The Hillingdon Hospitals NHS Foundation Trust has unveiled a larger Hospital 2.0 design for the redevelopment of Hillingdon Hospital in west London, replacing the previously approved layout with proposals for 538 overnight beds, all in single en-suite rooms, no basement and a separate energy centre.
The refreshed proposals entered public consultation on 26 October 2026 and sit within the New Hospital Programme's £1bn–£1.5bn total cost estimate band for Hillingdon. Laing O'Rourke has already signed the Hospital 2.0 Alliance call-off, but the project remains in Outline Business Case development and the Trust plans to submit a new planning application in 2027 before main construction starts from 2028 onwards.
Updated design for the new Hillingdon Hospital viewed from Royal Lane. Image: The Hillingdon Hospitals NHS Foundation Trust.
Hospital 2.0 resets the approved design
The Trust's updated plans confirm that the hospital has been redesigned around the New Hospital Programme's Hospital 2.0 model, a standardised national approach covering emergency care, inpatient wards, operating theatres, maternity, diagnostics and outpatient facilities.
That changes a scheme which already holds planning permission. Hillingdon Council's extant hybrid permission, application 4058/APP/2022/1788, covered a replacement hospital on the western part of the existing site together with a multi-storey car park, mobility hub, infrastructure and a wider outline masterplan. The original Design and Access Statement described a 79,603.6 sq m hospital with a basement, ground floor and seven upper storeys.
The 2026 design is larger, although the Trust has not yet published a revised gross internal area in its current consultation summary. It removes the basement entirely, moves staff accommodation above ground and introduces a separate energy centre intended to generate and manage heat, cooling, steam and electricity across the site.
| Element | 2023 approved design | 2026 Hospital 2.0 design |
|---|---|---|
| Hospital size | 79,603.6 sq m GIA | Larger building; revised GIA not yet stated in the current Trust summary |
| Vertical arrangement | Basement, ground plus seven storeys | No basement; staff areas moved above ground |
| Single-room provision | 73% | 100% |
| Overnight beds | Earlier approved configuration | 538 single en-suite beds |
| Energy infrastructure | Associated plant, generators and substation | Separate central energy centre |
Single-room provision rises by 27 percentage points
LCM's comparison of the 2023 design position recorded in Hillingdon Council committee papers with the current Hospital 2.0 proposals shows that single-room provision has increased by 27 percentage points, from 73% in the previous design to 100% in the refreshed scheme.
The change is not simply an internal specification update. Hillingdon's July 2025 Health and Social Care Select Committee papers recorded the move to 100% single-room accommodation as one of the requirements introduced through the Hospital 2.0 redesign. The committee was also told that communal spaces would need to be considered because moving away from shared bays changes opportunities for patient social interaction.
The Trust's current proposal puts all 538 overnight beds in en-suite single rooms and says the standardised design has been developed with input from more than 1,000 clinicians, Royal Colleges, healthcare staff and patients.
£766m Laing O'Rourke call-off is staged
Laing O'Rourke signed the construction contract for Hillingdon Hospital on 30 July 2026 under the Hospital 2.0 Alliance model. The Trust describes the contractor as its construction partner, while Laing O'Rourke says it intends to use digital engineering, offsite manufacturing and its integrated supply chain on the project.
The associated Contracts Finder award record, procurement OCID ocds-b5fd17-865a58e8-a127-439a-8afe-59d6b60cc157, gives £766m as the estimated value of the scheme across all stages. It also identifies an initial Stage Zero package valued at £1.958m for early constructability and advisory services.
The contract then separates Stage One pre-construction services from Stage Two design and construction works. Progression between the stages depends on the relevant Notice to Proceed and approvals from the Trust and New Hospital Programme, so the £766m figure should not be read as evidence that £766m of physical main construction has already been released.
That staged model is similar to the commercial structure LCM identified in the £837.6m Dragados award for West Suffolk Hospital, another Wave 1 Hospital 2.0 scheme where contractor appointment, design development and government approvals precede the main physical build.
£56m has been provided through the NHP so far
The government's New Hospital Programme annual report for 2025–26 places Hillingdon in a £1bn–£1.5bn total cost estimate band. That is the current whole-scheme estimate, not a fixed final construction budget.
The same government report records £12m of NHP funding provided to Hillingdon during the 2025–26 financial year and £56m provided through the programme to date. The financial figures are described as provisional, while Hillingdon remained in Outline Business Case development at the end of the reporting period.
The distinction between the £1bn–£1.5bn whole-scheme cost estimate, the £766m staged contractor call-off and the £56m of NHP funding provided to date is important. They measure different parts of the project and should not be combined into a single construction value.
LCM examined the same programme-wide commercial structure in its analysis of the New Hospital Programme construction pipeline, where standardised design, repeatable components and longer-term relationships with construction partners are intended to move hospital delivery away from individually designed procurement on every scheme.
Existing Hillingdon Hospital site shown in an aerial overview. Image: London Construction Magazine.
Main construction remains a 2028 milestone
The Trust's current delivery programme separates the work already happening around the live hospital from the main construction of the replacement building.
Site preparation, demolition and temporary service relocations run across 2025–2028. The updated planning application and Outline Business Case are scheduled for 2027, followed by submission of the Full Business Case to the Treasury in 2028. The Trust currently places preparatory works and construction by the appointed builder from 2028 onwards.
That sequence means Laing O'Rourke's appointment should not be confused with a main-build start. The existing hospital must remain operational while services are relocated and the western part of the site is prepared for the replacement building, with the new hospital planned alongside the existing clinical estate.
The construction logic is similar to other large live-hospital replacements, where decanting, service diversions, demolition and temporary accommodation form a separate delivery problem before the principal structure can proceed. LCM has previously examined those constraints at St Mary's Hospital in Paddington.
The 2027 planning application becomes the next design test
The current consultation closes on 13 December 2026. Feedback will inform the updated planning application that the Trust plans to submit to Hillingdon Council in 2027.
That application should provide the first statutory record of the redesigned building's exact floor area, height, footprint, energy-centre layout, parking arrangement and relationship with the wider masterplan. The current Trust material confirms that the hospital will be larger but does not yet give a replacement GIA comparable with the 79,603.6 sq m approved in the previous design.
How LCM calculated this
LCM compared Hillingdon Council's July 2025 Health and Social Care Select Committee record, which states that the previous hospital design contained 73% single-room accommodation, with the Trust's October 2026 Hospital 2.0 proposal requiring 100% single inpatient rooms. The difference is 27 percentage points. The comparison was checked on 31 October 2026 against the Trust's current consultation material and Hillingdon Council records.
Expert Verification & Authorship
Founder & Author, London Construction Magazine | Construction Testing & Investigation Specialist