Our key takeaways: 

The New Hospital programme is a political priority, but funding remains uncertain

The NHP continues to be a political programme with close input from political leaders and their representatives. This is likely to continue ahead of the next election in 2024 (or earlier).

Providers will need to be agile and responsive to political momentum, coordinating senior engagement to influence at national and local levels. This requires a clear and consistent narrative, shared by organisations, local systems such as Local Authorities, and ICSs. This will enable a clear engagement strategy with political decision makers.

The £3.7bn funding announced remains insufficient to deliver the 40 projects in parallel. It is not clear what this funding will cover, when it is available, or what the next spending review will secure. Backlog maintenance no longer appears to be a priority.

Projects costs are increasing rapidly, with some Providers seeing inflation of up to 10% driven by market challenges in forecasting, rising costs, and lack of capacity. An understanding of indexation risk, where it is held, and likely impacts on projects is required.

Collaboration between the national programme and Providers is vital

The national programme is still at an early stage of mobilisation. A standardised approach to procurement, Net Zero, Modern Methods of Construction, and analytical demand & capacity modelling is under development. There is a risk of rework when retro-fitting mature schemes to new emerging guidance.

Hospital construction projects, particularly part rebuild/ refurb, are significantly more complex than other construction programmes such as Prisons and Schools – there is a risk this complexity is underestimated in driving for standardisation and simplification.  

A more collaborative approach with two-way dialogue between the national and Provider teams could identify early opportunities on complex projects. This would include use of navigators in the national team to provide a single point of contact, and collective input from Providers to the national programme through a national membership organisation to build on existing communication routes.

This is an opportunity to introduce truly digitally enabled, integrated care

The NHP is an opportunity to introduce digitally enabled, integrated care – refocusing on prevention and out of hospital care, and right sizing any future hospital build, such as bringing together plans for Cavell Centres, One Public Estate, and NHP funding as a system.

These changes can be made ahead of any physical build but require clinical leaders to be embedded in programmes and play a key role in developing future vision and models. Seed funding can be used to backfill clinical colleagues, releasing their time to drive the on-the-ground change needed.

A focus on the estates aspects of projects only risks missing a key opportunity to transform care as part of the investment made.

Please contact Samuel.rose@thepsc.co.uk if you are working on delivering the New Hospital Programme and would like to be involved in a future roundtable.

The PSC exists to make public services brilliant. We’re known for tackling the most complex challenges in the public sector, including an extensive track record in capital investment programmes. Speak to our team to find out more. 

Authors: The PSC Built Environment Advisory Team (Samuel Rose, Nicole Samuel, Ellie Lane, and Joe Cruden).