In the most recent government list published last year, 42 NHS hospitals were confirmed to have reinforced autoclaved aerated concrete (RAAC) in "limited parts of the building".
Seven out of the 42 NHS hospitals were mostly constructed of RAAC and confirmed to need a full rebuild "given the risks these buildings pose to patients and staff," according to the Department of Health and Social Care.
Reinforced autoclaved aerated concrete (RAAC) is a form of lightweight precast concrete.
RAAC is less durable than traditional reinforced concrete
The “bubbly” material was commonly used in the UK during the 1950s-1990s, mainly as precast panels in flat roofs and occasionally in floors and walls, according to the Department of Health and Social Care UK.
RAAC is less durable than traditional reinforced concrete as the bubbles let water into the material, making RAAC buildings susceptible to structural failure when exposed to moisture.
Consequently, any rebar reinforcing RAAC can also weaken, decay or rust.
Further, this means that buildings made out of RAAC have a lifespan of approximately only 30 years.
The seven NHS hospitals most affected by RAAC and need a full rebuild are:
- West Suffolk Hospital, West Suffolk NHS Foundation Trust
- James Paget University Hospital, James Paget University Hospitals NHS Foundation Trust
- Airedale General Hospital, Airedale NHS Foundation Trust
- Frimley Park Hospital, Frimley Health NHS Foundation Trust
- Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust
- Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
- The Queen Elizabeth Hospital, King's Lynn NHS Foundation Trust
West Suffolk Hospital in Bury St Edmunds and James Paget University Hospital in Norfolk are the top two NHS hospitals most affected by RAAC, according to the Department of Health and Social Care.
West Suffolk Hospital, West Suffolk NHS Foundation Trust
A spokesperson for the West Suffolk NHS Foundation Trust told BBH that “RAAC planks are prevalent across a large proportion of the West Suffolk Hospital site.”
To date, according to the spokesperson for the West Suffolk NHS Foundation Trust, the new Hardwick Manor site has been acquired, outline planning permission for a replacement hospital has been secured and the team have commenced enabling works to prepare the site for the new hospital.
The enabling works include:
- The translocation of approximately one hectare of turf from its current location on Hardwick Manor in Bury St Edmunds to a new “compensatory habitat” in Suffolk
- The completion of archaeological trenching on the development site and construction compound
- The commencement of buffer planting.
- 100% of the wall panels have been treated with a specific treatment using zinc anode technology to prevent further deterioration.
To date, there have been no plank failures at the West Suffolk Hospital.
Further, the Trust has put in place a “continuous survey and assessment programme to check its RAAC infrastructure.” The checking measures include "tap tests and other approved industry-recommended tests," according to the spokesperson.
The checking measures include "tap tests and other approved industry-recommended tests
If an issue is found, remedial and mitigating work is undertaken immediately, and short-term, temporary props are installed to reinforce the plank.
Additional precautionary measures include bearing extensions to provide further support to the planks.
"Failsafe supports" of steel and timber beams are also put in place, which is a support system being implemented across the hospital.
Also, as of December 2023, 88% of roof planks have precautionary supports in place, which the majority of these are failsafe roof supports.
To date, there have been no plank failures at the West Suffolk Hospital
According to the spoke person for the West Suffolk NHS Foundation “West Suffolk NHS Foundation Trust, supported by the Government’s New Hospital Programme, is on track to deliver a new healthcare facility on Hardwick Manor in Bury St Edmunds in 2030”.
“We are well advanced in undertaking significant and planned estates maintenance programmes to support our RAAC infrastructure. This includes a rolling programme to regularly monitor and check the RAAC planks using the latest research and technology, which will remain in place until we move to the new hospital site,” The spokesperson added.
The spokesperson further told BBH that a construction company will be appointed once the outline business case for the new build has been approved, which is scheduled for mid-2025.
James Paget University Hospital, James Paget University Hospitals NHS Foundation Trust
A James Paget University Hospitals NHS Foundation Trust spokesperson told BBH that “the on-going specialist surveys have found nothing that would warrant the closure of any areas of the hospital.”
Further, the Trust has a programme of installing precautionary "end bearing" supports to RAAC planks in the hospital roof and this has been underway since 2021," according to the spokesperson.
To facilitate this work, the Trust is using a brand new "Concept Ward"
To facilitate this work, the Trust is using a brand new "Concept Ward" as a "decant’ space," the spokesperson explained.
