*Updated on 19 October*
This fact sheet sets out our position on the presence of reinforced autoclaved aerated concrete (RAAC) in the NHS. RAAC is a lightweight form of precast concrete, frequently used in public sector buildings in the UK from the mid-1950s to the mid-1990s.
A Department of Health and Social Care spokesperson said:
“The NHS has an established national programme to manage hospital buildings with confirmed reinforced autoclaved aerated concrete (RAAC), backed with significant additional funding of £698 million from 2021 to 2025, for trusts to put in place necessary remediation and failsafe measures. We remain committed to eradicating RAAC from the NHS estate entirely by 2035 and our approach is in line with guidance from the Institution of Structural Engineers
“Additionally, we have announced that the seven most affected NHS hospitals will be replaced by 2030 through our New Hospital Programme.
“Where structural surveys identify RAAC in their estate, trusts are inducted into this national remediation programme. Each site will be different – and just because RAAC is present, it does not necessarily mean there is a high risk.”
How many sites are affected?
- 42 NHS sites have been confirmed to have RAAC plank construction, the latest list is published on gov.uk. Through the national remediation programme, RAAC has been completely eradicated in 3 of these sites.
- In most identified cases, RAAC has been found in limited parts of a building, however 7 of these hospitals need a full replacement and will be rebuilt through the New Hospital Programme (NHP) before 2030. These 7 include Airedale, Queen Elizabeth King’s Lynn, Hinchingbrooke, Mid Cheshire Leighton, Frimley Park, West Suffolk Hospital, James Paget Hospital, more information on these can be found here.
What kind of mitigations are in place?
- The Institution of Structural Engineers has published guidance on remediation and management strategies.
- The approach will differ depending on the assessment of risk but these include secondary supports or beams for the highest risk to inspection regimes for lower risk areas, as well as plans for limiting operational loads, such as no-walk zones on RAAC roofs and maintaining roof drainage, restricting new or removal of existing equipment or reducing humidity.
Why is your approach different to schools?
- The NHS has been surveying sites and undertaking RAAC mitigation work since 2019 and is continuing to conduct a wider range of invasive surveys than many other sectors.
- Given that the school and hospital estates are different in a number of ways the approach to managing them differs. The hospital estate is mainly concentrated in a smaller number of larger buildings with dedicated teams of trained estates professionals who monitor and maintain them. Where mitigation work is required, this can be carried out with relatively minimal service disruption in hospital settings where patients can be relocated to different wards if necessary.
- Reducing the availability of advanced clinical settings could cause potential harm to patients. Keeping capacity open but being scrupulous about RAAC monitoring and mitigation until the RAAC can be removed is fully in line with the current evidence and recommendations of the Institute of Structural Engineers.
Has the guidance changed?
- The Department of Health and Social Care and the NHS have worked closely with academic institutions on technical research into RAAC.
- Our approach is in line with recommendations by the Institution of Structural Engineers. The latest guidance issued in April 2023 recommends that where RAAC is identified it should, depending on its condition, either be regularly monitored, mitigated, or replaced.
How can you be sure you’ve identified all instances of RAAC - could there be cases you don’t know about?
- NHSE has issued guidance for trusts nationally on how to establish the presence of RAAC in their estate. There is ongoing engagement with trusts on a national and regional level to ensure RAAC is identified across the NHS estate.
- Where structural surveys identify RAAC in their estate, trusts are inducted into the national remediation programme.
- It is important to stress that each site will be different – and just because RAAC is present, it does not necessarily mean there is a high risk.
- The NHS has been surveying sites and undertaking RAAC mitigation work since 2019 and is continuing to conduct a wider range of invasive surveys than many other sectors. This has increased the NHS’s ability to identify RAAC, including where it is not visible.
What about other parts of the health estate – for example, GPs/primary care services?
- DHSC and NHSE have engaged with Community Health Partnerships (CHP) and NHS Property Services (NHSPS) to understand their RAAC risk and the associated programmes. CHP has not identified any RAAC in its estate.
- NHSPS has identified 3 sites that are part of the national programme.
- Privately owned primary care estate is not part of the national programme. NHSE has issued RAAC guidance to private landlords who hold the responsibility for surveying and maintaining their own property.