NHS: Private Finance Initiative

As set out in the 10 Year Infrastructure Strategy (the Strategy) and the 10-Year Health Plan, in addition to significant capital investment, the Government would explore the feasibility of using new Public Private Partnership (PPP) models for taxpayer-funded projects in very limited circumstances, where they could represent value for money. This included the potential use of PPPs to deliver Neighbourhood Health Centres (NHCs).

A business case was developed by the Department and supported by National Infrastructure and Service Transformation Authority (NISTA). The business case was considered by ministers and has resulted in the announcement in the Budget published on 26 November 2025.

The Budget builds on the Strategy and the 10-Year Health Plan by confirming that the NHS Neighbourhood Rebuild Programme will deliver new NHCs through upgrading and repurposing existing buildings and building new facilities through a combination of public sector investment and a new model of PPPs.

This new PPP model is being developed by NISTA, and is supported by the Department, and will ensure private sector expertise is harnessed to deliver these assets on time and on budget.

The new model will build on lessons from the past and other models currently in use, and will draw on lessons learnt, including the National Audit Office’s 2025 report on private finance.

To ensure the NHC PPPs are managed transparently and are fiscally sustainable, these partnerships will be budgeted for as if they are on a balance sheet.

Delivering new NHCs through a combination of public investment and PPPs will also allow, for the first time, for evidence to be built and compared between different delivery models.