The National Audit Office (NAO) has published an update on the New Hospital Programme (NHP), which concludes that the final hospitals under the scheme are not expected to be complete until 2045-46. The seven hospitals that are predominantly constructed using RAAC (reinforced aerated autoclaved concrete) will not be complete until 2032-33. Furthermore, the NAO estimates that total capital funding of around £56bn will be required. This is a £33.8bn increase on the funding proposed in 2023.
The initial timescale for the NHP, set out by the previous government, was to deliver 40 new hospitals by 2030. Following a review, this target was declared to be undeliverable by the present government in January last year, and the programme was reset to put it on a more realistic timetable.
The RAAC seven
In 2022, an independent report recommended that these hospitals should be replaced by 2030 at the latest. Whilst the Department of Health and Social Care (DHSC) has prioritised these hospitals in its revised plan, the NAO analysis confirms they will not be replaced by that date.
A recent report, commissioned by the DHSC, concluded that with mitigations and sustained maintenance, these hospitals can remain operational beyond 2030. However, this approach comes with operational risk and significant cost. This report found that whilst ongoing remediation works will reduce the majority of risks of RAAC plank collapse, between 1% and 6% of planks are inaccessible and will therefore continue to present a risk.
Standardised approach
The New Hospital Programme aims to introduce a more standardised approach to design and construction, and the Hospital 2.0 design is working to improve efficiency and patient care, bringing many benefits to patients and staff, including single rooms, shorter walking distances for staff, paperless patient records and technologies such as infrared sensors to alert staff when a patient falls.
The centralised approach is expected to deliver an additional £7.5bn in savings and benefits compared to a Trust-led approach, however, it is taking longer than anticipated to complete the design. Originally this was scheduled for completion by 2023, but it is now expected by April 2026. It’s important that this design is correct, and NAO recommend sufficient time is allowed for testing and ensuring strong input from Trust staff and leaders
System capacity
The NAO cautions that the shift to community care must be monitored carefully to avoid specifiying under-sized hospitals. DHSC projection of future demand for hospital beds depends on more patients being treated in the community. These demand assumptions should be refined and clear contingency plans developed across the wider health system.
