Select Committee · Public Accounts Committee

New Hospital Programme update

Status: Open Opened: 12 Dec 2025 28 conclusions 1 report

The New Hospital Programme (NHP) was announced in 2020, with a commitment to build 40 new hospitals to add to the deteriorating hospital estate by 2030. In January 2025, government confirmed that all schemes previously included in the programme would be delivered, including replacing seven hospitals constructed with deteriorating reinforced autoclaved aerated concrete, or RAAC. …

Reports

1 report
Title HC No. Published Items Response
76th Report - New Hospital Programme update HC 1705 22 Apr 2026 28 Pending

Recommendations & Conclusions

28 items
2 Conclusion 76th Report - New Hospital Programme up…

With little contingency up to 2029–30, there is a risk that delays and cost overruns...

With little contingency up to 2029–30, there is a risk that delays and cost overruns in the early years will have knock on effects on subsequent hospital schemes. Although some of the early hospital schemes in the programme (known as ‘wave 0’) are open or due to complete soon, enabling …

HM Treasury
3 Conclusion 76th Report - New Hospital Programme up…

There is a risk that the new Hospital 2.0 design might not benefit some patients...

There is a risk that the new Hospital 2.0 design might not benefit some patients or may add cost. The Hospital 2.0 design was originally due to be ready in December 2023 but, following multiple delays, the Department will not finalise the design until summer 2026 at the earliest. A …

HM Treasury
4 Conclusion 76th Report - New Hospital Programme up…

The Department has not yet developed a convincing rationale for the proposed size of new...

The Department has not yet developed a convincing rationale for the proposed size of new hospitals or how larger hospitals complement aspirations for new models of care and reducing demand in hospitals. Shifting care out of hospitals and into the community is one of the key features of the NHS …

HM Treasury
5 Conclusion 76th Report - New Hospital Programme up…

The Department has been slow to develop the capacity and capability it needs to deliver...

The Department has been slow to develop the capacity and capability it needs to deliver such a complex programme. The Department’s central programme team for the New Hospital Programme will require significant technical expertise to deliver successfully. Prior to the 2025 reset, the programme had struggled to recruit staff and …

HM Treasury
6 Conclusion 76th Report - New Hospital Programme up…

The 46 hospital schemes must deliver quality hospitals on time and on budget over 25...

The 46 hospital schemes must deliver quality hospitals on time and on budget over 25 years and for £60 billion. Given its cost and importance, and that the design concept of Hospital 2.0 remains unproven, we are concerned that the New Hospital Programme is not being treated in government as …

HM Treasury
7 Conclusion 76th Report - New Hospital Programme up…

Wave 1 hospitals are significantly larger and more complex to build than the wave 0...

Wave 1 hospitals are significantly larger and more complex to build than the wave 0 schemes. The seven hospitals in wave 0, of which six will have fewer than 100 beds, are expected to cost £720 million in total. In contrast, the 16 wave 1 hospitals are forecast to cost …

HM Treasury
8 Conclusion 76th Report - New Hospital Programme up…

We asked the Department how it was ensuring that the smaller earlier projects would not...

We asked the Department how it was ensuring that the smaller earlier projects would not overrun and create a knock-on problem for the larger, more complex hospital projects in later years. NHS England told us that the reset had allowed it to revise the NHP’s governance arrangements, allowing for clearer …

HM Treasury
9 Conclusion 76th Report - New Hospital Programme up…

The Department told us that it hoped that lessons learnt from its delivery of earlier...

The Department told us that it hoped that lessons learnt from its delivery of earlier waves would allow the later, more complex waves to be delivered more effectively.13 However, the Department also acknowledged that the wave 1 hospitals would be a lot more complex than those currently being delivered through …

HM Treasury
12 Conclusion 76th Report - New Hospital Programme up…

We asked the Department if it expected to replace all seven RAAC hospitals on time,...

We asked the Department if it expected to replace all seven RAAC hospitals on time, or if some of the RAAC hospitals were facing timetable pressures, as reported by the National Audit Office. The Department told us that it did not take lightly the risk RAAC hospitals present, and understood …

HM Treasury
13 Conclusion 76th Report - New Hospital Programme up…

The Department also said it would have preferred to complete the replacement hospitals sooner, but...

The Department also said it would have preferred to complete the replacement hospitals sooner, but delivery speed had been constrained by market capacity. The Department said that it was confident, however, that it would be able to deliver the RAAC hospitals despite constraints in construction skills and capabilities. The Department …

HM Treasury
14 Conclusion 76th Report - New Hospital Programme up…

More broadly, there are other hospitals outside the programme with problems which the Department must...

