Eleven NHS trusts have signed long-term agreements with their construction partners under the Hospital 2.0 Alliance, formally opening delivery on the first wave of the New Hospital Programme. The schemes are worth roughly £14bn between them, seven of the eleven are RAAC replacements, and construction activity steps up from 2027 as the programme moves out of framework mobilisation and into build. The funding is settled. The people are not.
The programme is sequenced rather than simultaneous, and that is the single most important thing to understand about the hiring pattern it creates. Four waves, roughly forty schemes and fifteen years of work, funded at up to £15bn per five-year spending period and averaging around £3bn a year by 2030. Wave 1 is the sixteen schemes building between 2025 and 2030; Waves 2 and 3 follow through to 2039.
The immediate pressure is narrower than the national picture suggests. Four of the seven RAAC replacements — West Suffolk, Hinchingbrooke, Queen Elizabeth King's Lynn and James Paget — sit in the East of England, spread across roughly seventy miles and delivered by three different contractors. Independent assessment found the RAAC schemes cannot safely operate beyond 2030, so the four programmes with the least room to slip draw on one regional pool, and East Anglia carries very few people who have delivered an acute hospital before. No alliance member can solve that by taking people off the scheme down the road.
Demand also concentrates on the same nine disciplines on every scheme: project director, senior project manager, commercial manager, senior quantity surveyor, planner, design manager, MEP lead, information manager and project controls manager. Multiply nine by eleven and the programme needs several hundred senior delivery people. Insist that every one of them has prior acute hospital experience and the field narrows to a pool that numbers in the hundreds nationally rather than the thousands — while HS2, Sizewell C, the gigafactory pipeline and the data centre boom compete for the same commercial, planning and MEP populations. On our own estimate, the eleven schemes carry around 17,000 people at peak, about 300 of them senior delivery and commercial roles, and eighteen months to build those teams before the 2027 ramp-up.
The briefing sets out all eleven pairings, the wave structure behind them and where the demand lands discipline by discipline. The conclusion for anyone staffing one of these schemes is straightforward: standardised design compresses the build programme, so the recruitment programme has to compress with it. Saving nine months on site and then losing six waiting for a commercial manager is not a saving.