach?  

• Do you know your population health priorities? 

4: Incubate system working  

Integration is a necessity for transformation. We know that voluntary, community, faith and social enterprise (VCFSE), intermediate and social care are key drivers of an acute hospital’s performance. A major capital investment is an opportunity to incubate system working – testing new models and building confidence in delivery of system transformation. 

Key questions: 

• Are system partners embedded in your programme governance and design? 

• Have you aligned priorities to test system-wide transformation? 

5: Start now 

The ambition for the New Hospital Programme is huge. Delivery will require changes to both culture and behaviour, pathway design, and embedded use of digital and data. These changes take years, and if insufficient progress is made facilities may be too small on opening, not address inequality, and miss opportunities to transform care.  

Embedding these changes within programmes will not only address the immediate needs of the healthcare system but also pave the way for long-term innovation and improvement.

Find out more 

IMPOWER has 25 years of experience of delivering transformative programmes in health and care, using the latest behavioural insights to deliver better outcomes for less.  

If you are interested in hearing more about our work with capital programmes, get in touch to find out more about our series of learning events and round tables for NHS leaders.