Expert advice regarding the ageing NHS estate has undergone a significant change, sparking renewed debate over infrastructure safety and investment. Earlier this year, government advisers mandated that hospitals constructed with high levels of reinforced autoclaved aerated concrete (RAAC) needed complete replacement by 2030. However, the latest reports suggest that these same advisers now believe the lightweight concrete planks can remain “technically serviceable” until 2040, a full decade beyond the initial deadline. This revised guidance on managing critical infrastructure risk has caused considerable concern across the NHS.
Structural safety organisations advise, and the NHS has systematically inspected and carried out remediation work across its properties since 2019, prompted by significant structural collapses and safety warnings in other sectors. From the 1950s to the 1980s, constructors extensively employed Reinforced Autoclaved Aerated Concrete (RAAC) in UK public sector buildings. RAAC's degradation over time is now recognised, and moisture or excessive loads particularly accelerate this deterioration, often leading to sudden, catastrophic structural failure without preceding warning signs.
In 2025, the government and NHS England focused on a national programme to eliminate RAAC from hospital buildings. This involves interim safety measures and major capital projects. Official figures confirm dozens of sites with RAAC. Approximately £440 million supported this year's efforts, and seven hospitals have now completely eradicated the material through structural removal. The programme aims for a further 12 hospitals to be RAAC-free by March 2026.
The New Hospital Programme previously targeted replacing the seven hospitals most impacted by RAAC by 2030. However, the Department of Health and Social Care's fact sheet now outlines a formal commitment to completely remove RAAC from the NHS estate by 2035. The fact sheet acknowledges RAAC as a structural risk and details mitigation measures, including inspection regimes, operational load limits, and supports.
Clinicians, safety advocates, and some property professionals have met the technical advice suggesting that RAAC could remain serviceable until 2040 with scepticism. Updated engineering assessments may produce this new timeline, indicating that RAAC panels can safely exceed their original expected lifespan with ongoing maintenance and mitigation strategies. Nevertheless, critics caution that pushing back the deadline could foster a dangerous sense of complacency, potentially endangering patients and staff should the concrete unexpectedly fail.
NHS leaders divide over extending RAAC's useful life: some view it positively because it could alleviate pressure on capital budgets and allow more feasible timetables for reconstruction, particularly in lower-risk facilities, but others deeply concern that officially sanctioning a longer "technical lifespan" might erode the necessary political impetus for immediate action, potentially delaying essential replacements for facilities that are already obsolete. The NHS's planned capital investment, which includes the SR25 settlement of over £44 billion across the four-year Spending Review and a dedicated annual allocation of £750 million for estate safety, will support trusts in maintaining services while they carry out long-term rebuilding projects.
A core dilemma defines RAAC management: authorities must balance updated technical advice on its potential lifespan with the practical constraints of politics and funding. While safely extending RAAC's life until 2040 could allow NHS trusts to integrate replacement into long-term capital plans, a significant risk exists that relaxing the official position will provide an excuse to delay necessary action, thus jeopardising the safety and operational effectiveness of NHS buildings. Therefore, the NHS's near-future strategy for addressing RAAC will define its commitment to modernising its chronically underfunded estate.
