Are enough new hospitals being built in the UK?

Back in 2020, the Government announced the New Hospitals Programme (NHP). A programme committed to building 40 new hospitals in England by 2030.

According to the National Audit Office, the NHS in England has roughly 1,500 hospitals. Some of these hospital estates are in poor condition, with buildings requiring extensive repairs or total rebuilding. Underinvestment into hospital buildings has led to several closures over the years. Are 40 new hospitals enough to cover these closures? Let’s find out.

 

The New Hospitals Programme

The Government’s decision to build 40 new hospitals in England aimed to reduce waiting times for patients, and provide much needed medical facilities. The timeframe put forward was to have the new hospitals built by 2030. An ambitious target of 40 new hospitals in 10 years. The definition of a new hospital varies. It may range from a brand new building on a new site, to a significant refurbishment or alteration to an existing building.

According to GOV UK, this scheme is now expected to represent over £20 billion of investment in new hospital infrastructure. Despite Covid-19 delays, the project is underway. A total of three hospitals are now open to patients, with two hospitals complete and awaiting opening. Five further hospitals are under construction as of November 2023.

However, many organisations are criticising the speed and progression of the scheme. An article by the Guardian discusses how “an investigation by the Observer has revealed that only 10 of the 40 projects have the full planning permissions they need to go ahead.”  This poses the question, will 40 new hospitals be built by 2030 as planned? And what other factors influence the programme?

 

RAAC Hospitals

A major factor in the speed and success of the New Hospitals Programme is the addition of rebuilding various hospitals. There are 5 hospitals which have become a Government priority to be rebuilt due to poor quality building materials.

After a review of many hospitals in England, it was discovered that several were built using a type of concrete called RAAC. Meaning “Reinforced Autoclaved Aerated Concrete”. It was a common building material in the UK from the 1960s to the 1980s. The issue with this material is that it is a cheaper type of concrete, which contains bubbles and is more lightweight. It can also let water into the reinforcing steel frame causing it to rust and crumble over time.

How does RAAC impact the programme?

A major problem with RAAC is that it has around a 30 year shelf life, according to an article by The Standard. After its limited life span, the material can deteriorate quite significantly, causing issues for several older hospitals.

Structural assessment of the 5 hospital sites has confirmed they will no longer be safe to operate beyond 2030. Putting pressure on the Government to deliver as soon as possible. Construction on RAAC hospitals is due to begin in 2025, narrowing the time frame to just 5 years to repair 5 hospitals.

The following 5 hospitals are due to be rebuilt to some extent, as they have large amounts of RAAC:

• Airedale General Hospital in West Yorkshire
• The Queen Elizabeth Hospital in King’s Lynn, Norfolk
• Hinchingbrooke Hospital in Cambridgeshire
• Leighton Hospital in Cheshire
• Frimley Park Hospital in Surrey

You can find a list of all hospitals with confirmed RAAC.

While these hospitals remain open, fears that they will not be rebuilt before they are unsafe to operate in, are growing. Five hospitals have been identified for prioritisation. However, over 40 in total have been found to have some amount of RAAC concrete in their buildings.

An article in the Construction Index expressed concerns that if the rebuilding process is not sped up, some hospitals may have to close before their replacements are ready. Leaving patients without necessary care and resources. With an ever-growing backlog of patients waiting for tests and treatments, potential hospital closures can only worsen the situation.

 

Construction delays

After the announcement in 2020, just 3 new hospitals are now functioning and open to patients as of 2023. With a further two complete but unopened, and five under construction. As 2030 looms, many fear the ambitious target can not be met.

From the Guardian 2023, “there’s a 0% chance there’s going to be 40 new hospitals by 2030,” said the boss of one of the NHS Trusts awaiting a new hospital.” As mentioned earlier, only 10 out of 40 building projects have full planning permission. Without permissions already in place, significant delays could be expected. In the same article, it was stated that “those involved in some of the projects said they had already faced lengthy delays, leaving them with decrepit and often unusable buildings.”

In addition, in May 2023, the Daily Mail reported that “the main building works have yet to start at 33 facilities, it was revealed today. Another five are currently under construction.” As well as noting that the “health chief is ‘frustrated’ by the delays and lack of clarity over the huge scheme, which No.10 originally backed with £3.7 billion in funding.”

Between construction delays, budget concerns and a pressing time constraint. It appears that the 2030 target for 40 new hospitals may not be met. Despite continued optimism from the Government, many are concerned that more hospitals will close before they are repaired.

 

Investment

On top of a tight timeframe and construction difficulties, investment appears to be an issue in completing building of new hospitals. In October 2020, an initial budget of £3.7bn was confirmed. Since then, as of November 2023, the New Hospital Programme was expected to be backed by over £20 billion of investment.

Despite the £3.7bn initial investment announcement, many hospitals have not yet received enough funding to begin their projects. Hospitals in the programme were contacted by news outlets to determine the status of their progress. The BBC found that of the 40 hospitals in the scheme, just 8 had full funding. 31 had not yet received the money to start “core building work” but had received some money to kickstart the project. One hospital declined to answer.

Without the appropriate funding to begin the work, the 2030 target provides difficult for most of the hospitals involved. The Daily Mail highlighted the additional NHS costs, “backlog maintenance costs in the NHS have more than doubled from £4.7billion in 2011 to £10.2billion a decade later. Works needing done range from leaky gutters and faulty lifts, to the very fabric of hospital buildings.” The rising costs of running the NHS, on top of the New Hospitals Programme are likely to be a concern.

Budget is a major factor in the progress being made, and some organisations are concerned that financial limits may lead to hospitals being made “too small”, or that they won’t meet the needs of patients. Resulting in further financial loss and even more delays to development of the project.

 

Are enough new hospitals being built?

While the target of 40 new hospitals by 2030 is certainly ambitious, work has progressed on some hospitals and facilities across the UK. In addition, the identification of RAAC hospitals provides a positive future for those facilities. Now the hospitals are known to need repair, they are being prioritised. In July 2023, Sky News wrote that “the government is set to finish only 32 of its promised new 40 hospitals by 2030”. Though this does not meet the target, 32 new hospitals will majorly benefit the communities they operate in.

However, the lack of cohesive message and investment, combined with construction delays provides unrest and a lack of confidence in the programme meeting the established timeframe. In an article by The Guardian (September 2023), they write that “some hospitals are so dilapidated that they regularly have to shut wards and operating theatres to safeguard patients’ safety, a senior NHS boss has admitted.”

Without a significant push on beginning construction, many hospitals in the programme are unlikely to be rebuilt or refurbished by the Government target of 2030. Patients of dilapidated and run down hospitals may find themselves without the services and facilities they need if progress is not made quickly.

 

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