Reset Phase Q&A

Yes. The Monklands Replacement Project Reset Oversight Board held its first meeting on 30 July 2026. The board will decide the necessary actions for the reset phase and oversee their implementation. It has membership from key partners involved in the plans for the new University Hospital Monklands including: NHS Lanarkshire and North Lanarkshire Integration Joint Board; the Scottish Government; North Lanarkshire Council; NHS Scotland sub-national planning colleagues (west and east); Public Services Delivery Scotland, which includes NHS Scotland Assure – the body that ensures that planned infrastructure is safe and cost-effective.

NHS Lanarkshire was pleased to welcome Cabinet Secretary for Health and Care, Angela Constance, for a visit on 23 July 2026.

The Cabinet Secretary toured the existing Monklands site to see first-hand the maintenance challenges associated with the ageing hospital, and to speak to staff working there who live with those challenges every day. She then visited the site at Wester Moffat in Airdrie where the new University Hospital Monklands will be constructed.

She was joined by local constituency MSPs Neil Gray and Fulton MacGregor and, after the visit, Ms Constance underlined her commitment to building a new hospital on the Wester Moffat site and to providing additional targeted funding for the maintenance of the current Monklands.

She said:

“It was important to visit University Hospital Monklands and meet the dedicated staff who are providing excellent care to patients from across Lanarkshire as well as meeting with members of NHS Lanarkshire’s Board.
 
“Our commitment to building a new Monklands Hospital at Wester Moffat has not changed and I have asked for refreshed plans to be presented to Ministers in 2027. This reset will provide an affordable and credible route to delivery of that new hospital, ensuring that services are aligned to modern models of care to improve how care is delivered locally.
 
“In the meantime, I recognise the challenges facing staff in the existing Monklands site and I can confirm we will be providing additional financial support to NHS Lanarkshire to maintain safe and effective services while revised plans for a new Monklands Hospital are developed.
 
“This is not a decision I have taken lightly, but it is my responsibility to ensure major investment decisions are affordable, deliverable, and aligned with the future of our health and care system.”

The information below provides an overview of the total expenditure to date and what that investment has delivered.

Between 1 April 2016 and 31 May 2026, a total of £203.1 million has been invested in the Monklands Replacement Project. This expenditure has been incurred over a 10-year period and includes the purchase of the Wester Moffat site in Airdrie, the land on which the Scottish Government has committed to building a replacement hospital for the people of Lanarkshire.

This work has allowed the purchase and preparation of the site along with associated investigation work and approvals essential to a major hospital project.

The total amount covers a wide range of activity required to develop a project of this size and complexity including the purchase of land, pre-construction and enabling works to prepare the land for the main building phase, infrastructure works, professional and design services, staffing costs, engineering and technical studies, and other necessary planning and development activity.

Infrastructure works relate principally to costs associated with working with Scottish Power Energy Networks to move electrical pylons, engagement with Scottish Water to ensure adequate drainage and water supply, and other utilities-related enabling costs and expenditure relating to the provision of temporary accommodation and other engineering work.

Work will take place to maximise the benefits of the investment in the project to date to support the creation of a new Monklands hospital.

*This answer was originally published on 14 July with the figure £225.5m. It was corrected to £203.1m on 22 July following a further review of the expenditure.

The Monklands Replacement Project (MRP) has entered a new reset and redesign phase but our commitment to achieve Community Benefits through the MRP remains the same. Community Benefits bring job creation, learning opportunities, environmental initiatives and support for businesses large and small for the local area and further afield.

Our Summer School programme for senior pupils is a flagship Community Benefits initiative. This year two Summer Schools will run in July. Our Summer Schools have introduced school pupils to a wide range of careers associated with the NHS, offering local young people opportunities to learn about healthcare, construction, engineering, digital, sustainability and facilities management.

Students had booked places on these week-long learning opportunities before the reset was announced. We therefore felt it was important to honour that commitment and ensure this enthusiastic and engaged group of young people could still take part in the Summer Schools.

The information below explains what a maintenance backlog is, the current position at the hospital, and the work being undertaken to maintain safe and effective services while plans for a replacement hospital progress.

NHS Lanarkshire continues to invest in maintaining and improving the existing University Hospital Monklands estate to ensure safe, reliable and high-quality healthcare services are delivered while plans progress for the new hospital

The total maintenance backlog identified at the site as at 31 March 2026 was £47.9 million.

