Rebuilding RAAC Hospitals to Miss 2030 Deadline

Seven new hospitals to replace those built with Reinforced Aerated Autoclaved Concrete (RAAC) are now expected to be completed in 2032–33 – missing the original recommended 2030 deadline.

The delay puts patients and staff at continued risk from crumbling buildings with more than £500 million spent on maintenance costs so far to prevent structural failures at the seven hospitals.

Even the delayed completion dates assume a tight construction schedule with little contingency built in the next five years. There are “significant delivery risks” according to report published today: Update on the New Hospital Programme by the independent public spending watchdog, the National Audit Office (NAO).

Trusts whose new hospitals or refurbishments will open later will face additional costs to maintain ageing buildings for longer – estimated by DHSC at between £100 million and £140 million a year.

New Hospital Programme

Today’s NAO report follows their 2023 report criticising hospital building plans. It responded to the Department of Health & Social Care’s (DHSC) decision to reset the hospital building programme after reviewing the timetable and costs.

The reset building programme covers 41 hospitals, ranging from whole new buildings to major refurbishments, and will be carried out in 4 waves over the next 20 years.

Five other hospitals were already complete and open when the programme was reset in January 2025. These were Royal Liverpool University Hospital; Greater Manchester Major Trauma Hospital; Midland Metropolitan University Hospital; Northern Centre for Cancer Care; and Dyson Cancer Centre, Bath.

Rebuilding RAAC Hospitals

Sir Geoffrey Clifton-Brown, Chair of the Committee of Public Accounts, said: “New hospitals are desperately needed to address the longstanding backlog of investment.

“When the Committee of Public Accounts last reported on the New Hospital Programme in 2023, we found no confidence that the promises made in the Programme were deliverable. DHSC has since reset the Programme, providing a more realistic delivery timetable and cost estimates.”

“DHSC’s more centralised approach has the ability to deliver a greater return on investment, enhanced digital technology and improved emergency performance, with the longer-term funding commitment helping to secure increased commercial interest. However, further delays in fully addressing crumbling RAAC in hospitals pose significant clinical and cost risks, which must be addressed as a matter of urgency.”

Easiest and Smallest First

The final hospitals in the New Hospital Programme are expected to be completed in 2045-46. Although DHSC carried out analysis to rank the schemes, it ultimately prioritised schemes which were furthest advanced, and any smaller projects it could afford within its spending review settlement, the NAO says.

Government has allocated around £2 billion a year to the programme from 2025–26 to 2029–30, rising to £3 billion a year from 2030–31. An estimated total capital funding of around £56 billion will be required.

The NAO says more realistic planning assumptions mean that this is a £33.8 billion increase on the capital funding proposed in 2023. DHSC has built in a £12 billion contingency (21%) to reflect inflation, market pressures, engineering challenges and environmental requirements.

Hospital 2.0 Design

The reset hospital building programme plans to introduce a more standardised approach to design and construction. The new ‘Hospital 2.0’ design aims to improve efficiency and patient care, including each patient having their own room, shorter walking distances for staff, paperless patient records, and technologies such as infrared sensors to alert staff when a patient falls.

Across 28 Hospital 2.0 schemes, DHSC assumes that the number of overnight beds will rise by an average of 6%. To help it size new hospitals, DHSC now uses a more rigorous and transparent demand model, replacing earlier unrealistic assumptions that risked undersized buildings. The new approach is peer-reviewed and assumes a 92% bed occupancy, not a riskier 95% where hospitals would have less spare capacity for winter pressures, surges, or unexpected events. However, the model depends on a major shift of care into the community for its assumptions to hold.

DHSC estimates a £3.10 return for every £1 spent under a centralised programme, compared to £2.70 if individuals trusts built their own hospitals – delivering up to £7.5 billion more in measurable benefits. These potential benefits include better emergency and ambulance performance, digital technology benefits, and reduced hospital infections due to patients having their own room. If successful, DHSC expects to secure operational benefits from the 2030s, when the first Hospital 2.0 schemes open.

Main Contractor Interest

Since the new plan and funding commitments were announced, the programme has had expressions of interest from over 20 potential main contractors and is taking 16 pre-qualified bidders through ‘competitive dialogue’ to help them develop solutions and technical specifications prior to submitting final tenders.

