Further calls for capital boost

The Guardian reported this week that 34 buildings at 16 NHS trusts in England contain planks built from reinforced autoclaved aerated concrete (RAAC). The material was widely used in the1970s and 1980s to provide support to structures such as roofs and is reported to have an expected lifespan of 30 years.

Concerns emerged in recent years about its use in hospitals. However, health and social care minister Maria Caulfield (pictured) used a written answer to a Parliamentary question to report that more facilities were at risk than previously thought. The 16 trusts now believed to have RAAC planks within their structures compares to original estimates of just 13.

She said the issue was being addressed. ‘All affected trusts have employed structural surveyors to assess the condition of the infrastructure,’ she said. ‘A ring-fenced allocation of £110m has been provided to mitigate the immediate risk and trusts will receive a further £575m in the current spending review period.’

According to capital guidance for 2022/23, funding for RAAC hospitals has been separately identified within operational capital envelopes and is ringfenced.

The NHS Confederation said that NHS leaders had been warning about the dire state of many of the service’s buildings for some time. ‘Put simply, the government has starved the NHS of capital investment for more than a decade and we are seeing the impact of that now - both in terms of run-down buildings and a spiralling maintenance backlog,’ said the representative body’s senior acute lead Rory Deighton. ‘All of this is putting patients at risk.’

He added that the lack of investment in buildings and infrastructure was also hindering efforts to reduce the waiting list.

‘It’s critical that the government provides much quicker access to capital funding and invests in the estate at the Budget or any emergency Budget in the autumn,’ he said. ‘A failure to do so will continue to undermine the NHS’ ability to work efficiently and provide value for money to taxpayers despite the very best efforts of NHS leaders and staff.’

Last week, NHS England announced its plan to increase capacity and resilience ahead of an expected busy winter period. This will include increasing capacity by the ‘equivalent of at least 7,000 general and acute beds’. This will involve a mix of physical beds virtual wards and improvements elsewhere in the pathway.

Integrated care systems have already been asked to deliver virtual ward capacity of 40 to 50 virtual beds per 100,000 population (equivalent of up to 24,000 virtual beds) by December 2023. It is not clear how much of the new 7,000 bed target involves physical beds or how these beds will be staffed, given staffing shortages and caps on agency staff spending.