More broadly, there are other hospitals outside the programme with problems which the Department must address through wider spending on repairs and maintenance. The total backlog of work required to improve the NHS estate was estimated to cost £15.9 billion in 2024–25.26 We received written evidence from NHS providers highlighting …

HM Treasury
15 Conclusion 76th Report - New Hospital Programme up…

The Department aims to build hospitals in the programme to a new, standardised hospital design...

The Department aims to build hospitals in the programme to a new, standardised hospital design called Hospital 2.0. It expects the new hospitals to be more efficient to operate, digitally-enabled and to provide each patient with their own single bedroom. The Hospital 2.0 design was originally due to be completed …

HM Treasury
19 Conclusion 76th Report - New Hospital Programme up…

The NHP programme business case assumes a 6% average increase in overnight beds across all...

The NHP programme business case assumes a 6% average increase in overnight beds across all 28 schemes that the Department plans to build to the Hospital 2.0 design. Across eight schemes where the Department has carried out detailed modelling, the increase in the total number of beds planned for the …

HM Treasury
20 Conclusion 76th Report - New Hospital Programme up…

We asked the Department how it had concluded that the new hospitals required more beds...

We asked the Department how it had concluded that the new hospitals required more beds than those they were replacing given that its 10-year health plan aims to shift of care out of hospitals and into the community.41 The Department told us that, since 2023, it had updated overly optimistic …

HM Treasury
22 Conclusion 76th Report - New Hospital Programme up…

We asked for assurance about the quality of the NHP demand and capacity model, given...

We asked for assurance about the quality of the NHP demand and capacity model, given the importance of the output. The Department said that the model was good and had been awarded a prize by the Royal Statistical Society.47 In written evidence provided after the session, the Department assured us …

HM Treasury
24 Conclusion 76th Report - New Hospital Programme up…

In 2023 the previous Committee reported that the programme had struggled to recruit staff and...

In 2023 the previous Committee reported that the programme had struggled to recruit staff and had relied too heavily on external consultants.51 As of November 2025, the programme had a vacancy rate of 39%, resolution of which was being hampered by a recruitment freeze following the Department’s plans to abolish …

HM Treasury
25 Conclusion 76th Report - New Hospital Programme up…

The Department told us that while there had been a slight pause in recruitment, the...

The Department told us that while there had been a slight pause in recruitment, the programme was not currently under a recruitment freeze for key roles and it did not currently see resourcing as a concern.55 We challenged the Department on this, highlighting that the impact of public sector vacancies …

HM Treasury
26 Conclusion 76th Report - New Hospital Programme up…

The NHP programme board currently reports to the Department and NHS England boards.

The NHP programme board currently reports to the Department and NHS England boards. These boards provide scrutiny of the programme and ensure it is delivered effectively. The NHP programme board is supported by its executive committee, which in turn is supported by sub- committees that monitor various aspects of the …

HM Treasury
27 Conclusion 76th Report - New Hospital Programme up…

The Government recently established new arrangements for how particularly risky, costly and complex projects (‘mega...

The Government recently established new arrangements for how particularly risky, costly and complex projects (‘mega projects’) would be managed.61 Mega projects are afforded increased scrutiny and autonomy. For example, decisions at key stages involve the Prime Minister, Chancellor and relevant Secretary of State, advised by a panel including HM Treasury, …

HM Treasury
28 Conclusion 76th Report - New Hospital Programme up…

In September 2025 we reported that some critical programmes had been left out of plans...

In September 2025 we reported that some critical programmes had been left out of plans to strengthen governance of mega projects. The New Hospital Programme was not granted mega project status by the Treasury because it was considered a collection of small, standardised 57 Qq 23-25 58 Q 14 59 …

HM Treasury

Oral evidence sessions

1 session
Date Witnesses
9 Feb 2026 Charlotte Taylor · Department of Health and Social Care, Dr Amanda Doyle OBE · NHS England, Elizabeth O'Mahony · Department of Health and Social Care, Paul Mustow · Department of Health and Social Care, Professor Chris Whitty, Samantha Jones · Department of Health and Social Care, Sir Jim Mackey · NHS England View ↗

Correspondence

1 letter
DateDirectionTitle
2 Mar 2026 To cttee Letter from the Permanent Secretary at the Department of Health and Social Care…