*Updated on 3 October 2024*
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:
“We have inherited a broken NHS, with many hospitals in a state of disrepair, meaning patients have not been able to access the care they so desperately need.
“We are committed to fully removing RAAC from the NHS estate whilst working to keep facilities open, with patient safety at the forefront.
“Repairing and rebuilding our crumbling hospital estate is a vital part of our ambition to create an NHS that is fit for the future through our Ten-Year Health Plan.”
Q&A
How many sites are affected?
- There are now a total of 47 hospitals that contain RAAC as identified through continued surveys across NHS estates.
- Between February 2024 and October 2024, a total of two hospital sites have confirmed newly identified RAAC (Queen Victoria Hospital and Bristol Eye Hospital).
- Between February 2024 and October 2024, a further nine hospital sites (University Hospital Lewisham, Norwich Community, Barnsley, Chase Farm, Warrington General, Castle Hill, Blackpool Victoria, North Cambridgeshire – Wisbech, and Stepping Hill) have eradicated RAAC, bringing the total number of hospital sites that have eradicated RAAC to thirteen.
Which new hospitals have been added to the list?
- You can see the full list of hospitals affected by RAAC that has been published on Gov.uk: Reinforced autoclaved aerated concrete (RAAC) in hospitals: management information - GOV.UK (www.gov.uk)
Why has RAAC been identified at further NHS sites since February 2024?
- The increased identification of RAAC is driven by NHS trusts work to undertake more in-depth surveys in response to the updated Institution of Structural Engineers Guidance on RAAC.
- It can take time to complete the visual inspections and structural surveys to identify and establish the technical classification of RAAC due to challenges accessing areas with possible RAAC.
- None of the new sites identified are hospitals built predominantly out of RAAC.
What about the worst affected sites?
- Where new cases of RAAC are identified, monitoring and mitigations will be put in place where needed and panels will be removed over time.
- More broadly, we have confirmed that seven of the most RAAC-affected hospitals will be replaced as a priority.
- The department and the NHS have worked closely with academic institutions on technical research into RAAC.
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.
Could there be instances of RAAC in hospitals that you are not yet aware of?
- 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.
- 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. All NHS trusts responded to the RAAC survey and data collection commissioned by NHS England in May 2023. This has increased the NHS’s ability to identify RAAC, including where it is not visible.
What exactly is the NHS doing to make sure hospitals are safe for staff and patients?
- Through this remediation programme, RAAC has been completely eradicated in 13 sites so far. In sites where RAAC remains present, risk is mitigated through failsafe measures such as propping.
- This includes significant failsafe intervention in the seven hospitals that have RAAC throughout and will be replaced through the New Hospital Programme before 2030.
- Where structural surveys identify RAAC in their estate, trusts are inducted into the national remediation programme. As new areas with RAAC are identified, monitoring and mitigations will be put in place where needed and panels will be removed over time.
- The NHS has plans in place to manage any change in position with RAAC as part of the ongoing work every Trust undertakes to plan for a wide range of scenarios.
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 three 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.
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