Update on the New Hospital Programme

a) DHSC must maintain rigorous oversight of the programme to keep it on track, learn lessons between schemes and waves of construction and respond to evolving developments in healthcare, if it is to deliver hospitals that meet the future needs of clinicians and patients.

b) DHSC needs to get the design of Hospital 2.0 right, not just for the construction but also to achieve operational efficiencies in how new hospitals are run. In setting the timetable, DHSC needs to allow sufficient time to test that the design is fit for its stated purpose, with enough input from the staff and leaders of trusts who will work in and run new hospitals.

c As it finalises its long-term plans, DHSC should improve the cost estimates of its schemes and ensure there is close alignment between the delivery profile and the funding profile. DHSC may need to adjust expectations of the funds required or bring plans for building some new hospitals forward. Any decision to bring plans forward should be weighed against the delivery risk of delivering more schemes in parallel, the wider capacity of the construction industry to support government infrastructure projects, and the risk of driving up prices.

d) The programme?s future demand model is a good example of a transparent, open-sourced and peer-reviewed model. DHSC should seek to make the outputs of the model widely available within the NHS so that local decision making is on a consistent basis, and ensure that sufficient feedback is in place to refine and improve the model. DHSC should share and disseminate this good practice more widely across government.

e) There is a risk that if the shift of care from hospital to community does not develop as expected, DHSC could build hospitals that are too small. It should monitor this carefully and use the data to a) refine its model of demand and b) identify maximum tolerance levels should levels of demand not reduce as predicted. It should develop contingency arrangements should tolerance levels be exceeded. In developing contingency arrangements, DHSC should ensure it has considered potential investments in other parts of the health system, including primary care, as well as increases in hospital capacity.