Transparency data

New Hospital Programme: SRO appointment letter

Published 28 April 2025

To: Paul Mustow and Charlotte Taylor, joint senior responsible owners for the New Hospital Programme

From: Professor Sir Chris Whitty, Interim Permanent Secretary of Department of Health and Social Care

Nick Smallwood, Chief Executive Officer of the Infrastructure and Projects Authority

31 March 2025

Appointment as joint senior responsible owners for the New Hospital Programme

Dear Paul and Charlotte,

We are writing to confirm your appointment as joint senior responsible owners (SROs) of the New Hospital Programme (NHP) with effect from 1 April 2025. This letter sets out your responsibilities and the support you can expect from your department and the Infrastructure and Projects Authority (IPA) and its successor body the National Infrastructure and Service Transformation Authority (NISTA).

As SROs, you are directly accountable to Andy Brittain, Director General for Finance and Group Operations for the Department of Health and Social Care (DHSC), under the oversight of the Permanent Secretary as accounting officer for DHSC, and the Secretary of State for Health and Social Care.

Your programme forms part of the DHSC Finance and Group Operations portfolio, under the oversight of the DHSC Portfolio Oversight Board and is included in the Government Major Projects Portfolio (GMPP).

You have personal responsibility for the delivery of the New Hospital Programme’s strategic objectives and will be held accountable for the delivery of its objectives, policy intent and outcomes. This encompasses securing and protecting its vision, ensuring that it is governed responsibly, reported on honestly, escalated appropriately and for influencing the context, culture and operating environment of the programme. You are also responsible for ensuring the ongoing viability of the programme and recommending its pause or termination if appropriate. Where issues arise which you are unable to resolve, you are responsible for escalating these to DHSC Portfolio Oversight Board.

You remain accountable to ministers, as set out in the Civil Service Code, and should deliver the project in accordance with the objectives and policy intent as set by ministers.

In addition to your internal accountabilities, SROs for GMPP projects and programmes are personally accountable to Parliamentary select committees. This means that, from 1 April 2025, you will both be held personally accountable to and could be called by select committees to account for and explain the decisions and actions you have taken to deliver the programme.

It is important to be clear that your accountability relates only to implementation, within the agreed terms in this letter; it will remain for the minister to account for the relevant policy decisions and development.

More information on this is set out in Giving evidence to select committees - guidance for civil servants, sometimes known as the Osmotherly Rules. Information on the roles and responsibilities of the SRO are detailed in Government Project Delivery’s guidance on the role of the senior responsible owner.

You are expected to run your project/programme in accordance with the Government Functional Standard for Project Delivery, and the requirements of other functional standards as required, which is mandated for government departments and arm’s length bodies to follow. You should also make yourself familiar with the Teal Book, Government Project Delivery’s code of practice for project delivery, and any further guidance and requirements.

Time commitment and tenure

This will be a full-time role to enable effective delivery of the role and execute your responsibilities in full and will require each of you to spend at least 50% of your time to enable effective delivery of the role and execute your responsibilities in full.

You are required to undertake this role for a period of at least 3 years. Progress towards this will be reflected in your personal objectives. Any changes to the agreed time commitment or tenure of the role, as set out above, will require both departmental and IPA or NISTA consent.

The efficacy of the joint SRO role should be reviewed before 1 April 2026 and appropriate changes should be made to roles and responsibilities to address any issues arising.

Objectives and performance criteria

The strategic policy intent supported by this programme was first published in the previous government’s health infrastructure plan (HIP) on 26 September 2019, which references the new hospital commitment, further developed under the 2019 government manifesto and with detail on clarity around scope, timescales and funding provided in the then Prime Minister announcement of 2 October 2020.

This programme formalised government plans to transform the delivery of NHS healthcare infrastructure to provide world-leading experiences for as many patients and staff as possible, to meet the changing needs and rising demand the NHS is going to face in the 2030s and beyond.