NHS Lanarkshire is currently working with cost advisers to accelerate work required to support the extension of University Hospital Monklands’ operational life until the new hospital is in place.

A maintenance backlog represents the estimated cost of addressing outstanding maintenance requirements across a hospital estate. At University Hospital Monklands, this includes a range of infrastructure improvements associated with an ageing healthcare facility. The programme covers investment in mechanical and electrical infrastructure, heating and water systems, fire safety improvements, electrical resilience, replacement of plant and equipment, and refurbishment of clinical areas where required.

NHS Lanarkshire remains committed to maintaining the existing hospital and ensuring patients receive safe, effective care while work continues towards delivery of a replacement hospital.

Investment in the current site and planning for a new hospital are complementary activities, helping to ensure services can continue to be delivered safely both now and in the future. The Scottish Government has confirmed that targeted investment will be made in the existing University Hospital Monklands site to address current infrastructure pressures while the revised proposal is developed.

NHS Lanarkshire is working closely with the Scottish Government to understand the next steps following the decision not to proceed with the current plans. The Chief Executive has met with Scottish Government officials to discuss the implications of the announcement and how a replacement hospital can be progressed as quickly as possible. NHS Lanarkshire remains committed to securing a new hospital for Lanarkshire and ensuring patients, staff and communities are involved as future plans are developed.

To support the next phase of the project, NHS Lanarkshire has established two new groups. The Monklands Replacement Project Core Group, which met for the first time on 6 July 2026, provides leadership and oversight of the work required to progress the replacement hospital project. A Monklands Replacement Project Co-ordination Group will meet for the first time on 9 July 2026 and will help coordinate activity across services and departments to ensure a joined-up approach.

Yes. Senior leaders have been engaging directly with staff since the announcement. The Chief Executive has met colleagues at University Hospital Monklands to hear their views, concerns and questions, while the Director of Acute Services has met with staff, including members of the Monklands Replacement Project Team and the Medical Staff Association. Staff feedback is helping to inform ongoing discussions with the Scottish Government and will continue to be an important part of the process moving forward.

NHS Lanarkshire’s Board held an extraordinary meeting on 26 June 2026 to consider the implications of the Scottish Government’s announcement and discuss the actions needed to progress work on a replacement hospital. This meeting marked the beginning of a coordinated programme of work to engage with government officials, provide assurance to staff and stakeholders, and plan the next phase of the project.

The Cabinet Secretary for Health and Care confirmed that the Monklands Replacement Project will not proceed in its current form. The current Full Business Case for the new hospital has not been approved. Instead, the programme will move into a formal “reset” phase to develop a revised, more affordable and sustainable approach. The Scottish Government has been clear that its commitment to building a new Monklands hospital has not changed.

The decision was taken by the Scottish Government. It was announced by the Cabinet Secretary for Health and Care, Angela Constance MSP, in a statement to Parliament on 25 June 2026, and confirmed in a letter to NHS Lanarkshire the same day.

No. The Scottish Government has reaffirmed its commitment to deliver a new Monklands hospital. What is changing is how the project will be taken forward: the current design and business case will not proceed, and a revised approach will be developed during the reset phase. The need for modern, safe and sustainable hospital services for the people of Lanarkshire has not changed.

Yes. The Scottish Government has confirmed that core services will be retained in the new acute Monklands hospital, including Accident & Emergency (A&E).

The reset phase is a period of redesign. Its purpose is to develop a revised approach that delivers a new hospital as part of an affordable, sustainable, whole-system model of care across Lanarkshire and the wider West of Scotland. This means looking not only at the hospital building itself, but at how hospital, community and regional services fit together. This redesign work will begin this summer.

The Scottish Government expects this work to be completed over the next 12 months, with revised options brought forward for Ministerial consideration after that. The aim is to bring forward refreshed plans for a decision as early as possible in 2027.

The Scottish Government concluded that the Full Business Case could not be approved in its current form. This reflects the scale and cost of the proposal, and the need to make sure any major investment is affordable, deliverable, represents value for money, and aligns with the future direction of health and care.

The Scottish Government confirmed the current cost as upwards of £2.1 billion. It has said this would be the single largest health capital investment in Scotland — larger than projects such as the Queen Elizabeth University Hospital and HMP Glasgow — and that this is unaffordable within the current financial position.

