News / Hospital 2.0 still expected to accelerate building programme

The complete package of design elements included in the Hospital 2.0 standardised design will be available by May next year, according to the Department of Health and Social Care.

Members of the Commons Public Accounts Committee raised concerns this week about the ability of the government’s new hospital programme (NHP) to meet its commitment to build 40 hew hospitals by 2030. A key part of this programme is the use of a new standardised construction process, known as Hospital 2.0.

Only two of 40 promised new hospitals have been built to date (according to government definitions) – leaving a further 38 to be built in the remaining seven years. Committee members said this seemed highly unlikely to be achievable, particularly given the standardised design that will underpin many of the new builds has not been completed yet.

Natalie Forrest, the Department's senior responsible owner of the new hospital programme, acknowledged that adopting the new approach was a challenge. ‘However, Hospital 2.0 isn’t just about the design of the hospital it is the whole end-to-end process,’ she told the committee. ‘It is the business case process, design, construction, the operating model and the maintenance, which is equally important.’

She added that consideration had been given to how time could be reduced for all of those components of the process. ‘We anticipate going from an average of around 11 years, which is what we see currently, to around six years and significantly compacting the whole business case process, which we can be doing now in parallel to working around the design of the hospital. We can also be doing the work we need to do engaging clinicians and the public and the trusts themselves in their services' requirements.’

Earlier estimates have suggested that, with the new approach, hospital construction will be 25% cheaper and 20% quicker compared with traditional approaches.

Ms Forrest said that the first set of standards for Hospital 2.0 was already available – a mix of clinical standards, ‘adjacencies’ that would be expected, and some room designs. And Department of Health and Social Care permanent secretary Shona Dunn added: ‘The final elements of it – the complete package – will be in existence by May next year.’

Giving an example of the type of efficiency that could be achieved, Ms Forrest said that the number of door types in cohort two had already been massively rationalised. This would speed up the manufacturing process and reduce costs.

The NHP has been welcomed as replacing key parts of the NHS estate, but it is by no means meeting all the NHS’s capital needs. Backlog maintenance currently stands at over £10bn. Ms Dunn said that the NHP would make an important contribution to addressing backlog maintenance, with about a third of the current maintenance backlog sitting within a NHP site.

However, there was acceptance that providers within the programme would need to use some of their operational capital in the meantime to keep facilities operational, even though these facilities would be replaced in the short- to medium-term.

NHS England chief financial officer Julian Kelly (pictured) said that in the long run the programme would help the maintenance programme. ‘Given you are building hospitals to last for 60 years, it will definitely be better, because you have flagged hospitals with significant estates issues and we need to get on and replace those buildings. In the meantime, those hospitals will be making decisions to maintain estate so they can be sure they can continue to operate.’

Mr Kelly also confirmed that further NHS sites had raised concerns about the presence of reinforced autoclaved aerated concrete within their hospitals. The NHS has been running a programme to identify, mitigate and eradicate the concrete since 2019. Earlier surveys had found 41 buildings across 23 trusts with RAAC planks included within some part of their construction. Seven hospitals were built entirely – or in major part – with RAAC and will be replaced by 2030 as part of the NHP.

Mr Kelly said that while work was still ongoing to understand the full extent of the problems, the additional hospitals would amount to ‘tens not hundreds’.