In May 2023, the previous government confirmed that the New Hospital Programme was expected to be backed by over £20 billion of investment in hospital infrastructure to transform how critical national health infrastructure is delivered. This included a commitment to rebuilding 5 additional NHS hospitals constructed mostly using reinforced autoclaved aerated concrete and a future rolling programme of capital investment in hospital infrastructure to secure the building of new hospitals beyond 2030.

On 20 January 2025, the current Secretary of State for Health and Social Care announced the outcome of the review of the NHP following the general election. In summary, this concluded that all the schemes in the programme required capital investment but that a new timetable for delivery was necessary. The government is backing this plan with investment which will increase up to £15 billion over each consecutive 5-year wave, averaging around £3 billion a year, from 2030. The exact profile of funding will be confirmed in rolling 5-year waves at regular Spending Reviews, as with all government capital budgets in future.

Any proposed changes to scope which impacts on this intent or the realisation of benefits must be authorised by the NHP Programme Board and may be subject to further levels of approval.

The vision of the programme is to transform the way new healthcare infrastructure is delivered in the NHS including the building of new hospitals, and its 5 strategic objectives are to:

• deliver world leading hospital environments that are able to provide exceptional patient care at the right time and in the right place, as well as offering excellent working environments for our staff
• deliver hospitals at significantly lower cost and in significantly less time than for historical hospital delivery
• ensure that all new hospitals integrate innovative national standards for healthcare infrastructure and modern building requirements for safety and sustainability
• ensure that an enduring nationwide capability is created and maintained for enhanced healthcare infrastructure delivery, both in government and the private sector and across the lifecycle of projects delivered
• support the co-design and co-creation of schemes in collaboration with local and regional health systems

The New Hospital Programme operates a sponsor and delivery model across DHSC and NHS England (NHSE), with detailed roles and responsibilities set out in the NHP governance arrangement.

The SROs report directly to Andy Brittain as DG Finance and Group Operations for DHSC. The SROs as detailed in this letter have overall accountability for the programme’s objectives. The SROs lead the sponsor team whose role is to provide advice to the SROs, develop the strategic policy direction and to hold the delivery team to account through effective reporting and assurance. The SROs are jointly and severally accountable to Parliament for enabling the successful delivery of the NHP.

Your joint objectives and performance criteria as SROs, which relate to the programme are:

• ensure Wave 1 schemes are delivered on time and on budget in accordance with the approved programme business case
• implement Hospital 2.0, which maximises speed, efficiency and delivery of health care benefits through centralised standards with limited scope for variation, centralised design, modelling, and assumptions, with repeatable learning and efficiencies applied to the pipeline of hospital builds in the programme. Ensure future iterations remain aligned with agreed specifications of Hospital 2.0
• deliver the programme through the agreed sponsor and delivery model across DHSC and NHSE. Driving performance of programme delivery through oversight of delivery, governance, performance and assurance. This will be essential to ensure adherence to the mandate for the programme set by government
• continue to ensure that stakeholder engagement, across government, parliamentarians, the NHS and the public remains a constant priority
• drive at pace the procurement of an innovative new framework for hospital construction that meets the construction playbook requirements and encourages growth in the market for the programme, and a delivery partner that will ensure delivery of the programme objectives by having financial targets and deliverables set into their contract
• publish an annual report on the progress and development of NHP

The chief programme officer (CPO) is accountable for all delivery aspects of the programme and reports to the deputy chief executive and chief financial officer for NHSE, who reports to the NHSE chief executive. The CPO leads the NHP delivery team and has overall accountability for the delivery of the transformational elements, the programmatic enablers and hospital construction to time, cost and quality.

Additionally, you are expected to ensure value for money of the programme, both by bearing down on costs and improving benefits, wherever possible. This assessment of value for money should take into account both upfront investment cost and the whole life cost of the new hospitals being delivered.

You are expected to run your project in accordance with the Government Functional Standard for Project Delivery, the other functional standards as applicable to this programme and the requirements of the Government Project Delivery Framework.

Alongside your joint objectives, you will also have individual objectives.

