The information is shown in the following table.
National health service organisation Operational Capital value (£ million) Contract length (operational phase) Total value of annual unitary payments (cash terms) (£ million) Total value of annual unitary payments (real terms) (£ million) Worcestershire Acute Hospitals NHS Trust Yes 87 30 900 535 Derby Hospitals NHS Trust No 312 35 2,082 1,248 University Hospital of South Manchester NHS Trust Yes 67 35 1,064 653 Queen Mary’s Hospital Sidcup NHS Trust/Oxleas NHS Trust Yes 21 30 134 85 Central Manchester and Manchester Children’s University Hospitals NHS Trust No 512 37 2,856 1,805 Doncaster and South Humber Healthcare NHS Trust Yes 12 30 80 51 University Hospital Birmingham NHS Trust No 627 35 2,582 1,645 Barts and the London NHS Trust No 1000 35 5,295 3,374 University Hospitals Coventry and Warwickshire NHS Trust Yes 379 35 2,962 1,887 St. Helen’s and Knowsley Hospitals NHS Trust No 338 35 1,648 1,050 Barking, Havering and Redbridge NHS Trust Yes 238 36 1,749 1,119 East Lancashire Hospitals NHS Trust Yes 110 35 627 403 South West Essex Teaching PCT No 32 30 152 98 Salford Royal Hospitals NHS Trust No 190 34 621 401 Walsall Hospitals NHS Trust No 169 34 652 422 North Middlesex Hospitals NHS Trust No 144 34 1,038 670 North Cumbria Acute Hospitals NHS Trust Yes 67 30 570 372 Dudley Group of Hospitals NHS Trust Yes 137 37 1,060 694 Newcastle-upon-Tyne Hospitals No 299 33 1,240 813 Portsmouth Hospitals NHS Trust No 238 32 1,583 1,052 University College London Hospitals NHS Trust Yes 422 32 1,926 1,280 Sherwood Forest Hospitals NHS Trust No 326 32 1,599 1,062 Peterborough and Stamford Hospitals NHS Foundation Trust No 336 32 1,343 893 Mid Essex Hospitals NHS Trust No 148 32 678 450 Leeds Teaching Hospitals NHS Trust Yes 265 33 976 653 Derbyshire Mental Health Services NHS Trust No 36 30 137 92 South Essex Partnership NHS Foundation Trust No 32 30 115 78 West Middlesex University Hospital NHS Trust Yes 60 33 515 347 East and North Hertfordshire PCT Yes 15 30 83 56 Lewisham Hospital NHS Trust Yes 72 32 268 182 North Staffordshire Combined Healthcare NHS Trust Yes 28 30 153 104 Sussex Partnership NHS Trust Yes 22 30 151 103 Calderdale and Huddersfield NHS Trust Yes 65 30 731 499 Nottingham University Hospitals NHS Trust Yes 17 30 114 78 Sandwell and West Birmingham Hospitals NHS Trust Yes 26 30 138 95 Leeds Mental Health Teaching NHS Trust Yes 47 26 363 248 Berkshire Healthcare NHS Trust Yes 30 30 185 126 West Berkshire PCT Yes 19 30 139 95 Newham Healthcare NHS Trust Yes 52 30 492 336 Ipswich Hospital NHS Trust No 36 30 127 87 Lincolnshire Teaching PCT No 29 30 104 71 University Hospital of North Staffordshire NHS Trust No 375 30 1,788 1,222 Hereford Hospitals NHS Trust Yes 64 30 464 317 South Tees Acute Hospital NHS Trust Yes 122 30 1,149 785 Devon PCT Yes 10 30 64 43 Avon and Western Wiltshire MH NHS Trust Yes 83 30 275 188 Queen Elizabeth Hospital NHS Trust Yes 96 30 799 546 Surrey PCT Yes 29 30 132 90 Nuffield Orthopaedic NHS Trust Yes 37 30 191 131 Hull and East Yorkshire Hospitals NHS Trust No 67 30 178 121 Brighton and Sussex University Hospitals NHS Trust Yes 36 30 180 123 Mid Yorkshire Hospitals NHS Trust No 353 32 1,187 811 Brent PCT Yes 21 30 125 85 Buckinghamshire Hospitals NHS Trust Yes 45 30 441 301 Cornwall Healthcare NHS Trust Yes 10 30 108 74 North East London Mental Health NHS Trust Yes 11 30 51 35 Taunton and Somerset NHS Trust No 21 30 113 77 Birmingham and Solihull Mental Health NHS Trust Yes 18 30 253 173 St. George’s Healthcare NHS Trust Yes 46 32 319 220 Tees, Esk and Wear Valleys NHS Trust No 75 29 277 192 Tameside and Glossop Acute Services NHS Trust No 112 34 442 306 The Whittington NHS Trust Yes 32 30 158 110 The Royal Wolverhampton Hospitals NHS Trust Yes 13 30 130 90 Northumberland, Tyne and Wear NHS Trust Yes 31 30 210 145 Cambridge University Hospitals NHS Foundation Trust Yes 76 30 266 184 Salisbury Health Care NHS Trust Yes 24 30 104 72 Nottinghamshire Healthcare NHS Trust No 19 30 94 65 Wandsworth PCT Yes 75 30 429 298 Hull and East Yorkshire Hospitals NHS Trust Yes 22 30 84 59 Northamptonshire Teaching PCT Yes 28 30 90 62 Bromley Hospitals NHS Trust Yes 118 30 788 548 Leeds Teaching Hospitals NHS Trust Yes 14 30 73 50 County Durham and Darlington Acute Hospitals NHS Trust Yes 10 30 90 62 Sheffield Teaching Hospitals NHS Foundation Trust Yes 30 30 108 75 Hampshire PCT Yes 36 30 194 135 North West London Hospitals NHS Trust Yes 69 30 299 208 Kirklees PCT Yes 25 30 90 62 Norfolk and Norwich Health Care NHS Trust Yes 158 30 1,647 1,149 County Durham and Darlington Acute Hospitals NHS Trust Yes 48 30 366 256 Buckinghamshire Hospitals NHS Trust Yes 47 30 438 306 