The Concept Ward opened last summer and allows the Trust to move entire ward teams and their patients temporarily to a new location while these precautionary supports are fitted.
Airedale General Hospital, Airedale NHS Foundation Trust
The Airedale NHS Foundation Trust has also put structural support measures in place to support “any panels identified by structural engineers as being badly deteriorated or damaged,” according to the Trust's spokesperson.
500 of the most severely damaged planks are being supported with structural steel, timber or acrow-props.
Further, an external coating has been applied to reduce the rate of deterioration by preventing more water getting in.
The Trust is also fixing parts of the roof where the worst leaks are more likely to occur.
500 of the most severely damaged planks are being supported with structural steel, timber or acrow-props
Since RAAC was first discovered, the Trust has been working with NHS England, other affected RAAC hospitals and structural engineers to ensure "the right steps are taken to manage any issues to ensure the safety of our patients, visitors, and staff."
This includes a comprehensive programme of rolling inspections and putting in structural supports and installing structural solutions where necessary.
Airedale NHS Foundation Trust's spokesperson, said: “We are working with the New Hospital Programme to progress our plans, working towards their timescale of the hospital being constructed by 2030.”
“As part of this we are carrying out some surveying work at the hospital which will provide us with a complete picture of the hospital site to help continue the next steps of our planning,” the spokesperson added.
“Being on the New Hospital Programme means that we can now look forward to a future in a RAAC-free hospital estate,” the spokesperson concluded.
Frimley Park Hospital, Frimley Health NHS Foundation Trust
Frimley Park Hospital now has approximately 7,000 RAAC planks in place. In particular, the RAAC planks have been placed in key areas such as operating theatres, intensive care units, wards, and corridors.
However, the Trust is actively looking at alternative locations for a replacement for Frimley Park Hospital.
The Trust is actively looking at alternative locations for a replacement for Frimley Park Hospital
The current site is considered by the Trust to be “too small" to deliver modern healthcare standards to its growing and aging population.
A new hospital on the current site would require a phased demolition that would make it “impossible” for the Trust to complete a phased build by its 2030 deadline.
Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust
Graham Construction, UK-based construction company, is continuing to redevelop Hinchingbrooke Hospital with a proposal to create a new, purpose-built operating theatres block.
The block will be located between the main hospital site and the Treatment Centre.
Graham Construction, UK-based construction company, is continuing to redevelop Hinchingbrooke Hospital
This £30m proposed build forms the second phase of the ongoing redevelopment of the Hinchingbrooke Hospital site, following the completion of refurbishing the urgent care facilities in November 2020.
The new block will replace the theatres in the main hospital building, which are coming to the end of its operational life cycle.
However, this project is subject to business case approval from NHS England and NHS Improvement.
Leighton Hospital, Mid Cheshire Hospitals NHS Foundation Trust
Leighton Hospital is currently waiting for a final decision on the funding bid, submitted through the government’s New Hospital Programme.
The current Leighton Hospital is “aging"
The current Leighton Hospital is “ageing.” The Trust wants to replace it with a state-of-the-art facility that would better cater to the residents of Cheshire and the North West of England.
The new Leighton Hospital will be carbon neutral and digital innovation will be at the forefront of health services to tackle inequalities and to better cater to the growing and ageing population.
The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
To meet the 2030 deadline under the New Hospital Programme, the new Queen Elizabeth Hospital will be a single-phase new build on the existing hospital site.
The £862m project is now moving on from the strategic outline case stage to outline business case stage.
The new Queen Elizabeth Hospital will be a single-phase new build
Paul Brooks, Director of Estates and Facilities at the Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, said: “The QEH is a Reinforced Autoclaved Aerated Concrete (RAAC) hospital, and we continue to invest national capital funding to maximise the safety the Trust’s current building.
“Working with skilled engineering teams, we have implemented an intense installation programme over the past three years to create a steel and support structure to maintain the safety of the roof, for our patients, visitors and staff,” Brooks concluded.
Overall, all seven hospitals are planned to be rebuilt by 2030 as part of the UK Government’s New Hospital Programme.
“The NHS has asked the government to prioritise the rebuilding of these hospitals given the risks they pose to patients and staff - the full extent of which has come to light since the New Hospital Programme was first announced in 2020,” according to the Department of Health and Social Care.