Source · Select Committees · Public Accounts Committee
Recommendation 9
9
Deferred
DHSC delayed in creating standardised hospital design and approval processes.
Conclusion
DHSC claims that its plans to standardise approvals processes and that hospital design will reduce the time taken to build a hospital from as much as 11 years to about six. We asked whether there was a case for rebuilding some hospitals using traditional methods so that more work could be done sooner – as discussed later in this report, DHSC is delayed in creating the new standardised process and design. DHSC’s view was that reverting to the traditional method would actually take longer.15 We note though that the Infrastructure and Projects Authority has previously highlighted issues with the 7 HM Government, PM confirms £3.7 billion for 40 hospitals in biggest hospital building programme in a generation, 2 October 2020; accessed at www.gov.uk/government/news/pm-confirms-37-billion-for-40- hospitals-in-biggest-hospital-building-programme-in-a-generation 8 Q 45; C&AG’s Report, para 12 and Figure 5 9 C&AG’s Report, Figure 8; [DHSC letter 26/9] 10 Qq 42–43 11 Qq 56–57 12 C&AG’s Report, Figure 9 and para 2.18 13 Letter from Shona Dunn, DHSC dated 26 September 2023 14 Qq 47, 52; C&AG’s Report para 20 and Figure 12 15 Qq 29–31 The New Hospital Programme 11 capability of NHP’s leadership. As NHP has structured its programme, its central team will need deep expertise in large-scale programme management as well as design and construction skills.16
Government Response Summary
The government states it is examining the possibility of using existing design and contracting approaches for a small number of schemes to accelerate delivery, with final decisions on this to be made by summer 2024.
Government Response
Deferred
HM Government
Deferred
1.1 The government agrees with the Committee’s recommendation. Target implementation date: August 2024 1.2 The New Hospital Programme (NHP) recognises that progress has been slower than expected on some schemes as work has focused on bringing rigour around cost control and planning. It has also been important for the Department of Health and Social Care (the department) to ensure that the implications of including five additional hospitals constructed from reinforced autoclaved aerated concrete (RAAC) in the programme were fully understood. 1.3 Overall, however, the NHP has made progress. Four hospitals are open to patients, one hospital has completed construction and is due to open to patients shortly, 3 are due to open later next financial year and 18 schemes are in construction or have early construction activity underway to prepare sites. 1.4 The NHP recognises that it experienced some challenges in resourcing the Programme in its early stages, but it is now building capacity and capability rapidly through recruiting at pace and procuring a programme delivery partner. The Infrastructure and Projects Authority (IPA), NHSE and the department regularly review the capability of the NHP. The government will write to the Committee in March on programme capacity, in line with recommendation 7. 1.5 The NHP is currently examining the possibility of progressing a small number of schemes using existing approaches to both hospital design and methods of contracting, to deliver benefits to patients quickly and reduce backloading of the programme. Should this approach be progressed, schemes will be chosen based on criteria agreed with Ministers, and final decisions will be made alongside consideration of the NHP Programme Business Case by summer 2024.