The National Audit Office (NAO) has issued a report "Review of capital expenditure in the NHS" where it discusses the postponement of a replacement for Private Finance Initiative (PFI) model as a key challenge for NHS.

In June 2019, HM Treasury closed its consultation on the broader government approach to the role of private finance in infrastructure projects, after ending the use of the Private Finance Initiative (PFI)/Private Finance 2 but is yet to set out whether it will make a mechanism to enable private investment in capital projects available to the NHS.

According to the report "access to capital funding under PFI is no longer an option for NHS providers. The Chancellor confirmed at the October 2018 Budget that no further PFI projects could be entered into, but existing projects would be honoured. There are 156 existing PFI and Local Improvement and Finance Trust schemes with a total future commitment of GBP 52.4 billion (USD 68.2 billion). Of these, 26 schemes each have a total future commitment greater than GBP 500 million (USD 651 million)".