The SRO role will be split between Charlotte Taylor and Paul Mustow with the following activities being undertaken by each of them, together with an agreement to collaborate and support each other to ensure that a holistic role is performed to facilitate their accountability to ministers for the delivery of NHP. The sufficiency of these job descriptions will be reviewed at the first review in March 2026 and amended accordingly.

Charlotte Taylor’s role

Charlotte Taylor’s role is to:

• deliver and iterate the long-term NHP strategy, sponsor’s requirements and the programme business case, engaging all relevant subject matter experts across the programme’s wide stakeholder group
• proactively and collaboratively work across government, departments and stakeholders to ensure that the strategy can be translated into delivery outcomes
• ensure policy consistency and proactively influence and respond to policy changes which impact the NHP strategy, programme business case, and so on
• apply a comprehensive engagement strategy for ministers, cross-government, and cross-department stakeholders, ensuring robust, timely and high quality processes for briefing and other Department of State functions
• ensure that both programme and scheme funding is available to enable successful and timely delivery, meeting all Treasury requirements for the proper use of public funds and ensuring value for money

Paul Mustow’s role

Paul Mustow’s role is to:

• provide robust programme oversight, clear and effective governance and assurance of the technical and commercial programmatic approaches, to drive NHP delivery to time, cost and quality
• provide proactive oversight of the integrated programme, working across key stakeholders to ensure progress, performance, reporting and metrics are robust and aligned to NHP benefits
• establish and manage effective governance structures for NHP, ensuring clear accountabilities, driving improved performance and securing robust scrutiny at programme board and so on
• oversee development of, and provide scrutiny to, implementation of the NHP commercial strategy, ensuring that assurance conditions are met (Joint Investment Committee, IPA, Cabinet Office Commercial and so on) and benefits are delivered
• provide scrutiny to the development of the Hospital 2.0 standard designs and industrialised delivery approach, ensuring robust technical assurance in place to deliver programme business case benefits

Extent and limit of accountability

Finance and controls

HM Treasury spending controls will apply on the basis set out within the department’s delegated authority letter. Where the programme exceeds the delegated authority set by HM Treasury, the Treasury approval point process will apply, and the details of each approval process must be agreed with your HM Treasury spending team. You should consult departmental finance colleagues on how to go about this.

You should note that where expenditure is considered novel, contentious, repercussive, or likely to result in costs to other parts of the public sector, HM Treasury approval will be required, regardless of whether the programme expenditure exceeds the delegated authority set by HM Treasury. If in doubt about whether approval is required you should, in the first instance, consult departmental finance colleagues before raising with the relevant HM Treasury spending team.

The overall estimated budget, resourcing requirements and tolerances for your project or programme will be agreed as part of the approval process. You will be expected to deliver within these tolerances and report quarterly on these as part of GMPP reporting.

You should operate at all times within the rules set out in Managing public money. In addition, you must be mindful of, and act in accordance with, the specific HM Treasury delegated limits and Cabinet Office controls relevant to the New Hospital Programme.

Delegated authority

You are authorised to:

• approve expenditure associated with the direct running of the programme in line with the standing financial instructions of DHSC
• in relation to individual scheme business cases, make formal recommendations to the programme investment committee in line with agreed governance and departmental delegations as set by HM Treasury (per above)
• agree programme rescheduling within the financial profile agreed with HM Treasury at Spending Review 2025 (or subsequent fiscal events should this supersede the Spending Review 2025 agreement)

Where rescheduling is driven by individual schemes exceeding agreed business case tolerances agreed via HM Treasury approval, this would require agreement from both the programme board and HM Treasury in line with departmental delegations.

You are also responsible for recommending to the Director General for Finance and Group Operations, and the accounting officer the need to either pause or terminate the programme where necessary and in a timely manner.

These authority limits are subject to change and other conditions or tolerances may be set as part of the business case approval and ongoing monitoring processes which you should then operate within. Where issues arise which take you outside of these authority limits which you are unable to resolve, you are responsible for escalating these issues to Andy Brittain and the programme board.

Appointments

You should ensure you maintain a full-time chief programme officer to support you in the delivery of this programme and make other appointments as required for the control and delivery of your programme within your delegated authority.

