In a highly critical report published today, the PAC voices extreme concern at the New Hospital Programme’s lack of progress.
It warns the recently revised target to construct 32 new hospitals by 2030 rather than 40 as first planned is unlikely to be met.
The Committee says that delays to Hospital 2.0 have eaten into the time available to pilot new standardised designs in real-life scenarios running the risk of baking-in and replicating design and construction problems across England.
The PAC report highlights that most worryingly of all, the latest version of Hospital 2.0 is based on assumptions that appear very likely to produce hospitals that are too small.
Delays to signing off standardised design principles has also hindered meaningful engagement with the construction industry on the details of the design and the commercial pipeline of work.
Dame Meg Hillier MPm chair of the PAC, said that big questions remain to be answered about the industry’s capacity and appetite to build the required number of hospitals in the new way and to a very tight timetable.
It also challenges the plan to bolt the rebuilding of seven RAAC impacted hospitals on to the back of the revised programme risks some hospitals having to close before replacements are ready.
“The physical edifice that is the NHS is quite literally crumbling before our eyes. There was nothing inevitable about this heartbreaking crisis.
“It can be laid squarely at the door of the decision to raid budgets reserved for maintenance and investment in favour of day-to-day spending.
“The sharp distinction between capital and revenue budgets exists for a reason. We are now seeing the consequences of this short-termism visited on patients and services.”
She added: “Quite aside from the fact that the planned new hospitals risk being too small for future purposes, funding does not even appear to be in place to construct them in time, all underpinned by failures of basic record-keeping and fresh and urgent concerns over RAAC.
“Though we have no confidence that the NHP will deliver on its current promises, we hope that the recommendations in our report help to get it back on track – for the sake of all citizens who desperately need the NHS to get well soon.”
Recommendations:
The Department for Health is being urged to consider:
Whether more new hospitals should commence construction sooner using pre-existing approaches to design and contracting.
Start construction before the end of 2025 on replacements for the seven entirely RAAC hospitals.
Aim to be ready to start construction during 2024 of at least one early scheme that uses its standardised hospital design, with a particular focus on trialling new clinical infrastructure such as standardised operating theatres.
Amend its Minimum Viable Product version of Hospital 2.0 so it does not result in future hospitals that are too small, and should set out clearly how these future hospitals fit into its assessment of total required hospital capacity nationally and by region.
Avoid reducing planned capital investment to meet day-to-day spending needs in future
