Background
The NHS in England has around 1,500 hospitals, where most emergency and elective care is carried out. The hospital estate contains many old buildings, and its condition has been deteriorating. In 2020, the previous government announced the New Hospital Programme (NHP) and committed to build 40 new hospitals by 2030.
We reported on progress with the NHP in 2023 and raised concerns about substantial delays to the programme and risks to value for money. In January 2025, the government confirmed that it would deliver all the schemes previously included in the programme, including the replacement of seven hospitals constructed wholly or primarily from deteriorating reinforced autoclaved aerated concrete (RAAC).
It announced a new Plan for Implementation to fund the programme through five-year waves of investment, averaging around £3 billion a year from 2030, with the third wave beginning main construction between 2035 and 2039. In June 2025, the government published a 10-year infrastructure strategy which reaffirmed its commitment to the programme to build new hospitals.
Scope
This study will examine whether the Department of Health & Social Care has a resilient and credible programme for building new hospitals. It will examine what the Department is aiming to achieve with the programme, the processes it went through to develop the new implementation plan, how lessons have been learned in response to the issues raised in our previous report and how the new plan addresses these issues and risks. It will provide a high-level update on progress against milestones, costs and other measures.
Specifically, we will examine:
- whether it is clear what the programme is aiming to achieve
- whether there are mechanisms and processes in place to manage and reduce risks on the implementation plan
- whether schemes are on track to deliver against current plans
NAO team
Director: Andy Morrison
Audit Manager: Heather Thompson