Will Hospitals with Unsafe Concrete Miss Their Rebuild Deadline?

The UK government is facing significant delays in its efforts to rectify safety concerns surrounding hospitals constructed with reinforced autoclaved aerated concrete (Raac). A recent report indicates that remedial work on prioritised hospitals will not be completed by the previously set deadline of 2030, with new projections pushing completion dates to 2032 and 2033. This situation raises serious implications for patient safety and healthcare capacity in the UK.

Last updated: 15 October 2023 (BST)

What’s happening now

The National Audit Office (NAO) has released a report indicating that the government’s efforts to address the safety issues related to Raac in seven prioritised hospitals are falling behind schedule. The initial plan aimed for completion by 2030, but now the expected openings have been delayed to 2032 and 2033. Some hospitals are currently operating under precarious conditions, with roofs supported by metal props and certain areas closed off due to safety concerns.

Key takeaways

Delays in the construction of hospitals built with Raac are pushing completion dates to 2032 and 2033.
The original target of completing remedial work by 2030 is now deemed unattainable.
Health trusts are experiencing high maintenance costs to keep existing buildings operational.

Timeline: how we got here

The issues with Raac in hospitals have developed over several years, with key milestones including:

2019: Initial concerns regarding the structural integrity of Raac in hospitals are raised.
2022: Seven hospitals are identified for priority remedial work, with a target completion date set for 2030.
January 2025: Health Secretary Wes Streeting revises the New Hospitals Programme, prioritising 20 projects, including those with Raac.
October 2023: The NAO report reveals further delays, with completion dates pushed to 2032-33.

What’s new vs what’s known

New today/this week

The NAO report highlights that remedial work on hospitals constructed with Raac is significantly behind schedule, with the new completion dates now set for 2032 and 2033. This update contradicts earlier expectations of a 2030 completion.

What was already established

Concerns about Raac's durability have been known since 2019, leading to the identification of seven hospitals requiring urgent remedial work. The government's initial plan to resolve these issues by 2030 was already questioned prior to this latest report.

Impact for the UK

Consumers and households

The delays in hospital construction could adversely affect patient care and safety. Existing hospitals face escalating maintenance costs, which may ultimately drain resources away from other critical areas of healthcare, impacting access and quality of service for the public.

Businesses and jobs

Healthcare providers and construction firms involved in these projects may experience financial strain due to the extended timelines and increased costs. This could lead to job insecurity in construction and related sectors, particularly if funding is diverted from operational expenses to cover mounting maintenance bills.

Policy and regulation

The delays may prompt further scrutiny from the government and health regulators regarding the management of public funds and the delivery of healthcare infrastructure. The Department of Health and Social Care has indicated that it is committed to a funding plan and timeline, but the NAO report suggests that these may not be realistic.

Numbers that matter

£500 million: Estimated investment needed by 2025 to prevent structural failure in the prioritised hospitals.
2030: Original target completion date for remedial work on Raac hospitals.
2032-33: New completion dates for the affected hospitals.
£1.6 billion: Investment over the next four years to eradicate Raac from NHS buildings.
20: Number of sites where Raac concrete has been eradicated so far.

Definitions and jargon buster

Raac: Reinforced Autoclaved Aerated Concrete, a lightweight building material known for its insulation properties but less durable than traditional concrete.
NAO: National Audit Office, a UK government body that scrutinises public spending for Parliament.
NHS: National Health Service, the publicly funded healthcare system in the UK.

How to think about the next steps

Near term (0–4 weeks)

Government officials will likely assess the current state of the projects and may announce interim measures to mitigate risks in the affected hospitals. Continued monitoring of safety conditions will be essential.

Medium term (1–6 months)

Expect updates on the revised timelines and potential funding allocations to expedite construction efforts. The government may also engage with health trusts to address the mounting maintenance challenges.

Signals to watch

Updates from the Department of Health and Social Care regarding funding plans and construction timelines.
Reports on the operational status of hospitals facing Raac-related closures.
Public health assessments on the impact of these delays on patient care.

Practical guidance

Do

Stay informed about updates from local health authorities regarding hospital safety and operational status.
Engage with community health services to understand how delays may affect access to care.

Don’t

Ignore safety warnings from hospitals regarding structural integrity.
Assume that all services will continue as usual in affected facilities without disruption.

Checklist

Check for updates on local hospital statuses if you rely on these services for care.
Understand alternative options for accessing healthcare should your local hospital face closures.
Monitor community meetings for discussions on hospital funding and safety improvements.

Risks, caveats, and uncertainties

While the government has set new timelines and funding plans, the NAO report indicates that these may not be sufficient to meet the pressing safety needs of hospitals. The construction schedule is tight, with little room for unexpected delays, meaning deadlines could slip further. Additionally, the reliance on outdated buildings for patient care raises significant risks for both patient safety and healthcare access.

Bottom line

The government's efforts to address safety concerns surrounding Raac in hospitals are significantly delayed, with new completion dates now set for 2032 and 2033. This situation highlights the pressing need for urgent remediation and funding to ensure safe healthcare facilities for the public. As the NHS continues to grapple with these challenges, the implications for patient care and hospital capacity remain critical.

FAQs

What is Raac and why is it a concern for hospitals?

Reinforced autoclaved aerated concrete (Raac) is a lightweight building material that is less durable than traditional concrete, posing risks of structural failure in hospitals.

What are the new completion dates for the hospitals affected by Raac?

The completion dates for the hospitals prioritised for remedial work are now projected to be in 2032 and 2033, significantly delayed from the original target of 2030.

How much investment is needed to address the issues with Raac?

More than £500 million is estimated to be required by 2025 to prevent structural failures due to Raac in the prioritised hospitals.