Worsening estates challenges
St Mary’s Hospital estate is some of the oldest in the NHS, with parts dating back to 1845. As a Trust, we have the largest amount of ‘backlog maintenance’ in the NHS. In the last four years alone, the cost of our backlog maintenance has increased by 22.5 per cent - or £157 million, far outstripping the £104 million we have been able to spend on addressing backlog maintenance over that period.
In the past three months, we have had to respond to two new estates issues that are particularly challenging:
Main outpatient building
Following the discovery of reinforced autoclaved aerated concrete (RAAC) in the main outpatient building in November 2025, further structural analysis informed our decision in late December 2025 to close the whole building later this year to ensure everyone’s safety. This is requiring us to find new spaces for 50 clinics, as far as possible elsewhere on the St Mary’s site.
With support of NHS England’s national RAAC programme, we are working up plans to repurpose other facilities on the St Mary’s site, accelerate models of care changes to reduce the need for in-person appointments as well as potentially move some clinics to other sites.
Mint building
Following a routine structural inspection at the end of 2025, we identified further significant issues with the foundations of the Mint building. This is the oldest part of the St Mary’s estate, housing a range of clinical services as well as our education centre. We are continuing with immediate stabilisation works as well as further investigations to inform a more detailed risk assessment to determine the longer term future of the affected sections of the building.
Next steps in redevelopment
With our partners in the wider St Mary’s Redevelopment Funding Taskforce, we are continuing to explore additional financing sources and models to allow us to begin the main building works for a new St Mary’s as soon as we have planning permission. This would deliver a new hospital by 2035, against the current New Hospital Programme timetable which delays delivery until 2043 at the earliest.
We are aiming to complete the design work and submit a planning application – for the new hospital and the wider masterplan by Spring 2027.
