Suffolk hospital assessed legal risk of fatal roof collapse

Almost 200 props were being used to support the roof at the Queen Elizabeth Hospital in King's Lynn

An NHS hospital commissioned a report into the risk of corporate manslaughter charges should a fatal roof collapse occur, leaked documents reveal.

West Suffolk Hospital is spending tens of millions of pounds making dangerous reinforced concrete planks in its main building safe.

Hinchingbrooke Hospital, which is of similar design, has set a weight limit on patients at two of its theatres.

NHS England said the affected trusts were maintaining safe services.

The problems related to the use of reinforced autoclaved aerated concrete (RAAC) planks that have deteriorated or have structural weaknesses.

Between the 1960s and 1980s they were used in roofs, floors and walls of NHS buildings and schools and had an expected lifespan of 30 years.

The West Suffolk, in Bury St Edmunds, currently has 27 metal supports under the planks, while the Queen Elizabeth Hospital in King's Lynn in Norfolk has more than 200 - a temporary measure ahead of more comprehensive safety works.

Hinchingbrooke, in Huntingdon, Cambridgeshire, is closing two operating theatres to heavier patients until March while structural surveys are undertaken.

Published in June, the Annual Plan of the North West Anglia NHS Foundation Trust, which runs Hinchingbrooke, said "the RAAC panelling... affects the load-bearing of the floor, restricting the use of some theatres to patients under 120kg (19 stones)".

John Corrie had his operation postponed due to disruption caused by the safety works at West Suffolk Hospital

At West Suffolk Hospital, the entire roof structure is also being fitted with measures to catch any failing planks, alongside an experimental scheme to prevent further deterioration inside the wall panels.

The planks are also at risk of failure due to the reinforced metal bars inside them not aligning with supporting elements, and separate work was under way to correct this.

'Pretty upsetting'

Patients were being moved to other parts of the site as safety works were carried out.

John Corrie from Bury St Edmunds was due to have a prostate operation in July, but it was postponed.

He said he was told "it had to be cancelled because of a problem with the structure of the operating theatres".

"I don't think important public buildings like this should be allowed to get into this state. This is pretty upsetting for a lot of people," he said.

Tens of millions of pounds was being spent on a huge latticework structure under the roof of West Suffolk Hospital to catch ageing concrete planks if they failed

Documents leaked to the BBC reveal the depth of concern at the West Suffolk NHS Foundation Trust.

These included an initial risk assessment, which stated the chances of a plank collapse was "almost certain" and could have "catastrophic" consequences if mitigation measures were not in place.

But this had since been downgraded to "likely" as the hospital embarked on its safety works programme.

It was understood that as work continued the risk would recede further, though the programme would not be completed until spring 2023.

Mass Casualty Plan

Leaked documents show how the NHS carried out an exercise to plan for a possible collapse of RAAC planks at a hospital

The BBC has also learned of the existence of an emergency plan in the event of a "significant hospital structural failure" in eastern England.

Operation Rapture would see automatic authorisation to divert ambulances to other hospitals and invoke what was called the Mass Casualty Plan.

The leaked documents described how, in 2020, hospital trusts participated in Exercise Hodges that simulated a scenario where part of a hospital collapsed due to RAAC plank failure.

Among the questions raised was whether such a failure at one hospital would mean the three others in the region built using the material would have to suspend activity and transfer patients.

NHS England said it carried out such training exercises in the interests of safety and preparedness.

As well as the hospitals in Bury St Edmunds, Huntingdon and King's Lynn, the other site in eastern England featuring RAAC was the James Paget Hospital in Gorleston, Norfolk.

Some 7,000 roof planks have been checked at James Paget, and 18 have had additional support added.

Other hospitals facing similar problems include Airedale in West Yorkshire, Frimley Park in Surrey and Leighton in Cheshire.

Documents also revealed how the West Suffolk NHS Foundation Trust hired a law firm to produce a report into "corporate manslaughter" risks arising from a sudden collapse.

According to interim chief executive Craig Black, this stemmed from their efforts to obtain the fullest possible picture.

"We've had financial experts, technical experts, legal experts all look at the situation we are facing. It's unprecedented," he said.

Mr Black said closure of the hospital had been considered, but the trust concluded the risk of evacuating the hospital outweighed that of a sudden collapse.

The documents were leaked by an NHS whistleblower who felt the trust was not informing staff and patients of how serious the level of risk was.

Mr Black said he was "really sad to hear that staff would think that we're not being open".

"We have weekly briefings on the situation around RAAC; we have posters up around the hospital; we talk to staff continuously," he said.

A technical briefing written in May stated that nearly all the wall planks had corrosion and there was "a risk of severe corrosion in two-thirds".

More supports had been added where cracks had appeared in planks that were "considered at an immediate risk of collapse".

In February, a report by engineering consultants MLM described roof or wall failure could occur "with little or no warning" and that "investigations at the hospital have identified significant concerns about the structural integrity of the roof panels".

The trust implemented all of that report's recommendations.

West Suffolk Hospital's estates manager said they were "actively putting safety measures in place"

The hospital was due to be replaced within the next six to eight years under the government's New Hospital Programme, but the cost of keeping the building safe in the meantime has been put at more than £70m, according to the documents.

Estate manager Jacqui Grimwood said the presence of steel props should not unsettle patients.

"It should be reassurance they feel, because we're actively looking for the problems and actively putting safety measures in place," she said.

The hospital recently signed a £700k contract with Loughborough University to carry out testing in order to better understand the properties of RAAC and its lifespan.

RAAC 'mostly air'

Structural engineer Matt Byatt reviewed the leaked documents for the BBC.

He said the NHS was doing the right thing by surveying the affected buildings and installing props.

Structural engineer Matt Byatt reviewed the documents obtained by the BBC.

According to Mr Byatt "the level of risk is relatively high in that the RAAC panels are known to be in a state of deterioration".

Mr Byatt said RAAC was "a very weak material" and that unlike other forms of concrete, RAAC "is actually mostly air".

"There is a plan in place and a series of remedial measures in place to prevent collapse from occurring," he said.

He said he would feel safe working in the hospital given the safety measures.

NHS England said the affected hospitals were safe for patients, visitors and staff.

"Trusts in the East of England work in line with specialist industry advice and have been given more than £67m to help them manage their estates programme," a spokesman said.

"Trusts have maintained safe services for patients, who should access hospital care as they normally would, and also introduced a number of measures including improved surveillance and use of specialist equipment to help identify and fix any issues immediately."

The government said £110m was being spent this year to help hospitals across England address similar problems.