The construction schedule over the next few years is challenging as hospital schemes adapt to the new approach. If early schemes fall behind, there are risks of delivery dates slipping and work may bunch up later. This could lead to budget pressures on later hospital waves.

The programme also continues to face workforce challenges. As of November 2025, NHP had 138 vacancies out of 357 posts, a vacancy rate of 39% for public sector roles with gaps in digital, legal, commercial, project delivery and technical roles. The programme rated the risk of delays due to vacancies as Red (most serious).

NAO Recommendations

The NAO has several recommendations for DHSC and the New Hospital Programme, these include:

• Maintain rigorous programme oversight to keep delivery on track, learn lessons between schemes and respond to changes in healthcare needs.
• Get the Hospital 2.0 design right by allowing enough time for testing and ensuring strong input from trust staff and leaders.
• Strengthen long‑term cost estimates and align delivery and funding profiles, weighing any acceleration of schemes against delivery risks, industry capacity and price pressures.
• Share the future demand model widely across the NHS and government, ensuring consistent local decision‑making and continuous model refinement.
• Monitor the shift to community care closely to avoid under‑sized hospitals, refining demand assumptions and developing clear contingency plans across the wider health system.

Gareth Davies, head of the NAO, said: “The reset of the New Hospital Programme gives the Department a firmer platform to deliver long‑term improvements, and its ambition to transform hospital infrastructure has real potential provided designs are rigorously tested and programme delivery is well managed.”

New Hospital Programme Plan

Wave 0: Seven schemes under construction (expected cost of around £720 million).

• • CEDAR Programme
  • National Rehabilitation Centre
  • Royal Bournemouth Hospital, Dorset
  • Alumhurst Road Children’s Mental Health Unit, Dorset
  • St Ann’s Hospital, Dorset
  • Dorset County Hospital, Dorchester
  • Oriel Eye Hospital

Wave 1: 16 schemes due to begin construction between 2025-26 and 2028-29 (expected cost £16.6 billion, including £8.1 billion to be allocated from 2030-31). Includes seven existing hospitals containing RAAC, with construction of these replacement schemes to begin between 2027-28 and 2028-29.

• • Queen Elizabeth Hospital, Kings Lynn (RAAC)
  • Frimley Park Hospital, Surrey (RAAC)
  • James Paget Hospital, Great Yarmouth (RAAC)
  • Hinchingbrooke Hospital (RAAC)
  • West Suffolk Hospital, Bury St Edmunds (RAAC)
  • Leighton Hospital (RAAC)
  • Airedale General Hospital (RAAC)

• • Brighton 3Ts Hospital (Stage 2)
  • Derriford Emergency Care Hospital,
  • Plymouth Shotley Bridge Community Hospital, Durham
  • Poole Hospital, Dorset
  • Cambridge Cancer Research Hospital
  • Milton Keynes Hospital
  • Hillingdon Hospital, north-west London
  • North Manchester General Hospital
  • Women and Children’s Hospital, Cornwall

Wave 2: 9 schemes due to begin construction between 2031-32 and 2034-35 (expected cost of £14.5 billion, including £680 million on enabling works before 2030).

• • Leicester General Hospital, Leicester Royal Infirmary, Glenfield Hospital
  • Watford General Hospital
  • Specialist Emergency Care Hospital, Sutton
  • Whipps Cross University Hospital, north-east London
  • Kettering General Hospital
  • The Princess Alexandra Hospital, Harlow
  • Leeds General Infirmary
  • Torbay Hospital, Torquay
  • Musgrove Park Hospital, Taunton

Wave 3: 9 schemes are planned to start construction between 2034-35 and 2039-40 (with an estimated cost of £23.5 billion)

• • Royal Lancaster Infirmary
  • Charing Cross Hospital and Hammersmith Hospital, north-west London
  • North Devon District Hospital, Barnstaple
  • The Queen’s Medical Centre and Nottingham City Hospital
  • St Mary’s Hospital, North West London
  • Royal Preston Hospital
  • Eastbourne District General, Conquest Hospital, and Bexhill Hospital
  • Royal Berkshire Hospital, Reading
  • Hampshire Hospitals

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