Imperial College Healthcare NHS Trust has unveiled updated plans for a new St Mary’s Hospital in London, combining an 800-bed teaching hospital and major trauma centre with an expanded life sciences campus. Digital infrastructure, adaptable clinical spaces and closer integration between healthcare and research are central to the proposed redevelopment.
The Trust has opened a third round of public consultation ahead of plans to submit a planning application for the entire site in spring 2027. The redevelopment would transform the existing 10-acre site, where hospital services are currently spread across around 40 buildings.
Digital infrastructure
Under the latest proposals, clinical services would be consolidated into a single building of around 30 storeys and 185 metres high on the eastern part of the site. A central 'sky lobby' on the 14th floor would connect the main clinical zones, while also providing a sky garden, restaurant and café. The hospital design includes separate arrival and drop-off points for planned, urgent and emergency care. Wards would have single en-suite rooms, intended to improve privacy, comfort and infection prevention.
From a technology perspective, clinical spaces would provide more room for equipment such as robotic surgical systems and point-of-care diagnostics. Advanced digital infrastructure and connectivity would be embedded throughout the hospital and linked with systems used in community healthcare and patients' homes. Flexibility is another design principle. Clinical areas are intended to accommodate new treatments and changing ways of working, while allowing the hospital to adapt more quickly to future healthcare demands, including another pandemic.
The new building would be constructed first, allowing the existing hospital to continue operating during construction. Once services have moved, the remaining parts of the site could be redeveloped.
Research integrated into patient care
The plans go beyond replacing ageing hospital buildings. Research facilities would be incorporated directly into clinical areas, with the aim of shortening the distance between research, testing and the introduction of new diagnostics and treatments. This approach is also reflected in plans to expand Paddington Life Sciences, a partnership connecting the hospital with pharmaceutical companies, medical device developers, clinical trial organisations and technology businesses in Paddington Basin.
Because the new hospital would occupy a smaller footprint, the Trust says the amount of space available for developing and scaling research and innovation could almost double. The plans envisage greater collaboration between researchers, clinicians, companies, patients and local communities.
According to an independent evaluation cited by the Trust, expansion of the life sciences campus could support between 9,000 and 11,000 additional jobs and generate up to £1.3 billion in extra economic activity annually. These figures are projections rather than realised benefits and will depend on how the wider redevelopment develops.
Replacing an ageing NHS estate
The project is also driven by the physical condition of the current St Mary’s estate. Parts of the hospital date back to 1845, making it one of the oldest estates in the NHS. Imperial College Healthcare says it has the largest backlog maintenance liability in the NHS, despite spending millions of pounds each year on essential maintenance.
According to the Trust, floods, utility outages and structural problems occur regularly and are making it increasingly difficult to operate services safely. The redevelopment is therefore intended not only to modernise care but also to address longstanding infrastructure risks. Some historic elements would remain. The Grade II-listed Clarence Memorial Wing and the western section of the Mint Building would be retained and restored. The wider masterplan also includes new pedestrian and cycling routes and two green public spaces, Mint Square and Canalside Square.
Public input shapes latest design
The latest proposals incorporate feedback from two previous consultation rounds. In particular, the Trust says concerns about accessibility, wayfinding and the relationship between the hospital and its surrounding neighbourhood have influenced the revised plans.
A project team including development manager Stanhope, masterplan architects Allies and Morrison and hospital architects HOK is working with the Trust on the redevelopment. Patients, staff and local residents are now being asked to comment on the updated designs. Their feedback will inform the next stage before the anticipated planning application in 2027.
If realised, the project would represent more than a replacement hospital. By combining digitally connected clinical care with research infrastructure and commercial life sciences activity on the same site, St Mary’s is being designed around a model in which healthcare delivery, technology development and medical research increasingly operate alongside one another.
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