The five hospitals are Airedale in West Yorkshire, Queen Elizabeth King’s Lynn in Norfolk, Hinchingbrooke in Cambridgeshire, Mid Cheshire Leighton in Cheshire, and Frimley Park in Surrey. These hospitals have significant amounts of reinforced autoclaved aerated concrete (RAAC), a lightweight type of concrete used to construct parts of the NHS estate in the past but has a limited lifespan, after which it deteriorates significantly.

The NHS has asked the Government to prioritise the rebuilding of these hospitals given the safety risks they pose to patients and staff – the full extent of which has come to light since the New Hospital Programme was first announced in 2020. The Government reaffirmed its committed to eradicating RAAC from the wider NHS estate by 2035, pointing out that it has already allocated £685 million in immediate support to affected trusts to help keep patients and staff safe.

Two of the worst affected hospitals – West Suffolk Hospital in Bury St Edmunds and James Paget Hospital in Norfolk – have already been announced as part of the Programme, with construction of these new hospitals also prioritised on safety grounds. Together with the five hospitals announced today, the hospitals will be rebuilt using a standardised design known as Hospital 2.0.

As a result of this reprioritisation, as well as the rising cost of construction materials, up to eight schemes that were originally due to be constructed towards the end of the decade will now be completed after 2030.

“Still on track”

The Government states it remains committed to delivering all hospitals within the Programme as soon as possible and has promised to ensure all schemes have adequate funding. It claims to be still on track to deliver its manifesto commitment to build 40 new hospitals in England by 2030, because in addition to the five RAAC hospitals, three mental health hospitals will also be delivered through wider capital funding by 2030 – as part of a commitment to eradicate dormitory accommodation from mental health facilities across the country and improve quality of care.

Two hospitals in the New Hospital Programme are already complete – Northern Centre for Cancer Care, North Cumbria Integrated Care NHS Foundation Trust; and Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust – and five are in construction, says the Government, which claims that by the end of 2024, more than 20 will be underway or complete.

The five hospitals under construction are: Midland Metropolitan Hospital – Sandwell and West Birmingham Hospitals NHS Trust; Northgate Hospital – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust; Greater Manchester Major Trauma Hospital – Northern Care Alliance NHS Foundation Trust; 3Ts Hospital – Brighton & Sussex University Hospitals NHS Trust; and Bath Cancer Hospital – Royal United Hospital Bath NHS Foundation Trust.

The Government asserts, too, that it will do everything it can to accelerate the completion timeline of the hospitals impacted, if circumstances allow.

Health and Social Care Secretary Steve Barclay said: “These five hospitals are in pressing need of repair and are being prioritised so patients and staff can benefit from major new hospital buildings, equipped with the latest technology.

“On top of this, I’m strengthening our New Hospital Programme by today confirming that it is expected to represent more than £20 billion of new investment in hospital infrastructure. As we approach the 75th anniversary of our fantastic NHS, this extra investment will ensure it can care for patients for decades to come and help cut waiting lists, so they get the treatment they need quicker.”

The new Louisa Martindale Building at Royal Sussex County Hospital in Brighton is due to open later this year, while work at Moorfields Eye Hospital is due to start imminently, having cleared its final business case.

Cohort 2 projects in the Programme comprise ten schemes. Eight are now ready to proceed, in line with the plans set out by their respective Trusts: the National Rehabilitation Centre; Derriford Emergency Care Hospital in Plymouth; Cambridge Cancer Research Hospital; Dorset County Hospital in Dorchester; in addition to St Ann’s Hospital, Christchurch Hospital, the Royal Bournemouth Hospital, and Poole Hospital, all in Dorset.

The two remaining schemes within Cohort 2 – Shotley Bridge Community Hospital and the Women and Children’s Hospital in Cornwall – will also be approved to proceed, but in line with the standardised design elements the Government is promoting through Hospital 2.0. All schemes within Cohort 3 are also now able to proceed with funding, and will be constructed using the Hospital 2.0 model. The Health Secretary also confirmed that four hospitals in Cohort 4 remain on track for completion by 2030, with some work beginning next year.

Rolling programme

In future, new schemes will be considered through a rolling programme of capital investment in hospital infrastructure to secure the building of new hospitals beyond 2030. According to the Government, it will mean further future investment to upgrade NHS facilities across the country, with details to be agreed periodically to provide greater future certainty.

By developing a national approach to delivering new hospitals, they can be built more quickly and at a reduced cost, says the Government, which adds that patients and staff will benefit from modern hospital design making use of the latest technology, digital innovation, and sustainability to improve patient experience and provide a better working environment.

Commenting on the announcement, Nigel Edwards, chief executive of the Nuffield Trust, described it as “a welcome recommitment to the ailing new hospitals programme, which seems to have been proceeding extremely slowly”.

But he also called for more clarity around the funding sums and how they have been calculated, stressing: “If there is no more money to go around, we shouldn’t make the mistake of raiding funds that are also urgently needed for upgrading inadequate NHS IT or addressing the backlog of maintenance, which hasn’t been done.”

He added: “We must not forget that this comes after a lost decade of investment in hospital buildings in England. If these sums had been invested a decade ago there is no doubt that the NHS would be in a far better position than it is now. We lag our European neighbours when it comes to the numbers of scanners and other pieces of diagnostic equipment.”

Short of cost expectations?

Matthew Taylor, chief executive of the NHS Confederation, pointed out that the £20bn of investment earmarked for the New Hospital Programme “falls significantly short of the £35bn it is expected to cost” – as reported by HSJ in April.

Lamenting how the NHS has been allowed to fall into “a significant state of disrepair over the last 15 years”, he said: “A comprehensive and long-term capital investment plan is needed to support the NHS get out of this hole, and this must also include primary care, where one in five GP premises are deemed not to be fit for purpose currently.”

Sir Julian Hartley, chief executive of NHS Providers, echoed other commentators in calling for more detail on the funding announced, but he also warned that the total may not satisfy capital demand.

“Many more mental health, acute, community and ambulance services continue to be disappointed at the lack of money for critical capital projects, with the bigger picture being that too many NHS buildings and facilities are in a dire and deteriorating state,” he said. “The fact that 100 trusts bid for the last eight NHP places shows that we need a step change in capital investment by the government. Trusts that missed out still need major capital investment to overhaul ageing estates.”

Health infrastructure specialist Archus is supporting several NHP schemes with programme management services, including projects for Leeds Teaching Hospitals NHS Trust and Hillingdon Hospitals NHS Foundation Trust. The company’s director of commercial and performance, Victoria Head, commented: “Through standardisation, the use of modern methods of construction, and a new approach to capital project delivery, the Programme is drawing on best practice to enhance delivery, value for money and, ultimately, improve the patient and workforce experience, creating sustainable infrastructure that will shape the future of healthcare delivery in the UK.

“We should recognise that even if all 40 hospitals are successfully built, this will still not address the level of investment required in the estate to adequately reduce the serious and significant risk that exists in the short term. At the same time, healthcare continues to see rising demand for its services and rapidly widening health inequalities.”

Senior responsible owner of the New Hospital Programme Natalie Forrest described the announcement as “a significant milestone” for the Programme.

“We’re continuing to build healthcare infrastructure that improves patient care – including modern designs, creating single rooms ensuring maximum natural light and access to outdoor spaces,” she said. “This new design will reduce the workload of NHS staff through digital solutions, well-designed flow, and designated areas for staff recuperation. I look forward to continuing to work with all Trusts already in the Programme and welcoming the new ones into the New Hospital Programme.”

More details on current schemes that will be completed past 2030 will be set out in due course, ministers confirmed.