The NHS New Hospital Programme (NHP) is one of the largest attempts in a generation to modernise England’s hospital estate. Established in 2020, the programme was originally presented as a plan to deliver 40 new hospitals by 2030. Its purpose was to replace ageing and unsafe buildings, improve patient care, provide better working environments for NHS staff and introduce more modern technology and sustainable hospital design.

However, the programme has experienced significant delays, rising costs and changes in scope. In January 2025, the government reset the programme, replacing the original timetable with a longer-term plan based on several waves of investment. By 2026, the programme had moved from planning and review towards a more structured delivery phase.

 

Why is the New Hospital Programme needed?

Much of the NHS estate in England is ageing and requires substantial investment. Older buildings can be expensive to maintain and may not be suitable for modern healthcare. Problems can include outdated infrastructure, inefficient layouts, poor ventilation and inadequate facilities for patients and staff.

The presence of reinforced autoclaved aerated concrete (RAAC) in a number of NHS hospitals has added urgency to the programme. Hospitals containing RAAC have been prioritised because of the safety risks associated with the material. The 2025 programme reset specifically placed a number of RAAC hospitals into the earlier delivery wave.

Modernising hospitals is also important because demand for NHS services is changing. An ageing population, advances in medical technology and increasing pressure on emergency and planned care mean that hospitals need facilities that can support new models of healthcare.

 

From the original 40 hospitals to a revised programme

When the NHP was established in 2020, the government committed to delivering 40 new hospitals by 2030. The programme was subsequently expanded and was described as involving more than £20 billion of investment.

By 2024, however, concerns had emerged about whether the original timetable and funding commitments were realistic. A government review concluded that the programme was significantly delayed and did not have a sufficiently secure funding plan.

In January 2025, the government announced a major reset. It confirmed that all schemes would continue to receive capital investment, but construction would take place over a much longer period. The revised programme was divided into waves:

Wave 0: schemes already under construction or sufficiently advanced.

Wave 1: schemes expected to begin construction between 2025 and 2030.

Wave 2: schemes expected to begin construction between 2030 and 2035.

Wave 3: schemes expected to begin construction between 2035 and 2039.

The government committed to investment of up to £15 billion in each five-year spending period, equivalent to an average of around £3 billion a year.

The revised approach therefore represents a significant change from the original ambition of having the projects completed by 2030. Instead, it aims to provide a more affordable and realistic pipeline for hospital construction over the following decades.

 

How many hospitals are involved?

The programme has also evolved in terms of how its projects are counted. The latest NHS New Hospital Programme annual report describes the programme as involving 46 hospital schemes across England, with £9.6 billion of funding over the current spending review period. Seven schemes were open to patients at the time of the 2025–26 annual report.

These include major developments such as the Royal Liverpool Hospital, the Dyson Cancer Centre in Bath, Midland Metropolitan University Hospital and the redevelopment of the Royal Sussex County Hospital in Brighton.

The fact that the programme is described as a collection of “schemes” is important. Not every scheme represents a completely new hospital on a previously undeveloped site. Some involve major redevelopment, replacement buildings, extensions or projects covering more than one hospital site.

 

The Hospital 2.0 approach

A central feature of the revised programme is Hospital 2.0, a standardised approach to designing and constructing NHS hospitals.

Rather than designing every hospital completely from scratch, Hospital 2.0 aims to create common standards, designs and construction methods that can be adapted to local circumstances. The intention is to reduce unnecessary costs and construction time while maintaining flexibility for individual hospitals.

The approach includes features such as single bedrooms, easier-to-navigate layouts, modern digital systems and more efficient use of hospital space. The government says standardisation should help improve productivity, quality and value for money.

In July 2026, the government announced that NHS trusts and construction partners had signed 11 long-term partnerships to deliver the next phase of hospital projects. These partnerships are intended to make construction more efficient and support the use of the Hospital 2.0 model.

 

Progress so far

The programme has now moved beyond being purely a future construction plan. Several facilities are already open, while others are under construction or progressing through detailed business cases and planning.

According to the 2025–26 annual report, seven NHP schemes were open to patients. Other projects had reached different stages, including construction, planning, land acquisition and business-case development.

During 2025–26, for example, construction started on the Derriford Emergency Care Hospital in Plymouth, while major construction work continued on projects such as Brighton 3Ts. Several hospitals containing RAAC continued through the business-case process, with the aim of addressing their long-term infrastructure problems.

