Source · Select Committees · Public Accounts Committee
First Report - The New Hospital Programme
Public Accounts Committee
HC 77
Published 17 November 2023
Recommendations
5
Acknowledged
Amend Hospital 2.0 design to prevent undersized hospitals and assess national capacity.
Recommendation
DHSC is at risk of locking in a standard design that will result in future hospitals being too small, which could lead to significantly greater expenditure and disruption in the long run. The version of Hospital 2.0 that DHSC used …
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Government Response Summary
The government notes the recommendation, stating it will engage with any future Health and Social Care Committee inquiries and is continuing to review Hospital 2.0 designs with experts to meet local needs, with the next product release expected in May 2024.
HM Treasury
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Conclusions (6)
8
Conclusion
Acknowledged
The raiding of capital budgets in the recent past is an underlying cause of the estates crisis the NHS is now in. As this Committee has highlighted several times, DHSC has for some years focused on short-term financial viability in ways that failed to consider the long-term consequences for services …
Government Response Summary
The government agrees in principle not to reduce planned capital investment, but states it will continue to follow its usual processes for financial decisions, including switching capital budgets in exceptional circumstances, and will make considerations clear as part of Ministerial advice.
22
Conclusion
Acknowledged
NHS England told us that it had set up a separate programme in 2019 to deal with RAAC.44 In 2020, government committed to remove RAAC from the NHS estate by 2035, subsequently allocating £685 million for RAAC management and remediation for the period up to 2024–25.45 This has been supplemented …
Government Response Summary
The government acknowledges its commitment to eradicate RAAC by 2035, stating this will remain under review. It notes ongoing work to rebuild affected hospitals and assesses financial implications, with future funding needs beyond 2024-25 to be addressed in subsequent Spending Reviews.
25
Conclusion
Acknowledged
We asked whether NHS trusts were getting adequate help from national bodies given the risks they had to manage. NHS England told use that it was helping trusts to source the right technical support, but trusts themselves were responsible for managing their estate and the risks within it.55 Trusts were …
Government Response Summary
The government, despite stating 'recommendation implemented', broadly outlines ongoing work with NHS Trusts to expedite RAAC surveys and publish information. It doesn't specifically address the committee's observation on the adequacy of help provided to trusts, beyond implying continued support through existing work.
27
Conclusion
Acknowledged
DHSC launched a major capital investment programme, the Health Infrastructure Plan (HIP), in 2019. It comprised 27 schemes, all of which joined NHP in 2020. When one of the HIP schemes was split into five separate schemes, the total number grew to 31. An additional scheme (Shotley Bridge Hospital) was …
Government Response Summary
The government acknowledges the committee's summary by providing background on the deteriorating NHS estate, the commitment to build 40 new hospitals by 2030, and the establishment and funding of the New Hospital Programme to address these issues.
41
Conclusion
Acknowledged
In written evidence, the NHS Confederation also highlighted to us that the NHS was suffering because of the under-investment in capital. It said this was hampering productivity and efficiency at a time when record numbers of adults were unable to work owing to ill health and progress needed to be …
Government Response Summary
The government acknowledged the Committee's findings on under-investment in NHS capital, stating it provides record amounts of capital and is committed to providing more certainty through rolling investment programmes.
42
Conclusion
Acknowledged
We asked DHSC whether NHP would affect the maintenance backlog. DHSC told us that the programme would help to address the backlog because around a third of the reported backlog was at sites that would be redeveloped or replaced by an NHP scheme. NHS England accepted that there would be …
Government Response Summary
The government acknowledged the Committee's observations regarding the New Hospital Programme and maintenance backlog, reiterating its commitment to capital investment and providing record funding for the NHS.