DHSC details £700m NHS plans to counter unsafe concrete

Second perm sec Shona Dunn tells MPs four-year RAAC bill is “likely” to rise if capital contingency spending is prioritised
West Suffolk Hospital is one of the "worst affected" hospitals set for reconstruction. Photo: David J. Green/Alamy Stock Photo

By Jim Dunton

18 Oct 2023

The Department of Health and Social Care has spent more than £300m dealing with problem concrete on the NHS England estate over the past two years, and is set to spend at least £380m more in the next two, MPs have been told.

DHSC second permanent secretary Shona Dunn detailed the expense of remediating structures built with reinforced autoclaved aerated concrete – or RAAC – in a letter to members of parliament’s Public Accounts Committee that has been published this week.

Dunn’s letter, which follows her appearance before the committee last month, said £110m had been allocated to NHS England to deal with the “most immediate” issues from the failure-prone lightweight concrete in 2021-22, with a further £5m of “operational capital contingency”.

In 2022-23, the spending review allocation was £196m, with a further £13m of contingency cash, she told MPs.

“A further £209m of the SR settlement has been allocated for the financial year 2023-24 and £171m for financial year 2024-25,” Dunn said. “However, the total spend is likely to be higher if further NHSE operational capital contingency is prioritised for RAAC during this period.”

She added that in addition to national funding, hospital trusts could also spend some of their local capital allocations on RAAC surveys and mitigation.

MPs asked Dunn for details of the NHS’s plans for dealing with RAAC early last month, days after the Department for Education announced that around 150 schools were at risk because of the presence of the construction material, prompting classroom closures at the start of the autumn term.

The PAC session heard that NHS England has had a programme in place to deal with RAAC in hospital buildings since 2019, and that 24 schemes with fully worked-up proposals to eradicate the material were in place. Seven projects involve full hospital rebuilds.

MPs were told that most of the worked-up schemes were expected to be completed by 2030 and that NHS England had a commitment to eradicate all RAAC from hospital buildings by 2035. However, they also heard that investigations into NHS England’s full exposure to RAAC were ongoing.

Of the seven hospitals being fully rebuilt, five were added to the New Hospital Programme this summer. The remaining two – West Suffolk Hospital in Bury St Edmunds and James Paget Hospital in Norfolk – were already included in the programme. The "reprioritisation" means eight of the 40 projects in the scheme, which are badged as "new hospitals" but are mostly upgrades or additional facilities, will be pushed beyond the original 2030 deadline.

In her letter, Dunn told MPs that the NHS had been surveying sites and undertaking RAAC mitigation for the past four years and was continuing to conduct a “wide range of invasive surveys”.

“This has increased the NHS’s ability to identify RAAC, including where it is not visible,” she said. “NHSE has issued guidance for trusts nationally on how to establish the presence of RAAC in their estate, and there is ongoing engagement with trusts on a national and regional level to ensure RAAC is identified across the NHS estate.”

At September’s PAC hearing, NHS England chief financial officer Julian Kelly was reluctant to give MPs an up-to-date figure for the number of NHS trusts now reporting that they may have RAAC on their estates – in addition to the cases that have already been confirmed.

However, he agreed with PAC chair Dame Meg Hillier’s suggestion that the figure was “in the tens, not hundreds”.

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