Maximising NHS Spend: how agile delivery turns budgets into better outcomes

When the NHS approaches financial year end, many trusts face the familiar challenge of ensuring budgets are carefully managed and utilised. The real opportunity isn’t just in spending on time, but in spending strategically, so every pound delivers lasting value.

Agile, fast-turnaround estate project delivery can be an effective way to achieve this balance. By adapting the principles of agility - responsiveness, collaboration and sequencing - NHS estates and capital projects can unlock both financial efficiency and clinical benefit.

Using agile delivery to spend smarter

The agile way of working, when applied to construction and estates programmes, can help trusts deliver faster, reduce waste, and get assets operational sooner.

A practical example is early procurement. Many healthcare projects rely on bespoke components such as air-handling units, clinical pendants, imaging equipment or theatre control panels, with lead times of up to 20 weeks. On a 12-week construction programme, that delay can be critical.

By identifying long-lead items early and allowing the trust to purchase items directly, before works begin, teams can:

• Use available budget efficiently within the financial year.

• Reduce on-site delays by having equipment ready when needed.

• Avoid unnecessary prelims and overheads caused by idle time.

This approach not only accelerates delivery but can reduce overall costs and risk exposure.

Case studies: fast, focused and clinically driven

• Bournemouth Hospital – Stroke Unit

With winter pressures approaching, Bournemouth Hospital, part of the University Hospitals Dorset NHS Foundation Trust, needed new stroke beds open before peak season. Early procurement of critical air-handling equipment and a re-sequenced programme enabled completion on time and within budget, protecting vital bed capacity.

• North wing courtyard development

For this four-storey infill scheme at Southampton General Hospital, the client procured the steel frame directly to fast-track the programme ensuring the frame was able to be delivered as soon as the ground works were completed.. Plant was installed directly on adjacent roofs while the main build progressed, cutting weeks from the schedule and demonstrating how smart sequencing can transform delivery speed.

• University Hospital Southampton NHS Foundation Trust PICU expansion

Clinical demand required two new paediatric intensive care beds in record time at Southampton General Hospital. Following six weeks of preparation, the team completed the works inside the live hospital environment in just two weeks, a remarkable example of preparation, prefabrication, and collaborative working in action.

• Reducing programme time through overlap and agility

Beyond procurement, agile delivery focuses on adaptive programme management. By overlapping stages - for instance, progressing technical design alongside planning - projects can save up to 8–12 weeks, bringing facilities online sooner and reducing exposure to cost escalation. An example was when we designed and constructed a new oncology care unit at University Hospital Southampton NHS Foundation Trust in just nine months during the pandemic – timelines were tight, so we needed to manage the build efficiently.

Delivering value beyond year end

Maximising NHS spend isn’t about last-minute spending, it’s about strategic, agile investment. Planning early, identifying opportunities to accelerate procurement, and sequencing works intelligently, means NHS trusts can deliver essential clinical improvements while meeting financial responsibilities.

The ability to move quickly, think creatively and collaborate effectively ensures that every project delivers more than just a building, it delivers better care, faster.

Our team has helped many trusts turn year-end spend into lasting value through smarter procurement, collaborative design and fast-track delivery. We can deliver individual disciplines or fully integrated teams under one umbrella. We call it 1 Team: Architects, Building Surveyors, Technologists, Project Managers, Principal Designers, Quantity Surveyors, Building Services Engineers, Low Carbon Consultants and more.

Our 1 Team approach provides an optimal client experience, reducing risk, and cost and promoting project agility in fast-paced NHS environments. It's how we deliver high quality projects that go beyond technical excellence to improve healthcare for patients. Let us know if Kendall Kingscott can help with your estate requirements.