Source · Select Committees · Public Accounts Committee
Recommendation 3
3
Accepted
There is a risk that the new Hospital 2.0 design might not benefit some patients...
Recommendation
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 key aspect of the design is that wards will consist of solely single bedrooms. The Department expects single bedrooms to lead to efficiencies such as fewer hospital acquired infections and shorter hospital stays for patients. However, some research has indicated that the clinical and economic impact of single bedrooms may be modest. The Department has not clearly explained what metrics it will use to assess whether it is realising benefits, nor has it sufficiently focused on unexpected downsides of 100% single bedroom wards. For example, some patients, particularly those that are frailer or more vulnerable, may feel alienated being alone and monitored remotely. The Department acknowledges that the new hospitals may incur more staff costs until new ways of working are embedded. 4 recommendation The Department must ensure the new hospital design delivers benefits. It should: a. alongside its Treasury Minute response to this report, the Department should write to the Committee with details of how it expects the new design to lead to measurable benefits for patient experience, patient outcomes and operational efficiencies; b. identify tangible risks to achieving these benefits and seek to manage these; and c. commission and report the results of an independent assessment of whether the benefits are being realised following the opening of the first hospitals built to the new Hospital 2.0 design.
Government response summary AI-generated
The government agrees and confirms it has already written to the Committee with details on expected benefits and evaluation plans for Hospital 2.0. It also outlined its approach to managing risks and committed to reporting independent impact evaluation findings from 2034-35, with earlier learning from post-occupancy reviews.
Summary of the government's response below — read the verbatim text to verify.
Government Response
Accepted
HM Government · verbatim extract
Accepted
The government agrees with the Committee’s recommendation. Recommendation implemented The department has written to the Committee alongside this Treasury Minute providing further detail on: the key features of the programme’s standardised approach, known as Hospital 2.0; the benefits it is expected to deliver, including how the programme is refining and quantifying these benefits and capturing lessons learnt; and how the programme will evaluate the impact of Hospital 2.0 in due course. The government agrees with the Committee’s recommendation. Recommendation implemented The department recognises the importance of continuing to monitor and manage risks to achieve programmatic benefits. In line with systems for reporting risk within DHSC and NHSE, risks are managed locally, including through the NHP Programme Board, unless they need to be escalated. This process assesses both strategic risks, relating to the delivery of the programme’s benefit outcomes and objectives; and delivery risks, which concern the key milestones and deliverables, along with cost related risk. Risks are defined around programme delivery, with a focus on identifying root causes and the mitigating actions required to address them. The programme is part of the Government Major Projects Portfolio (GMPP), which provides greater accountability, transparency, and scrutiny of the government's highest-value projects. As part of the GMPP, Programme risks are reported, scrutinised and assured through regular reporting and assurance reviews. The government agrees with the Committee’s recommendation. of the Hospital 2.0 design are being realised once the first fully Hospital 2.0 compliant hospitals are operational. This evaluation will assess whether the benefits set out in the Programme Business Case are being achieved in practice, including improvements in patient outcomes and experience, workforce wellbeing and productivity, safety, and operational efficiency. Once hospitals built to the full Hospital 2.0 standard have been operational long enough for benefits to be measured, substantive impact evaluation can take place. The programme expects at the earliest this can take place between 12-24 months post opening. Based on current delivery schedules, as set out in the Plan for Implementation, the department expects to report independent impact evaluation findings from the end of the 2034–35 financial year. Learning will also be captured earlier through post-occupancy evaluation and scheme-level reviews, and lessons learnt implemented in subsequent waves. The findings from the independent assessment will be reported through programme- level governance arrangements and will inform ongoing refinement of the Hospital 2.0 design to ensure the programme is maximising the benefits.