Recommendation 7

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 £16.6 billion in total, including £8.1 billion from 2025–26 to 2030–31.9 Furthermore, ten of the wave 1 hospitals are the first schemes the Department is building to the novel Hospital 2.0 design, which is not expected to be finalised until summer 2026.10 The programme has included a contingency of only 3% of total funding from 2025–26 to 2029–30, compared to a total contingency of 21% across the programme, and so there is little headroom for any delays or cost overruns that occur in the early years.11