The government’s New Hospital Programme (NHP) has been restructured with updated funding, timelines, and standardised designs.
The move follows a 2026 National Audit Office (NAO) update, which built on its 2023 assessment that delivering on the original commitment to build 40 new hospitals by 2030 was not realistic given the funding and market constraints.
The latest report also confirms that all seven hospitals identified for early replacement because of reinforced autoclaved aerated concrete (RAAC) will now open in 2032–33, missing the original 2030 replacement target.
RAAC hospital replacements delayed
The reset aims to make the programme more deliverable, with hospitals built with RAAC now missing the 2030 replacement deadline.
Seven RAAC hospitals, including West Suffolk, Hinchingbrooke, James Paget, Queen Elizabeth (King’s Lynn), Leighton, Airedale, and Frimley Park, are now scheduled to begin main works between 2025 and 2030, with openings expected in 2032–33.
Under the revised timetable, these sites are expected to open in 2032–33, two to three years later than the originally planned 2030 target.
The Department of Health & Social Care (DHSC) now oversees the New Hospital Programme, taking over functions formerly held by NHS England.
Despite 39% of NHP delivery roles being vacant, DHSC says hospitals affected by RAAC can operate safely, with NHS trusts having already invested over £500m in mitigation works.
NHP adds fourth wave to new timeline
The original timeline of the NHP was widely criticised as unfunded and unrealistic, prompting the Labour government to reset and group the hospitals in the programme into waves.
The NHP now covers 41 hospital schemes, both new builds and major refurbishments, organised into four delivery waves, up from three waves previously.
Total capital requirements are estimated at £56bn, including a £12bn contingency for inflation, construction pressures, and technical risks.
Funding is planned at around £2bn per year from 2025–26 to 2029–30, rising to £3bn per year from 2030–31.
Full programme completion is now projected for 2045–46, well beyond the original 2030 target.
Hospital 2.0: standardised design to support delivery
A central feature of the reset is the introduction of “Hospital 2.0”, which focuses not on just replacing old buildings but standardising hospitals to be faster, cheaper and more digitally and operationally modern.
Key features include increased use of single rooms for inpatients, shorter staff walking distances and improved digital infrastructure, including paperless records and smart monitoring.
Across 28 Hospital 2.0 schemes, DHSC expects an average 6% increase in overnight bed capacity, supported by assumptions of 92% occupancy and greater use of community care.
The cost savings of a centralised programme
Centralised programme management is projected to generate £3.10 of benefits per £1 spent, compared with £2.70 if trusts delivered schemes independently.
Benefits include improved patient safety, efficiency, and reduced infection rates.
However, risks remain significant: tight construction schedules, limited short-term financial contingency, and 39% vacancies in NHP delivery roles, particularly in digital, commercial, and project management, could still affect delivery.
The NAO also cautions that standardised designs must be refined with clinical input and closely aligned with evolving NHS service models.
What is next?
The NHP reset represents a course correction after the original 2030 target proved unrealistic.
The report concludes that the reset provides a more credible framework for delivery but highlights that sustained funding, workforce capacity, and effective management will be needed over the next two decades.
The delay of RAAC hospital replacements underscores the scale of the challenge.