Source · Select Committees · Public Accounts Committee
Recommendation 26
26
Accepted
Replacing seven high-cost RAAC hospitals by 2030 poses significant challenge and closure risk.
Conclusion
The seven RAAC hospitals each has a replacement cost estimated at between £500 million and £1.5 billion.57 NHP intends to build all seven RAAC replacement hospitals by 2030 using its standard Hospital 2.0 design. DHSC and NHS England are prioritising NHP schemes above other kinds of capital investment and recognise that they must replace the RAAC hospitals as quickly as possible.58 They told us it would be a challenge to complete them by 2030 because of the size of the schemes and the fact that only some of them have previously developed plans.59 Hospitals with extensive structural problems due to RAAC, even with mitigations, might be at risk of closure right up until the day they are replaced.60 49 DHSC, Transparency data: Hospitals with RAAC in England, 19 October 2023; accessed at www.gov.uk/ government/publications/reinforced-autoclaved-aerated-concrete-raac-in-hospitals-management-information 50 Qq 5–6 51 Q 28 52 NHP0007 53 Q 1 54 Q 8 55 Qq 16–20 56 Q 22; Letter from Shona Dunn, DHSC dated 26 September 2023 57 C&AG’s Report, Figures 17 and 18 58 Qq 13, 25 59 Qq 1, 14–15, 25 60 Qq 24, 111 16 The New Hospital Programme Transparency of the scheme selection process
Government Response Summary
The government, despite the item being a conclusion, states 'recommendation implemented' and commits to beginning early works to prepare sites for the seven RAAC replacement hospitals by the end of 2025. It also reiterates the commitment to eradicate RAAC by 2035 and continue ongoing monitoring.
Government Response
Accepted
HM Government
Accepted
3.1 The government agrees with the Committee’s recommendation. Recommendation implemented 3.2 The NHS has been at the forefront of the public sector response to RAAC and has been surveying sites since 2019. The department will continue to work with NHS Trusts to expedite surveys where possible RAAC is identified. While publishing surveys in full will not be possible due to the commercially sensitive information contained within, the government commits to continuing to publish and update information on confirmed RAAC within the NHS on Gov.uk. 3.3 The department will continue to keep the commitment to eradicate RAAC from the NHS estate by 2035 under review. Significant RAAC eradication will occur before 2035, including the work to rebuild the seven hospitals most affected by RAAC as part of the NHP. The department supports construction on the replacements for the seven entirely RAAC hospitals as a priority, and at a minimum, we aim to begin early works to prepare sites by the end of 2025. The existing hospitals will remain open and safe due to ongoing monitoring and mitigation of existing RAAC, in line with current evidence and recommendations from the Institution of Structural Engineers. 3.4 The department regularly assesses the financial implications of increased RAAC identification. Work is on-going with Trusts where RAAC has been recently identified to assess the financial and clinical implications of eradicating RAAC from these sites. The funding needs for RAAC mitigation and eradication beyond 2024-25 will inform the department’s bids at subsequent Spending Reviews and future budgets. 3.5 The department will write to the Committee with an assessment of the scale of RAAC in other parts of the health and social care system, noting there is no obligation for private owners to report the presence of RAAC to the department. The letter will include the name of the senior NHSE official responsible for its plan on RAAC.