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RAAC in healthcare premises - identify, assess, manage

on Monday, 09 October 2023.

RAAC (reinforced autoclaved aerated concrete) has made headlines over the last month, as schools have been closed to carry out inspections. However, RAAC is not confined to schools.

As a popular building material from the 1960s to the 1990s, it can be found in all sorts of buildings, including GP Premises and hospitals and health centers. Presently, 27 hospitals in England and two acute hospitals in Wales have been identified as having RAAC.

NHS England (NHSE) and NHS Wales Shared Services Partnership (NHSSSP) have been engaging with healthcare providers and landlords, requiring RAAC assessments to be carried out to identify problem premises.

The Department of Health and Social Care (DHSC) and NHSE have engaged with Community Health Partnerships (CHP) and NHS Property Services (NHSPS) to understand their RAAC risk. CHP has not identified any RAAC in its estate. NHSPS has identified three sites.

If you have not yet taken any action to assess RAAC in your healthcare premises, we would encourage you to do so as soon as possible.

Who is this note for?

Landlords, tenants and owner occupiers of healthcare premises all have an interest in identifying RAAC and ensuring that premises are safe.

  • Occupiers are responsible under the Occupiers' Liability Acts and under workplace health and safety legislation to ensure that premises are safe for employees and others (such as visitors and trespassers). This applies equally to tenants who occupy, landlords who have control over common areas, and owner-occupiers. Failure to comply can lead to civil or criminal liability if harm results.
  • Landlords may have undertaken to maintain the structure of their premises, and may be liable to tenants and third parties for any harm which results from disrepair in the premises. Landlords who have a right to maintain the structure may also be liable to third parties who suffer harm from any disrepair, under s4 of the Defective Premises Act 1972.
  • Tenants may also have undertaken to maintain the structure of the premises they let, and may be liable to their landlords to keep the premises in repair. This will include keeping RAAC in repair.

Other stakeholders, including employees, lenders, insurers, regulators and Department of Health and Social Care via NHSSSP and NHSE (and the ICBs), will also be interested in ensuring that RAAC is dealt with appropriately.

What should you do?

The Institute for Structural Engineers (IStructE) and Health and Safety Executive (HSE) have issued guidance on dealing with RAAC. They suggest a three stage approach:

  1. Identification: RAAC isn't present in all buildings. It's therefore necessary to identify whether RAAC is present. The Department for Education has published guidance on the identification of RAAC, which is relevant to most premises. An experienced property manager should be able to apply this guidance without the need for a specialist surveyor or engineer, but you may choose to engage a specialist if in doubt. GPs occupying leasehold buildings should seek assurances from their landlord that they have undertaken a survey to identify the presence of RAAC in the building.
  2. Assessment: If RAAC is identified, you should seek specialist advice on the risk that it presents. This may involve intrusive surveys and may be disruptive. Stakeholders are encouraged to work together to allow assessment to take place, but it may be necessary to seek legal advice if agreement cannot be reached to carry out these inspections.
  3. Management: While RAAC is being assessed, and afterwards, you should seek specialist advice on steps you should take to minimise the risk of harm. This may involve vacating premises while assessments take place; structural work to support failing RAAC; or a programme of monitoring for RAAC which is still safe.

Sector-specific guidance on RAAC, including the conduct of risk assessments and monitoring, has been published by the Local Government Association, the Department for Education and NHS England and NHS Wales, which may be more broadly applicable.

How can we help?

We can help healthcare providers who own or rent their premises and landlords of healthcare providers to consider the impact of these developments and how to manage the risks associated with them. We can also assist where disputes arise regarding access, costs and liability for inspections and repairs. We can also assist with communications with stakeholders, regulatory reporting, funding and, where a building has failed, liaison with the HSE and insurers and liability for claims.


Should you have any queries relating to RAAC, please contact Philip Sheppard in our Property Litigation team on 07384 256178 or Ben Willis in our Healthcare team on 0117 3145394, or complete the form below.

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