East Lancashire Hospitals NHS Trust Yes 30 30 134 93 Oxford Radcliffe Hospitals NHS Trust Yes 134 30 832 582 County Durham and Darlington Acute Hospitals NHS Trust Yes 61 30 525 367 Oxford Radcliffe Hospitals NHS Trust No 129 30 690 483 Gloucestershire Hospitals NHS Foundation Trust Yes 32 30 142 99 Kingston Hospital NHS Trust Yes 28 30 338 236 Northgate and Prudhoe—Neuro Disability Centre Yes 24 30 62 44 King’s College Hospital NHS Trust Yes 76 35 727 520 Swindon and Marlborough NHS Trust Yes 100 28 689 494 East London and the City Mental Health NHS Trust Yes 15 30 63 45 Tees, Esk and Wear Valleys NHS Trust Yes 16 30 32 23 Northumbria Health Care NHS Trust Yes 54 30 253 185 Northumbria Health Care NHS Trust Yes 18 30 72 53 Northamptonshire Healthcare NHS Trust No 36 28 139 104 Barnet and Chase Farm Hospitals NHS Trust Yes 54 30 622 471 Luton and Dunstable Hospital NHS Trust Yes 15 30 51 39 Dartford and Gravesham Hospital NHS Trust Yes 94 25 602 471 Total — 10,480 — 59,396 39,406 Note: For convenience of calculation, the real terms figures do not take account of the minor variations to date included in the cash figures. The overall effect though is negligible i.e. the aggregate real terms figure of £39 billion is almost identical to the effect of simply stripping out compound inflation at 2.5 per cent. from the total cash figure of £59 billion.
There are many hundreds of contracts negotiated annually between national health service bodies and private sector suppliers for a full range of services and equipment that involve elements of public private partnerships. These range from service contracts with private hospitals and social care placements to leases of equipment and private finance initiative contracts.
Of the three major areas of public private partnership contracts for which information is collected centrally—private finance initiative (PFI) schemes, NHS local improvement finance trusts (NHS LIFT) and independent treatment centres (ISTCs)—lists have been placed in the Library. For PFI and NHS LIFT the lists show only those schemes which have reached financial close as it is not possible to predict final capital values and annual payments on schemes which are still in the planning or procurement stages. The lists show the estimated capital value of each scheme (an approximation to asset value), where appropriate, as well as the annual unitary payment made by each NHS body to their private sector partner.
For ISTCs, the table shows the total contract value for Wave 1 schemes. The total contract value represents the estimated nominal value at the time of signing, calculated in accordance with an estimate of the inflation index as specified in each contract. Procurement of Phase 2 of the ISTC programme is ongoing and all contractual values remain commercial in confidence at this time.
In the case of the PFI schemes, under current accounting standards the facilities do not appear on the balance sheet of the NHS body during the life of the contract; and by the end of the contract all the debt raised by the private sector has been paid back. So although the facility will have a residual value when it reverts to the ownership of the NHS trust or primary care trust at the end of the contract, it will go on their balance sheets as an asset without an off-setting liability or ‘debt’.
In the case of NHS LIFT schemes the facilities also do not appear on the balance sheet of the NHS body during the life of the contract. However, the shorter contract lengths (typically 25 years compared with 30 or more in a PFI scheme) mean there is a small outstanding debt owed by the NHS LIFT project company at the end of the contract (i.e. their outstanding borrowings). In NHS LIFT this is a project company ‘risk’ in terms of recouping enough from the future use or disposal of the asset to meet this debt (known as ‘residual value risk’). The NHS body has an option to buy the facility or walk away from the contract, in which case the project company must look to sell the facility on the open market or lease it out again. So again, there is no ‘debt’ owed by the NHS body at the end of the contract.
In the case of the ISTCs, where the contract lengths are much shorter, many of the contracts involve a residual value payment to the contractor at the end of the term. This means that in this case the ‘residual value’ risk lies with the NHS (i.e. the risk here is that the theoretical residual value will exceed the actual market value that can be achieved). So there is a ‘debt’ owed by the NHS body at the end of the contract. Information on the ISTC contracts that involve residual value (RV) payments and the amounts in each case have also been placed in the Library.