Source · Select Committees · Public Accounts Committee
Recommendation 11
11
Rejected
New Hospital Programme's cost and time saving estimates for standard design are very ambitious.
Conclusion
DHSC aims to improve the cost-effectiveness and quality of new hospitals by standardising hospital design, including the business case process, and making increased use of modern methods of construction.19 Many traditional hospital construction schemes suffered from cost overruns and delays, which the NHP team believes it can reduce through a more centralised, modern approach. But NHP’s estimates of the level of savings that can be made are very ambitious. It has previously said that schemes that fully adopt its new approach would cost 25% less and take 20% less time to build than under traditional design and construction approaches. Then, at our evidence session in September, DHSC was more optimistic regarding time savings, telling us the model would reduce the total time taken to develop new hospitals from an average of 11 years to about six. This would amount to a time saving of some 40%, twice as much as was estimated earlier in 2023.20
Government Response Summary
The government disagrees with the committee's implicit recommendation, reaffirming its commitment to test Hospital 2.0, its standardised approach, starting with RAAC schemes, while undertaking deep dive reviews and developing prototyping facilities from late 2024.
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.