With the aim of minimising costs while still meeting its programme objectives, the NHP team has been focusing on a basic version of Hospital 2.0, known as the ‘minimum viable product’ (MVP). Under MVP, hospitals will have the minimum viable set of services, in the minimum viable building size, built to the minimum viable specification, and at the minimum viable cost and time to build. All hospitals from cohort 3 onwards will have single rooms only, instead of open wards.29 But some of the assumptions used to determine the size of an MVP hospital are likely to result in hospitals that are too small to meet future needs, which would be a risk to efficiency and effectiveness as well as presenting clinical challenges:30 • MVP assumes there will be a 1.8% reduction each year in hospital capacity needed as a result of more people being treated outside hospital, in the community.31 This may be unrealistic because NHS England does not currently have a funded strategy to deliver such reductions and government has not produced 24 C&AG’s Report, para 6 25 Qq 29–31 26 Qq 60, 117 27 Qq 78–79 28 Q 117 29 C&AG’s Report, paras 3.9–3.11 30 Q 61; C&AG’s Report, para 24 31 C&AG’s Report, para 3.14 The New Hospital Programme 13 a long-term plan for social care. Neither does the assumption take account of a number of significant pressures outside hospitals, including in adult social care, community mental health services and GPs.32 • MVP also assumes that future patients will stay in hospital for 12% less time on average. This may be unrealistic because England already has one of the shortest lengths of stay per patient of any country in the Organisation for Economic Co- operation and Development (OECD) – 4.5 days on average in England in 2019– 20, compared with 8 days in the OECD. NHP even paid for research which did not back up this assumption.33 • Finally, MVP assumes that future bed occupancy will run on average at 95%. Once again, this may be unrealistic because England already has