Governance and assurance

You should pay attention to ensuring effective governance for your programme, including the establishment of a programme board with appropriate membership and clear terms of reference.

As SRO, you must ensure that the programme secures appropriate business case approval from relevant investment committees, Cabinet Office and HM Treasury. You should also ensure that the programme remains aligned to the strategic outcomes, costs, timescales and benefits in line with the approved business case as well as monitoring the context within which the programme is being delivered to ensure it remains valid.

Where a change impacts the scope, costs, benefits, or planned delivery milestones agreed as part of an agreed business case, you are responsible for following the agreed change request approval process and setting a new, approved, business case baseline.

You should ensure that an accounting officer assessment is completed alongside the approval of the programme business case and that this is published on GOV.UK as part of the government’s transparency requirements on major projects. You are responsible for bringing to the attention of the accounting officer any material changes in the programme which could require a new accounting officer assessment to be completed and published. Guidance on completing accounting officer assessments for major projects is available from HM Treasury.

Although you are directly accountable for this programme, you are also expected to support delivery of the department’s overall strategic objectives. This means that you are expected to work collaboratively with other SROs and project directors in adjacent projects and programmes and within the DHSC portfolio, portfolio management office and portfolio director to manage dependencies, resources, schedules and funding to support delivery of the overall change the department needs to achieve its strategic objectives.

You should ensure that appropriate and proportionate assurance is in place and agree on the level and frequency of assurance reviews through the maintenance of an integrated assurance and approvals plan. You should develop this plan and its maintenance in collaboration with the departmental assurance co-ordinator and the IPA or NISTA.

Programme status, reporting and transparency requirements

The programme status at the date of your appointment is reflected in the most recent quarterly return on the programme to the IPA and is the agreed position as you assume formal ownership of the programme.

You are responsible for ensuring the honest and timely reporting on the position of the programme to the IPA and subsequently NISTA while it remains on the GMPP and for providing reports and information to the DHSC portfolio management office as required. Reporting should include carbon measurement, and other sustainable development goals demonstrating evidence that the project contributes to an overarching environmental strategy and is aligned with defined net zero pathways. Information on the programme will be published annually by the IPA.

As part of the government’s commitment to transparency on major infrastructure projects, you are responsible for publishing on GOV.UK:

• a summary of the accounting officer assessment completed in line with the approval of the programme business case and summaries of any subsequent assessments should they be required
• a summary of the HM Treasury approved programme business case
• a close out report after the programme has completed

Development and support

As graduates of the Major Projects Leadership Academy, you are expected to maintain your continuing professional development as a project leader, including your status as an accredited assurance reviewer. To maintain your accreditation, you will be required to participate in a review at least once every 12 months.

The department will assist you in securing the necessary resources to support the programme, and will set clear guidance, requirements and standards, which align to the Government Functional Standard for Project Delivery, to enable good governance and effective delivery. You will be part of the department’s cohort of major project leaders who will be expected to support each other, share good practice and lessons learned and to collectively develop solutions. You should liaise with the department’s head of profession for project delivery to discuss the maintenance and development of your delivery and leadership skills.

The IPA and subsequently NISTA will be available to you for support, advice and assurance throughout the programme’s time on the GMPP. In light of the importance and complexity of the programme you are afforded dedicated resource from IPA (and NISTA) through the Mega Project Lead role.

Following approval of the business case and entry onto the DHSC portfolio, the Portfolio Oversight Board provide ongoing oversight and support and will take steps to help resolve and escalate risks, issues or constraints that are acting as a blocker to successful delivery.

We would like to take this opportunity to wish you both every success in your role as joint SROs.

Yours sincerely,

Professor Sir Chris Whitty
Interim Permanent Secretary of the Department of Health and Social Care

Nick Smallwood
Chief Executive Officer, Infrastructure and Projects Authority

Confirmation of acceptance of appointment

I confirm that I accept the appointment of senior responsible owner for the New Hospital Programme, including my personal accountability for implementation, as set out in the letter above.

Paul Mustow
31 March 2025

Charlotte Taylor
31 March 2025