On 29 September 2019 the then Secretary of State for Health and Social Care announced a new Health Infrastructure Plan (HIP), with a commitment to funding for six new hospitals as well as “seed funding” to support the initial stage of a further 34 hospital building sites (across 21 projects). The package of funding includes:

  • £2.7 billion to deliver a first phase of 6 major hospital rebuilds, aiming to deliver by 2025 (HIP1);
  • £100 million to support a second phase of 21 major projects, comprising 34 hospital sites, to go to the next stage of developing their plans (HIP2).

The Government stated that subject to business case development, and future spending reviews, the aim is to deliver the second phase of hospital rebuilds between 2025 and 2030. They also noted that other projects will be able to bid into HIP2 “and other future waves”.

Further background on approvals and allocation can be found in the Health infrastructure plan, published on 30 September 2019, and the initial lists of 6 hospitals to be developed under HIP1 and 21 trusts receiving seed funding under HIP2 published on the Gov.uk website. Some further background on the allocation of the NHS capital investment budget can be found in the National Audit Office (NAO) report, Review of capital expenditure in the NHS (February 2020).

On 2 October 2020 the Prime Minister confirmed that the trusts that received seed funding under HIP2 will now all be fully funded to deliver 25 new hospitals by 2030, with an invitation for 8 further schemes to bid. A new hospital (in Shotley Bridge, County Durham) was also added to the HIP2 programme. The announcement also noted that the budget for the Hospital Infrastructure Plan has increased to £3.7 billion: PM confirms £3.7 billion for 40 hospitals in biggest hospital building programme in a generation

A Guardian report on this October 2020 announcement noted that a number of what the Government describes as “40 new hospitals” are projects that have already started, or comprise rebuilding projects on existing sites, consolidations of other hospitals, or extra units. The paper also quoted Saffron Cordery, deputy chief executive of NHS Providers, welcoming the announcement but warning that the actual cost of the planned building projects would be about £20 billion, most of which would need to be found in the next few years: “Building a new, average mid-sized hospital costs around £500m, so this [£3.7bn] is just an initial down payment.”: Most of Boris Johnson’s promised 40 new hospitals will not be totally new

A PQ response on the HIP, from 26 January 2021, is set out below:

Hospitals: Modernisation

26 Jan 2021 | 140299

Asked by: Navendu Mishra

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to modernise hospital estates.

Answering member: Edward Argar | Department: Department of Health and Social Care

The Health Infrastructure Plan (HIP) will deliver a long-term, rolling five-year programme of investment in health infrastructure, including capital to build new hospitals. The Prime Minister confirmed 40 hospitals will be built by 2030, with funding of £3.7 billion confirmed over the next four years. An open competition will be run to identify eight further new schemes.

The HIP will modernise estates by more than delivering new hospitals; the Government has committed £450 million to upgrade accident and emergency departments, £400 million to eradicate dormitory accommodation from mental health facilities and £600 million to upgrade and refurbish National Health Service hospitals. In addition, local health systems will shortly be receiving confirmation of their capital envelopes for 2021-22 and the settlement from HM Treasury has enabled us to protect the level of capital funding for trusts which enables them to progress priority investments agreed with local health partners.

On 15 July 2021 the Department of Health launched the ‘Our NHS Buildings’ website. It is the official home of the government’s major NHS infrastructure projects across the country, including new hospital builds and upgrades. The government also invited NHS Trusts to bid to build eight new hospitals as a part of the larger hospital building programme: Eight new hospitals to be built in England

 The Autumn Budget and Spending Review 2021 on 27 October 2021 announced ‘£4.2 billion over the SR21 period to make progress on building 40 new hospitals by 2030, with 30 of the hospitals already announced to be built outside London and the South East and to upgrade more than 70 hospitals’.

The Nuffield Trust briefing, Lessons from the last hospital building programme, and recommendations for the next (July 2020) and a Full Fact article from August 2021 provide further background.


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