Billions invested in NHS infrastructure reform

The partnership between the Government Commercial Agency and NHS England has secured nearly £5 billion in healthcare construction over the last four years

Through the ProCure23 agreement, the NHS has delivered new cancer centres, intensive care units, and diagnostic hubs while saving costs through capped fees and standardised contracts.

A four-year review of the partnership between the newly formed Government Commercial Agency (GCA) and NHS England reveals a massive overhaul of the UK’s healthcare estate.

Since 2022, the ProCure23 (P23) agreement has successfully awarded £2.5 billion in construction schemes, with another £2.2 billion already in the pipeline.

Transforming the frontline

The collaboration has delivered a wide range of essential facilities across the country, focusing on increasing capacity and modernising aging infrastructure. Between 2025 and 2026, several high-profile projects were completed or initiated:

• Cancer care:

  • A new Principal Treatment Centre for Children’s Cancer Services at Evelina Children’s Hospital in South London.

• Critical care:

  • A 21-bed intensive care unit at Kingston Hospital.

• Diagnostics:

  • Two new Community Diagnostic Centres (CDCs) for Warrington and Halton.

• Outpatients:

  • A three-story outpatient facility at North Manchester General Hospital.

The “gold standard” framework

The success of these projects is attributed to the CWAS 2/ProCure23 agreement, a “Gold Standard” framework designed to make public sector construction faster and more cost-effective.

The agreement offers the NHS capped framework rates and fees, ensuring that taxpayer money goes further. Trusts also gain free access to NHSE implementation leads and a pool of approved suppliers who specialise in complex healthcare design. Crucially, all P23 suppliers are committed to Net Zero carbon techniques and modern construction methods, ensuring that new buildings are environmentally sustainable.

NHS infrastructure: CWAS 3 and beyond

As the current agreement enters its final stages, the GCA has announced the launch of Construction Works and Associated Services 3 (CWAS 3) in March 2027.

This new 8-year agreement will consolidate three existing frameworks into a single route to market for the entire public sector.

A major focus of CWAS 3 will be improving access for SMEs (Small and Medium Enterprises) through dedicated project lots and guaranteed prompt payment terms.

By simplifying the process, the government aims to continue building an NHS estate that is both resilient and fit for the future.