Source · Select Committees · Public Accounts Committee
Recommendation 4
4
Rejected
Start construction by 2024 on an early scheme piloting standardised hospital design.
Conclusion
DHSC must quickly complete and test its standardised hospital design to avert further delays to hospital construction, and to reduce the current high risk of cost and quality issues in years to come. DHSC has taken too long to get its Hospital 2.0 design off the drawing board. It continues to be optimistic that the design and a related new commercial model will reduce future construction costs by 25% and could even reduce the total time taken to develop new hospitals from 11 years to six. Yet, until the design is complete and has been tested, these claims are at risk of being just pipe dreams. Unlike Denmark’s programme for building ‘super hospitals’, DHSC has not allowed time for proper piloting of its new standard hospital. Failure to pilot thoroughly could store up problems for future generations because of defective or poorly thought through standardisation. The New Hospital Programme 7 Recommendation 4: For the twin purposes of piloting and making progress, DHSC should aim to be ready to start construction during 2024 of at least one early scheme that uses its standardised hospital design, with a particular focus on trialling new clinical infrastructure such as standardised operating theatres.
Government Response Summary
The government rejects the recommendation to start construction of a standardised hospital design scheme in 2024, stating that starting construction without sufficient design maturity risks increased time and cost.
Government Response
Rejected
HM Government
Rejected
The government disagrees with the Committee’s recommendation. The government agrees that NHP should test Hospital 2.0, its standardised approach to building hospitals, and intends to do so at the earliest opportunity within one of the RAAC schemes, given the importance of prioritising these to protect patient and staff safety. However, construction is unlikely to start in 2024. Consistent evidence from major programmes demonstrates beginning construction ahead of achieving sufficient maturity of design ends up costing time and money. The NHP is however conducting deep dive reviews into how Hospital 2.0 would work in a variety of schemes, and working closely with clinicians, NHS trusts, Royal Colleges, patient and public groups, and the supply chain to gather best practice to include in Hospital 2.0. The standardised reference designs are being tested for fit against the constraints and contexts of specific types of hospital schemes, including low-rise and high-rise hospitals. This will provide learning on how Hospital 2.0 designs may need to be adapted when applied to other settings. The NHP intends to test and further develop Hospital 2.0 designs through more established prototyping facilities from late 2024, subject to business case processes and approvals, alongside ongoing design work and anthropometric studies. These prototyping facilities aim to engage patients, clinicians and manufacturers in improving the designs of key elements, such as operating theatres, and aid training and familiarisation to support commissioning and efficient roll-out of services in new hospitals. The NHP will feed back all learning from different schemes as aspects of Hospital 2.0 designs are applied into a continuous learning process. In 2023, the NHP launched a library of Hospital 2.0 products to trusts, external parties and industry, supporting planning and scheme development, before a detailed release of Hospital 2.0 in May 2024.