Deadline to fix unsafe crumbling NHS hospitals will be missed

The ambitious government target to remediate NHS hospitals constructed with Reinforced Autoclaved Aerated Concrete (Raac), a dangerously brittle material, will be significantly missed, according to a stark new report from the National Audit Office (NAO). While the original deadline for addressing the most critical Raac-affected sites was set for 2030, the report now indicates that these essential remedial works are unlikely to be completed until 2032 or even 2033. This considerable delay comes with a weighty price tag of escalating maintenance costs for already aging infrastructure and, more alarmingly, poses significant operational and clinical risks to patient safety.

Last year, seven hospitals identified as being built with Raac were prioritised for urgent remedial action, with the government initially promising a swift resolution. However, the NAO’s findings reveal that these seven prioritised schemes will not be completed until the 2032-33 period, a timeframe fraught with "significant operational and clinical risk and cost." In a number of these hospitals, the precarious state of the Raac is so severe that roofs are currently being supported by temporary metal props, and certain areas have already been cordoned off and closed to the public due to safety concerns.

The scale of the problem extends beyond these seven immediate priorities. The government’s wider New Hospitals Programme, initially trumpeted as a promise to deliver 40 new hospitals by 2030, has been openly acknowledged by Health Secretary Wes Streeting as a set of promises that "were never going to be met." In a significant recalibration of the programme in January 2025, Mr. Streeting revised the scheme, refocusing efforts on 20 priority projects, including those affected by Raac. This revised plan included increased funding and, crucially, later completion dates. The NAO report concedes that this 2025 review has placed the programme on a "more realistic, stable, long-term footing," with strategies such as standardising designs for some new buildings intended to accelerate delivery and reduce costs.

Despite these adjustments, the timeline for some of the new hospital constructions continues to slip. The NAO report specifically highlights Torbay, Kettering, and Musgrove Park hospitals as facing significant delays, with their estimated opening dates now projected to be nine to ten years later than originally planned under the previous, less realistic, blueprint. This prolonged delay in replacing compromised facilities means that affected health trusts are grappling with immense maintenance bills to ensure the ongoing safety of their existing, aging buildings. By 2025 alone, the seven initially prioritised hospitals will have required over £500 million in investment simply to prevent structural failure.

The inherent fragility of Raac is central to the urgency of this situation. This lightweight, pre-cast concrete, often described as "bubbly," is significantly less durable than traditional reinforced concrete. Its porous structure makes it susceptible to water ingress, which weakens the material over time, leading to crumbling and, in the worst-case scenarios, catastrophic collapse. The NAO’s warning underscores the immediate danger posed by these structures, where essential patient care is being delivered within buildings at risk of structural compromise.

The Department of Health and Social Care (DHSC) has stated that its objective is to eradicate all Raac concrete from the NHS estate by 2035. The department claims that Raac has already been removed from 20 sites and that it is allocating £1.6 billion over the next four years to address the issue. However, the NAO’s report casts doubt on the feasibility of meeting even this revised target, especially given the tight construction schedules and limited contingency planning within the next five years. The report explicitly warns that delivery dates could slip further, compounding the existing challenges.

The financial burden on affected NHS trusts is substantial. Hospitals such as West Suffolk Hospital in Bury St Edmunds and The Queen Elizabeth Hospitals in King’s Lynn are already facing enormous expenditure to maintain the safety and operational capacity of their Raac-affected sites. This diverted funding, intended for critical upgrades and expansions, is instead being funnelled into emergency repairs and temporary structural supports, diverting resources away from essential patient services and innovative healthcare solutions.

Sir Geoffrey Clifton-Brown, Chair of the Public Accounts Committee, has emphatically stated that the ongoing delays in addressing the crumbling Raac infrastructure must be rectified "as a matter of urgency." His sentiment is echoed by Mr. Tim Mitchell, President of the Royal College of Surgeons of England, who, while acknowledging that a "steadier plan is better than drifting," voiced deep concern over the prolonged wait for essential hospital capacity. He argued that "patients cannot wait a decade for capacity that we need now," and that NHS trusts are being forced to "pour scarce funds into patching up old buildings for longer, when that money should be used to create extra operating theatres, securing ring-fenced beds and making sure that there is enough staff to run them." This highlights a critical trade-off: continued investment in failing infrastructure at the expense of vital service development and expansion.

In response to the NAO report, a spokesperson for the Department of Health and Social Care maintained that the government has "confirmed a sustainable funding plan and an achievable timetable to deliver all schemes in the programme." They asserted that they are "now getting on with building these much-needed facilities as quickly as possible." However, the NAO’s detailed analysis and the warnings from medical professionals paint a picture of significant challenges and potential further setbacks, suggesting that the optimistic pronouncements may not fully reflect the complex realities on the ground. The continued reliance on temporary measures and the ongoing risk to patient safety within Raac-affected hospitals remain pressing concerns that demand immediate and sustained attention, beyond the current projected timelines. The report serves as a critical reminder of the long-term consequences of infrastructure neglect and the urgent need for robust, realistic planning and adequate funding to ensure the safety and efficiency of the NHS.