2 In reviewing these issues, we interviewed senior staff from four NHS trusts and NHS foundation trusts (NHS providers) in May and June 2019 (a mental health trust, two acute providers and a community health provider) in varying financial positions and with different levels of backlog maintenance. We used semi-structured questions to ask about their most significant capital-related issues facing their trusts. We interviewed senior staff from the Department of Health & Social Care (the Department) and NHS England and NHS Improvement and we also interviewed stakeholders such as NHS Providers, the Kings Fund, the Health Foundation and the Healthcare Financial Management Association.
3 We reviewed various documents such as the NHS Property and Estates report by Sir Robert Naylor, NHS providers' accounts and various research documents such as the Organisation for Economic Co-operation and Development's Health at a Glance. We examined NHS Digital's Estates Return Information Collection data, NHS providers' financial data, OECD data and the Department's accounts.
4 Cash figures are given in nominal prices, unless stated otherwise.
5 We excluded GP practices from our scope because, as private businesses, their own investment in capital does not count towards the Department's capital spending limit. Since our focus is predominantly on physical assets in NHS providers, we also excluded discussion of capital expenditure on research and development.