NHS trusts in England have been told to ensure contingency plans are in place to deal with the potential failure of a form of weak concrete used in some hospital buildings.
A letter from NHS England called for trust bosses to review evacuation procedures in the event of failure of reinforced aerated autoclaved concrete (RAAC).
The letter, addressed to the chairs and chief executives of all trusts and integrated care boards, noted "heightened public interest" in the presence of RAAC in the NHS estate following recent publicity surrounding its use in school buildings.
RAAC is a lightweight, 'bubbly' form of concrete commonly used in construction between the 1950s and mid-1990s and predominantly found as precast panels in roofs and occasionally in walls and floors . An alert was issued in May 2019 after the Standing Committee on Structural Safety documented the collapse of a RAAC panel roof in a school "with no apparent warning".
RAAC Found at 27 NHS Sites
According to the latest letter, signed by NHS England's chief commercial officer Jacqui Rock and national director for emergency planning and incident response Dr Mike Prentice, 27 NHS sites with RAAC have previously been identified, and RAAC eradicated in three of them.
The letter stated: "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."
Although effective management of RAAC "significantly reduces associated risks", the letter warned that it does not 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 highlighted.
A regional evacuation plan was created and tested in the East of England, with lessons learned communicated to other regions, according to NHS England.
The Department of Health and Social Care has stated a commitment to eradicate RAAC from the NHS estate by 2035 and is taking steps to protect patients and staff in the interim, with funding of £698 million from 2021 to 2025 to enable trusts to put in place remediation and failsafe measures.
Seven hospitals in England with RAAC are due to be rebuilt under the New Hospital Programme before 2030. They are Airedale, Queen Elizabeth King's Lynn, Hinchingbrooke, Mid Cheshire Leighton, Frimley Park, West Suffolk Hospital, and James Paget Hospital.
Saffron Cordery, deputy director of NHS Providers, said it was "concerning that those with remaining RAAC planks have to wait until 2035 before they'll be removed from the NHS estate".
The Institution of Structural Engineers published updated guidance in April this year on the critical risk factors associated with RAAC panels.