The programme is therefore progressing at different speeds depending on the individual hospital, its funding, planning requirements, land availability and construction readiness.

 

Funding and value for money

Funding is one of the most important issues surrounding the New Hospital Programme. Large hospital projects can cost hundreds of millions or even billions of pounds, and construction costs have increased considerably in recent years.

The 2025 reset was partly designed to address this problem by creating a longer and more affordable timetable. Rather than attempting to construct all projects simultaneously, the government is using five-year investment waves.

The 2025–26 annual report states that £1.83 billion had been provided to trusts since the 2021–22 financial year for NHP schemes, with most of this funding supporting earlier-wave projects.

The government has also attempted to improve procurement and construction efficiency. The introduction of standardised hospital designs and longer-term relationships with construction companies is intended to provide better value for taxpayers.

 

What will the programme mean for patients?

For patients, the benefits should ultimately go beyond having newer buildings.

Modern hospitals can be designed around patient safety and experience. Single bedrooms can provide greater privacy, while clearer layouts can make hospitals easier to navigate. Better facilities can also improve infection control, accessibility and the overall environment in which patients receive treatment.

Modern buildings can additionally accommodate new medical technologies and changing models of care. This is particularly important as more diagnostic and treatment services become increasingly technology-dependent.

However, patients should not expect every benefit to appear immediately. Many projects will take years to complete, particularly those in the later waves. The government has also acknowledged that the programme needs to operate alongside wider efforts to improve existing NHS buildings.

 

Benefits for NHS staff

Hospital buildings have a significant impact on staff as well as patients. Outdated buildings can create difficult working conditions, while inefficient layouts can increase the time staff spend moving between departments.

The New Hospital Programme aims to provide modern clinical environments that are safer, more efficient and better suited to contemporary healthcare.

The programme’s standardised approach is also intended to make hospital design more consistent. This could allow lessons learned from one project to be applied to another, potentially reducing duplication and improving the way hospitals are designed and constructed.

 

Wider NHS investment

The New Hospital Programme is only one element of the government’s wider plans for NHS infrastructure.

The government’s 10 Year Capital Plan, published in July 2026, sets out a broader programme of investment in hospitals, primary care facilities and other NHS infrastructure. It also emphasises providing more healthcare closer to people’s homes rather than relying exclusively on large hospitals.

This means that the future NHS estate is likely to involve a combination of major hospitals, neighbourhood health centres, community services, diagnostic facilities and upgraded GP surgeries.

In September 2026, the government also announced more than £1.5 billion for over 950 NHS infrastructure projects, including major hospital improvements, maintenance, safety work, ventilation and cooling systems.

 

Challenges facing the programme

Despite the progress, the New Hospital Programme faces several significant challenges.

First, construction on this scale is expensive and takes many years. Changes in construction prices, interest rates, supply chains and labour availability can all affect costs and schedules.

Second, the programme has to balance the need for new hospitals with the need to maintain the existing NHS estate. Hospitals cannot simply wait for a new building to be completed before essential repairs are made to their current facilities.

Third, the programme has already experienced delays. The 2025 reset acknowledged that the original timetable was unrealistic and introduced a substantially longer delivery schedule. The success of the revised programme will therefore depend heavily on whether it can maintain realistic budgets and timelines over successive governments and spending reviews.

Finally, there is the challenge of ensuring that standardisation does not come at the expense of local needs. Hospitals serve different populations and provide different combinations of specialist services. Hospital 2.0 therefore needs to provide common standards while still allowing individual NHS trusts to design facilities around their local communities.

 

The NHS New Hospital Programme: Conclusion

The NHS New Hospital Programme represents a major investment in the future of healthcare infrastructure in England. Its central objective is to replace or modernise ageing hospital facilities and create buildings capable of supporting the NHS for decades to come.

The programme has, however, changed considerably since it was first announced in 2020. The original ambition to deliver 40 new hospitals by 2030 was replaced in 2025 by a longer-term, phased programme designed to be more affordable and achievable. By 2026, the programme was entering a more active delivery phase, supported by Hospital 2.0 and new partnerships between NHS trusts and the construction industry.

Its ultimate success will depend not simply on how many hospitals are built, but on whether they are delivered safely, affordably and on time—and whether they genuinely improve the experience of patients and staff. If those objectives are achieved, the New Hospital Programme could play an important role in creating an NHS estate that is safer, more efficient and better prepared for the healthcare demands of the future.