Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Accepted
The Department has not yet developed a convincing rationale for the proposed size of new...
Recommendation
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 10-year plan, but the Department has assumed that larger hospitals will be needed. The Department has not clearly explained why bed capacity for hospitals in the New Hospital Programme needs to increase by 6% when it has also committed to spending more on care outside hospitals relative to what it spends in hospitals. The Department has engaged with NHS trusts to ensure that plans to provide care within and outside hospital settings are joined up, but local community care projects will be difficult to align with the New Hospital Programme as funding is separate. Some hospitals may require additional capacity to improve flow of patients in and out of the hospital, but we see a risk that hospitals will fill to the number of beds available with a knock-on impact on running costs. Bed numbers for wave 1 hospitals are not yet completely finalised, even though some of these hospitals are due to start construction in 2027–28. On its visit to Denmark in the last Parliament, the Committee learned that the Danish hospital rebuilding programme aimed to reduce significantly the total numbers of beds. recommendation Once the new design for hospitals is finalised, the Department should write to the Committee to: • provide further assurance on the bed capacity needed in new hospitals given its wider focus on shifting care out of hospitals and into the community; 5 • explain the new model of care that will be employed in these hospitals and how each individual scheme has taken expected changes to community care into account when deciding bed numbers; and • in cases where increases are necessary, explain how this is needed to optimise the flow of patients through hospital and quality of care.
Government response summary AI-generated
The government agrees with the recommendation and commits to writing to the Committee in Spring 2027. This letter will provide details on planned bed capacity for Wave 1 schemes, explaining how numbers reflect their Model of Care, expected demand, and the planned shift to community care.
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. recognised by the Royal Statistical Society, the Health Foundation and the National Audit Office as an example of a transparent, open sourced and peer-reviewed model. This provides trusts and system partners with a consistent, iterative approach to assessing future demand and testing assumptions, including population growth, ageing, proposed changes in service models, and the planned shift of care into the community (“left shift”). Mitigations may not offset projected growth, so schemes may require increases in bed numbers to remain sustainable. The NHP supports the 10 Year Health Plan’s three shifts. Each trust sets out its future plans through its Target Operating Model and Model of Care, drawing on forecast demand, local service plans and best practice. The programme supports Trusts to right size their hospital. The design for Hospital 2.0 will be finalised shortly, and the plans for each hospital will then be determined through each scheme’s Outline Business Case (OBC). NHP’s standardised Hospital 2.0 design supports flow by prioritising admission avoidance, improving clinical adjacencies, supporting infection control, improving bed utilisation, and allowing capacity to adapt. The department will write to the Committee in Spring 2027, as schemes in Wave 1 progress through the OBC approval process, providing information on planned bed capacity, including how a scheme’s bed numbers reflect its Model of Care the expected demand and planned shift of care into the community.