NHS orders urgent review of all hospital buildings over crumbling concrete

Trusts urged to assure assessments of RAAC are ‘sufficiently thorough’ after schools ordered to close
West Suffolk Hospital will be rebuilt by the Government due to the presence of RAAC
PA
Daniel Keane5 September 2023

NHS England has ordered hospitals to conduct an urgent review of their buildings for reinforced autoclaved aerated concrete (RAAC).

In a letter issued to NHS managers on Tuesday, trusts were instructed to ensure that RAAC assessments are “sufficiently thorough and cover all buildings and areas” on their estate.

It follows the decision to fully or partially close more than 100 schools in England at risk of collapse due to the presence of RAAC, a lightweight building material used from the 1950s up to the mid-1990s. The material has been compared to an “aero chocolate bar”.

The Government has been aware of public sector buildings that contain RAAC since 1994 and it began monitoring their condition in 2018.

Ministers have already allocated £700 million for NHS hospitals in England with RAAC issues but courts, police stations and prisons could also be affected.

The National Audit Office has said that 41 hospitals had RAAC, while seven were built with the aerated concrete “throughout”.

The letter to trust leaders was issued by the NHS' chief commercial officer Jacqui Rock and the health service's National Director for Emergency Planning and Incident Response, Dr Mike Prentice.

They wrote: “In light of the need to maintain both the safety and confidence of staff, patients and visitors, we recommend that in those organisations where the presence of RAAC has been confirmed and is being managed, boards take steps now to assure themselves that the management plans in place for each incidence – and particularly where panels are currently subject to monitoring only – are sufficiently robust and being implemented.”

Trusts must ensure that assessments made on RAAC were “sufficiently thorough and covered all buildings and areas on your estate”, the letter said, including "plant/works, education and other non-clinical areas/buildings”.

The letter also sets out how trusts should manage a potential incident related to RAAC.

“Effective management of RAAC significantly reduces associated risks; but does not completely eliminate them. Planning for RAAC failure, including the decant of patients and services where RAAC panels are present in clinical areas, is therefore part of business continuity planning for trusts where RAAC is known to be present, or is potentially present.”

It also urges trusts to familiarise themselves with learnings from a regional evacuation plan created and tested in the east of England as a “matter of priority”.

In the capital, £800 million is needed to fix the backlog of the most serious “high risk” defects, those which urgently need fixing to prevent catastrophic failure, major disruption to clinical services or safety failings resulting in serious injury.

Downing Street confirmed on Tuesday that there were no plans to publish a list of public buildings that contain RAAC.

The Prime Minister’s official spokesman said: “The advice we’ve had across the piece is that the way to manage Raac will vary depending on the circumstances in which it’s found.

“We have mitigations in place across the NHS estate, equally, they also have estate managers who monitor the conditions of buildings and that’s not the case in education settings, as you might expect in a small primary.

“And that’s why the approach is differing, depending on settings.”

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