Upgrades to hospital estates affected by reinforced autoclaved aerated concrete (RAAC) will ‘proceed at pace’ despite the Labour government’s ongoing spending review.

The new administration announced in July it would review the Conservatives’ flagship New Hospital Programme (NHP), which pledged to build or expand 40 hospitals by 2030.

This prompted concerns that redevelopment work and the removal of RAAC would be stalled.

But Health Secretary, Wes Streeting, has told MPs that the seven hospitals in the programme which were constructed largely of RAAC, will not be considered under the scope of the review.

On 20 September, The Department of Health and Social Care (DHSC) published the terms of reference for the NHP review.

And it stated that the probe will assess ‘the appropriate schedule for delivery of schemes in the context of overall constraints to hospital building and wider health infrastructure priorities, while also looking at where improvements can be made’.

Out of scope will be schemes that have approved full business cases, and any associated phases that have specific commitments.

The review assumes these will continue to their current delivery timelines.

Safety risks

Also out of scope will be the critical seven hospitals with RAAC, which will ‘proceed at pace due to the substantive safety risks associated with these’.

Instead the review will consider all remaining hospitals in the programme without full business case approvals for their main build phase.

The review will present a full range of options to be taken forward for the overall size and ambition of the programme to provide a clear approach for the programme going forward.

The review will also feed into the spending review process, where decisions on the outcome will be taken in the round and the Government will confirm the outcome of the review as part of that process.

The review was requested by Streeting and the Chancellor of the Exchequer and will be jointly led and resourced across the DHSC, NHS England, and HM Treasury (HMT).

It will be led by the director for delivery, performance and assurance in the DHSC’s New Hospital Programme sponsor team, along with senior colleagues from the NHS England delivery team and HMT.

A fast turnaround

A steering group, including representation from HMT, the Cabinet Office, and the Infrastructure and Projects Authority (IPA) will be convened to oversee the review, directed by the senior responsible owner for the NHP, the chief financial officer at NHS England, the director general for finance at the DHSC, and senior officials in HMT, reporting to the Permanent Secretary of the DHSC.

It will conclude ‘as soon as possible’ and will be submitted to the Streeting and the Treasury for consideration.

Under the review, key data will be collated for each of the hospitals, including criteria around clinical outcomes, deliverability, cost, and estate condition.

Data will be drawn from existing sources where possible. Where the information is not held, or not up to date, further data may be requested from NHS trusts or regional teams.

The hospitals in scope will be prioritised according to the criteria.

The review will look at the possible timelines for delivery for each scheme, along with clinical considerations, risk, and cost profiles and present a range of options to be taken forward.

Options and recommendations for phasing of the programme will then be established for ministers to consider.

The recommended options for scope, size, and phasing will be supported by confirmation of the optimum approach for delivery, underpinning clinical assumptions and the associated commercial strategy.