A review has raised questions over the future of the £800m PFI Paddington hospital.

The review, carried out by the Department of Health, the National Audit Office and the Treasury and finally released this week, said there should be a rethink that included examining NHS requirements in the entire West London area.

The report said: “The Strategic Health Authority should lead a process identifying options for investment in the NHS in West London for heart and lung, paediatrics, tertiary services and St Mary’s’ infrastructure.”

A source on the review team added: “The review is not saying they should redo the Paddington scheme, but they should look at the whole of the medical needs in west London.”

The scheme’s costs rose from £360m to more than £800m by last year. The review said: “There was no clarity in the project team on the financial limits within which they should operate.”

It identified a host of problems in the original outline business case, released in 2000. These included:

  • A very low construction contingency at 3% (usually 12-14%)
  • No facilities management offices
  • No sensible allowances made for decanting of patients and facilities.

The review criticised the Strategic Health Authority and Department of Health’s roles in the scheme.

It said: “There is no evidence they recognised the complexities and considered whether the trusts needed particular support.”

The NWSH said that it welcomed the review and added that the new business case for the scheme would be submitted by the end of the year.