Source · Select Committees · Public Accounts Committee
Recommendation 18
18
Accepted
DHSC promises rigorous review of Minimum Viable Product assumptions, despite potential affordability issues.
Conclusion
We challenged DHSC about the realism of the MVP assumptions, particularly in the context of a growing and aging population, and asked if it would review them. DHSC told us that these were baseline assumptions, enabling like-for-like comparisons to be made between schemes, and that it was going through a process to decide what size each new hospital needed to be. It assured us it was going to review the assumptions rigorously.36 As discussed later in this report, however, any deviations from MVP to make individual hospitals bigger may create an affordability problem for NHP, because the hospitals will cost more.
Government Response Summary
The government accepts the recommendation, stating it will keep hospital size assumptions under constant review. It details work underway with NHS England to develop modelling, put forward program scope options by May 2024, and create a bottom-up model with trusts to assess demand and ensure future expansion capability.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. Recommendation implemented The government agrees that it is vital that future hospitals are the right size and it will keep the assumptions on size of future hospitals under constant review. The NHP is working jointly with wider NHSE to develop its modelling and ensure fit with regional and national modelling on the long-term infrastructure needs of the NHS, across acute, community and primary care settings. NHP is also putting forward different options on programme scope, as is normal practice, as part of its programme business case, which is due to be agreed by May 2024. To tailor its central modelling to local needs, NHP is also developing a standardised, bottom-up model to assess the most probable net demand, jointly with NHS trusts and integrated care boards. This work requires a high level of collaboration with a wide range of local NHS and other stakeholders to combine national expertise and best practice with local knowledge. As well as ensuring that hospitals are not too small, this approach will also ensure that hospitals are not too big, thus avoiding unnecessary capital costs and ensuring that trusts can afford the running costs of the new facilities. One of the principles of Hospital 2.0 is that it should maximise the opportunity for future expansion, and this has been factored in standard designs to ensure this can happen for minimum cost and operational disruption.