Hospitals built with outdated Raac will miss 2030 replacement deadline
Timetable for new facilities now pushed back to 2032 and 2033
The goal of replacing all seven hospitals predominantly built using reinforced autoclaved aerated concrete (Raac) by 2030 will be missed, according to a new report.
The new buildings are now expected to open in 2032 and 2033, although some are already facing pressure under the revised timetable, according to the National Audit Office (NAO).
Its latest report on the New Hospital Programme also highlights that more than £500 million has been spent to alleviate the risks of Raac in the seven hospitals up to 2025.
Raac is a lightweight material used widely in public buildings between the 1960s and 1980s.
Concerns over its safety prompted a nationwide inspection of schools, hospitals, courtrooms and other structures - with risks identified at dozens of locations.
The previous government pledged to replace seven hospitals built predominantly from Raac - Airedale, Queen Elizabeth King's Lynn, Hinchingbrooke, Mid Cheshire Leighton, Frimley Park, West Suffolk Hospital and James Paget Hospital in Great Yarmouth.
According to the NAO, an independent report in 2022 estimated 2030 as the latest possible replacement date for these buildings.
The NAO said that while these projects are being prioritised in Labour's revised New Hospital Programme, they are not expected to open until 2032/33, which has "implications for maintenance costs and patient safety".
As it stands, Hinchingbrooke, James Paget Hospital, Leighton, Queen Elizabeth King's Lynn and Frimley Park will open in 2032, with the remainder expected in 2033.
It comes after a report published in December concluded that, with sustained maintenance, the hospitals could remain open beyond 2030 "but with significant operational and clinical risk and cost".
The NAO said: "Hospitals made from Raac face significant risks until they are replaced.
"These seven hospitals have required significant investment, more than £500 million by 2025, to mitigate the most significant risks."
It also emerged that some Raac hospitals are already facing timetable pressures against the revised plans.
"West Suffolk Hospital, Bury St Edmunds, told us it has little time left before its planning permission expires," the NAO said.
The New Hospital Programme was announced by the Conservative government in 2019 with a pledge to build 40 new hospitals by 2030.
Last January, Health Secretary Wes Streeting said the construction of the new facilities will take at least a decade longer than planned.
The Government committed funding to 41 schemes, in addition to five that were already complete.
Mr Streeting set out a new timetable, with work proceeding in four "waves", the final part of which will not begin until between 2035 and 2039.
The NAO described the new plan as "more realistic", and said that the Department of Health and Social Care (DHSC) had prioritised Raac hospitals while ranking the remaining schemes based on deliverability, existing maintenance and safety risks, and affordability.
However it claims schemes were ultimately ranked based on how far advanced they are, and if DHSC could afford it within its spending review settlement.
The Government's blueprint shows the total cost of the 46 hospital schemes will be £60 billion - of which £56 billion is capital - with a completion date of 2045/46.
This is a £33.8 billion increase on the capital funding proposed in 2023, the NAO said, and includes around £12.4 billion for unanticipated cost increases.
Current projections suggest DHSC has "sufficient capital" to cover its plans, but with "little contingency" in the next few years, the report said.
It added: "Over the next few years, with construction due to begin on all wave one schemes by around 2028, there are risks of delivery slipping against a challenging schedule.
It warned there is a "risk that cost pressures in the earlier waves could have a knock-on impact".
The NAO said that "new hospitals are badly needed after many years of under-investment and in the context of a large maintenance backlog".
It described the New Hospitals Programme as "ambitious" and said the latest reset by DHSC has put the project on a "more stable, long-term footing".
In its recommendations, the NAO said DHSC must "maintain rigorous oversight" of the programme to keep it on track.
It urged the Government to get the design of buildings right, "not just for the construction but also to achieve operational efficiencies in how new hospitals are run".
Figures published in September showed that Raac had been removed from 20 hospitals, although 41 sites still contained the substance.
A further 12 hospitals are due to have Raac removed by the end of March.
Reacting to the NAO report, Daniel Elkeles, chief executive of NHS Providers, said: "Ageing hospital buildings may have to stay in use way past their 'use-by' dates, putting patients and staff at risk and costing NHS trusts and taxpayers millions of pounds because some NHP schemes are now not expected to begin construction until 2039.
"More delays risk normalising unacceptable conditions for patients and staff, with outdated buildings remaining in use far longer than planned.
"We understand the government's decision to speed up replacing hospitals where Raac has been found in much older NHS buildings. Trusts are having to support collapsed roofs with scaffolding and steel props to keep patients and staff safe."
Mr Elkeles added that Raac "isn't the only serious problem across the NHS" and "more delays add eye-watering costs and inflation".
A DHSC spokesperson said: "This report demonstrates this Government has put the New Hospital Programme on a stable long-term footing after inheriting a plan that was unfunded and undeliverable.
"We've confirmed a sustainable funding plan and an achievable timetable to deliver all schemes in the programme. We are now getting on with building these much-needed facilities as quickly as possible.
"We are backing the NHS with £1.6 billion across the next four years to safely remove and mitigate Raac to protect patient and staff safety and deliver a health service fit for the future.
"The NAO's interpretation of the changing costs of the scheme is mistaken as this does not include the additional nine hospitals we are now building."