£56bn hospital programme on track but delivery risks remain

A brand new replace from the Nationwide Audit Workplace says the reset has put the programme on a extra credible footing, with ultimate hospitals now anticipated to finish in 2045-46.

Nonetheless, seven hospitals constructed predominantly utilizing Strengthened Aerated Autoclaved Concrete will not be anticipated to open till 2032-33, regardless of being prioritised.

For contractors, the reset brings long-term certainty and a stronger ahead pipeline, however the NAO warns that the following 5 years can be important, with a decent building schedule and restricted contingency leaving little room for early slippage or price overruns.

Key milestones are approaching. The Hospital 2.0 alliance contract was on account of be awarded on the finish of the 12 months however has now slipped into early 2026. Crucial work to attract up normal design will now be accomplished by April 2026.

Market curiosity has been robust, with greater than 20 contractors expressing curiosity and 16 corporations shortlisted for aggressive dialogue.

Wave 1 schemes are on account of begin on website by 2028-29, together with Milton Keynes Hospital and Leighton Hospital.

However capability dangers stay in key public sector shopper supply roles. As of November 2025, the programme had a 39% emptiness charge with gaps in digital, industrial and technical expertise flagged as a crimson threat.

The reset, introduced final 12 months by the Division of Well being & Social Care, follows a evaluation triggered by the watchdog’s 2023 discovering that the programme was not deliverable as initially deliberate.

It now covers 41 hospital schemes delivered throughout 4 waves over the following 20 years. 5 schemes had been already full when the programme was reset in January 2025.

Complete funding to ship all 46 schemes now stands at £60bn, together with £56bn of capital spend – a £33.8bn improve on 2023 assumptions – with a £12bn contingency in-built to replicate inflation, market strain, engineering complexity and environmental necessities.

Capital funding of £8.9bn has been allotted between 2025-26 and 2029-30, with spending rising to round £3bn a 12 months from 2030-31 onwards. Virtually 90% of funding earlier than 2030 is earmarked for wave 1 schemes, concentrating work within the late 2020s and early 2030s.

RAAC stays the largest quick threat. An unbiased 2022 evaluation beneficial changing seven RAAC hospitals by 2030, however the NAO says this deadline can be missed. By 2025, greater than £500m had already been spent stopping structural failure, whereas trusts face £100m–£140m a 12 months in further upkeep prices as replacements are delayed.

The reset leans closely on the Hospital 2.0 mannequin, designed to standardise layouts, enhance buildability and create a extra predictable marketplace for contractors. Options embody single-patient rooms, shorter employees journey distances, digital affected person information and new monitoring expertise.

Throughout 28 Hospital 2.0 schemes, DHSC expects in a single day mattress numbers to rise by a mean of 6%.

NAO head Gareth Davies mentioned the reset had created a firmer platform however warned supply self-discipline can be important.

“The reset of the New Hospital Programme offers the Division a firmer platform to ship long-term enhancements, and its ambition to remodel hospital infrastructure has actual potential supplied designs are rigorously examined and programme supply is nicely managed,” he mentioned.

Sir Geoffrey Clifton-Brown, chair of the Committee of Public Accounts, mentioned delays in tackling RAAC posed “vital scientific and value dangers” and warned that rigorous oversight was important to cease sufferers and clinicians ready even longer for brand spanking new hospitals.