West of Scotland sub-national planning arrangements bring health boards across the West of Scotland together to plan services regionally. Because decisions about a new Monklands hospital affect service configuration, capacity and investment across the wider region, the reset phase will be taken forward through these arrangements, supported by the Scottish Government.

NHS Lanarkshire will continue to play a central and critical role. The Scottish Government has been clear that NHS Lanarkshire’s clinical leadership, local knowledge and project expertise will be essential to shaping a revised model and making sure it can be delivered. Detailed governance arrangements for the reset — including roles and responsibilities — will be developed with the Scottish Government and confirmed in the coming period.

No. A great deal of work, expertise and commitment from clinical teams, staff, patients, communities and partners has gone into developing the current plans over a number of years. That work has been instrumental in establishing the case for change and will help to inform the next stage of planning. We will make sure it continues to shape how services are delivered in future.

The arrangements for engagement and consultation during the reset are still to be confirmed as part of the new governance for the programme. What is clear is that NHS Lanarkshire is committed to involving staff, patients, families, communities and partners as the work develops, and a communications and engagement plan is being put in place. We will set out how people can take part as soon as those arrangements are agreed.

Patient safety and continuity of services remain the immediate priority. University Hospital Monklands will continue to provide acute services as normal throughout the reset period. Patients should continue to attend their appointments as usual.

The existing hospital will continue to provide acute services during the reset. There is no change to how patients access services as a result of this announcement. If any changes to individual services were needed in future, these would be communicated clearly and in the usual way.

Maintaining safe and effective services at University Hospital Monklands remains an immediate priority for NHS Lanarkshire. The existing site has known infrastructure pressures, which is part of the reason a replacement hospital is needed. The Scottish Government has confirmed it will continue to work with NHS Lanarkshire to support the existing site, including targeted investment to maintain safe and effective services and address those pressures.

The Scottish Government has confirmed that targeted investment will be made in the existing University Hospital Monklands site to address current infrastructure pressures while the revised proposal is developed. NHS Lanarkshire will work with the Scottish Government to agree the scope, priorities and timing of this investment.

No decision has been taken on the long-term future of the existing University Hospital Monklands site. The immediate priority is to keep services running safely there during the reset period. The longer-term use of the site will be considered as part of the wider planning work, and we will share more information when it becomes available.

Community Health Hubs bring a range of services together in modern facilities closer to where people live. This can include general practice, community nursing, mental health care, diagnostics and outpatient services. The aim is to provide quicker access and earlier intervention in the community, and to reduce pressure on acute hospitals so they can focus on people who need specialist care.

As part of the announcement, the Scottish Government confirmed new Community Health Hubs in Hamilton and Cumbernauld, two GP walk-in facilities in Shotts in North Lanarkshire, and a shop-front walk-in facility in Lanark in South Lanarkshire (which NHS Lanarkshire was already progressing). Further work will be done with the Scottish Government, Integration Joint Boards, local authorities and primary care partners to confirm the scope, timing, funding and delivery of these services.

The reset phase looks at the whole system of care, not just the hospital building. Strengthening community-based services is part of making sure care is delivered in the right place — closer to home where appropriate, and in hospital when specialist care is needed. These developments will be considered alongside the new hospital and existing services as the revised model is developed.

University Hospital Monklands continues to operate as normal, and there is no immediate change to services or to your role as a result of this announcement. The site will continue to provide acute services throughout the reset period, supported by targeted investment to address infrastructure pressures.

NHS Lanarkshire began speaking with staff as soon as possible following the announcement, including direct engagement with teams and senior leadership presence. We are committed to sustained, open engagement as the reset progresses. We will continue to work closely with Staff Side, and support is available to colleagues affected by the announcement through our usual staff support channels.

The knowledge, technical expertise and clinical leadership developed through the project are highly valued and will be important to the next phase. The Scottish Government has recognised that this expertise will be an important consideration as arrangements for the redesign are established.

We will work urgently and constructively with the Scottish Government to provide updates as soon as we are able. The Scottish Government has also committed to keeping stakeholders updated over the coming year. Updates will be shared on the Monklands Replacement Project website and through NHS Lanarkshire’s usual channels.

Further information will be published on the Monklands Replacement Project website at www.monklands.org as it becomes available. The Scottish Government’s statement is available on gov.scot.