Guy’s and St Thomas’ NHS Foundation Trust has confirmed that Guy’s surgical centre costs are running above the original approved budget, with key milestones now at risk of delay on the eight-storey elective surgery building being delivered by McLaughlin & Harvey.
The dedicated elective surgery centre, planned for the Guy’s and St Thomas’ estate in central London, will provide six operating theatres focused on non-emergency procedures. Forecast costs are exceeding the programme’s original approved budget envelope, according to a report from the trust’s Transformation and Major Programmes Board Committee meeting on 13 May.
Guy’s surgical centre costs trigger affordability review
A trust spokesperson told Construction News: ‘As reflected in our published board papers, the Guy’s surgical centre programme is facing increasing cost, design and timeline pressures, including forecast costs above the original approved budget and a likely delay to key milestones. We are looking at ways to mitigate these issues and, in the meantime, we are working with partners to progress the full business case.’
The committee supported a further review through the Investment Programme Board to reassess affordability, scope, delivery options and alignment with system partners and commissioners. When McLaughlin & Harvey and architectural practice Ryder were announced on the scheme in August 2025, the trust did not disclose the contract value or overall programme cost. According to The Construction Index, the project carries a cost of £100m, which now frames the scale of the budget pressure the trust is managing.
At the time of that announcement, enabling works were already underway. Construction was expected to begin in summer 2026 and complete by the end of 2028, with the centre set to open in 2029. The committee’s latest assessment puts that timetable under pressure, though the report separately noted the programme remained complex but was progressing well overall.
Risk profile spans construction, workforce and digital integration
The committee identified a range of risks bearing on the programme’s delivery confidence. Construction complexity, workforce supply, digital integration and Synnovis delivery were each called out. The report stated that confidence in meeting the delivery timetable depended on those risks and programme interdependencies being managed effectively, a condition that reinforces why the Investment Programme Board review was considered necessary.
For a scheme of this kind, the risk register reflects the layered challenge of delivering clinical infrastructure within an operational hospital estate. Coordinating six operating theatres, digital systems integration and a phased build-out across eight storeys on a constrained central London site carries inherent programme complexity, quite apart from the current cost pressures.
McLaughlin & Harvey financials and broader trust pipeline
The cost pressures at Guy’s arrive as McLaughlin & Harvey reported a mixed set of financials. In its accounts for the year to 30 June 2025, the County Antrim-headquartered contractor saw revenue fall by a third to £612.1m, while pre-tax profit rose by 52 per cent to £18.2m. Construction News approached the contractor for comment on the Guy’s situation; no response had been received at time of publication.
The difficulties on the surgical centre sit alongside a separate major capital project on the same trust estate that is moving forward. In June, Sisk was appointed to a £67.8m contract to deliver a new children’s cancer treatment facility for the trust, serving as principal supply chain partner for the Children’s Cancer Services Principal Treatment Centre project at Evelina London Children’s Hospital.
With the full business case still in progress and the Investment Programme Board review now confirmed, the next formal affordability decision will set the parameters for whether the 2029 opening target can be preserved or must be revised.
