Building better for the future

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As the NHS prepares for a new wave of hospital building, Nuffield Trust’s Chief Executive, Nigel Edwards argues that more can be learned from the last period of significant redevelopment and construction of new acute facilities that took place between 1997 and 2010.

The health charity has published a discussion paper focusing on the lessons that should be learned from this previous hospital building programme, together with recommendations for the next phase that we about to enter.

The government’s five-year scheme for new building projects across the NHS, unveiled in the Health Infrastructure Plan, HIP, has given the go-ahead for over 40 different building schemes as part of a ‘rolling programme of investment in health infrastructure’. Some of these projects are major redevelopments.

Writing in the paper, Chief Executive Nigel Edwards says that: “Experience demonstrates the importance of planning for the whole system, rather than just hospitals in isolation, and to form a plan for many services – thinking beyond health care delivery alone.”

The paper pulls together the views of several experts who were involved in the previous phase of hospital development, with contributions from NHS project directors, architects, health planners, researchers and consultants. It also considers the impact of COVID-19 on the structure and provision of healthcare services, which underlines the need for flexibility and enhanced focus on infection control, among other issues.

Among the key issues identified by Nuffield Trust are:

• The need to improve planning and the assumptions that underpin it

• Identifying ways to improve the quality of design, procurement, project management and construction

• Concerns regarding the approvals process.

The paper covers several key aspects of the building and redevelopment process, including planning, capital allocation, skills/expertise, design, quality and opportunities that may have been missed previously. It makes a number of recommendations for different parts of the system: NHS Trusts, ICSs/STPs and NHS England.

Download the full paper here.



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