The St Mary’s Hospital redevelopment has moved into a third round of public consultation, with updated plans showing a much clearer picture of how an 800-bed teaching hospital and expanded life-sciences campus could reshape one of Paddington’s largest development sites.
Imperial College Healthcare NHS Trust opened the consultation on 30th September 2026. The proposals remain at pre-application stage. No planning application for the wider redevelopment has yet been submitted, and no planning permission has been granted for it.
The Trust is working towards a planning application for the whole site in spring 2027. Its latest corporate timetable anticipates a planning decision in 2028, subject to the statutory process, while a separate funding taskforce is exploring ways to bring delivery of the new hospital forward to around 2036.
The latest consultation for the hospital redevelopment is therefore a design and engagement milestone rather than a planning decision. That distinction matters because the proposals are still being refined and several important elements, including detailed massing, planning obligations, environmental effects and delivery arrangements, will ultimately have to be tested through the formal application process.
St Mary’s Hospital plans use a smaller footprint
The latest St Mary’s Hospital redevelopment plans place the new hospital on the eastern part of the existing campus, allowing it to be built while the current hospital remains in use.
The Trust says the purpose-built hospital would contain around 800 beds and continue St Mary’s Hospital’s role as a teaching hospital and major trauma centre. Clinical services that are currently dispersed through a complex estate of roughly 40 buildings would be brought together in a single, taller building of around 30 storeys and approximately 185 metres.
The new hospital redevelopment is intended to have a smaller and simpler footprint. That is central to the wider masterplan because it would allow much of the remaining land to be released for research, commercial life-sciences uses, public realm and other complementary development after clinical services move into the replacement building.
Among the more detailed features now being consulted on within the hospital redevelopment are separate arrival and drop-off points for planned, urgent and emergency care, single en-suite ward rooms, more space for modern equipment and flexible areas intended to adapt to changing models of care.
A sky lobby is proposed at the 14th floor, linking the hospital’s main clinical zones and providing space for a sky garden, restaurant and cafe. Research facilities would also be integrated into clinical areas rather than treated as a separate part of the campus.
Trust chief executive Professor Julian Redhead described the hospital redevelopment scheme as a “once in a generation opportunity” to replace an estate that has become increasingly difficult to maintain.
Six acres could support an expanded life-sciences campus
The hospital is only one part of the proposal. By consolidating clinical functions on the eastern side, the Trust says around six acres could ultimately become available for complementary life-sciences development linked to the existing Paddington Life Sciences cluster.
The wider ambition is to bring healthcare, research, technology businesses and commercial laboratory space closer together. The Trust says independent evaluation indicates that the expanded cluster could support between 9,000 and 11,000 additional jobs and generate up to £1.3 billion a year in extra economic activity.
The current masterplan also includes new and improved walking routes through the site, wider footways, new crossings and cycle connections. Two new public spaces, Mint Square and Canalside Square, are proposed as part of the wider public realm strategy.
The Grade II listed Clarence Memorial Wing and the western part of the Mint Building are intended to be retained and restored. Heritage is likely to remain a significant planning issue given both the listed buildings on the campus and the relationship with surrounding townscape.
Westminster policy already anticipates a comprehensive redevelopment
The planning policy position is unusually important here because Westminster City Council adopted a revised City Plan in January 2026 which contains a specific site allocation for St Mary’s Hospital.
Policy 8 of the Westminster City Plan 2019-2040 supports delivery of a new hospital alongside commercial growth, high-value jobs, improved public realm and complementary uses.
It requires hospital redevelopment proposals to come forward through a developer-led masterplan agreed with the council. It also expressly recognises that existing levels of healthcare need to be maintained while the replacement hospital is constructed on a smaller footprint.
That policy framework closely matches the phasing now being presented by the Trust. The eastern part of the campus is intended to take the new hospital first because it can be released with less disruption to clinical services. Only after the new building is operational would the remainder of the site be progressively freed for redevelopment.
For anyone following the wider policy context, Planning Geek’s guide to the London Plan explains how strategic planning policy operates alongside Westminster’s local plan.
St Mary’s Hospital consultation is not a planning application
The third hospital redevelopment consultation runs from 30th September to 31st October 2026, with public exhibitions, community events, a webinar and a dedicated consultation hub in Paddington Square.
The Trust says it will review the feedback alongside continuing clinical, technical, design and planning work. A further phase of engagement is expected in spring 2027 before the formal application is submitted to Westminster City Council.
That means the drawings now on display should not be treated as a consented scheme or as necessarily representing the final application. Height, detailed architecture, access arrangements, servicing, public realm, environmental mitigation and the precise life-sciences components may all continue to evolve.
This latest round follows consultation earlier in 2026. The Trust reported that 92% of respondents who answered its question about the overall masterplan supported the vision, while concerns included height and massing, effects on residents, traffic, parking and construction disruption.
Paddington’s constraints shape the St Mary’s Hospital redevelopment
St Mary’s Hospital occupies an approximately 10-acre central London site immediately beside Paddington Station and close to the Grand Union Canal. The location gives the redevelopment exceptional public transport access but also creates a dense set of constraints.
Westminster’s planning evidence has previously highlighted the need to consider neighbouring heritage assets, public realm, permeability and the operational requirements of nearby transport infrastructure. Transport for London has also identified constraints associated with Paddington Station and underground railway infrastructure in the area.
That approach is likely to be one of the central planning questions for the eventual application: whether the benefits of a consolidated hospital, improved public realm and economic growth justify the scale and townscape effects of a very tall building in this part of Westminster.
Funding affects delivery, but not the current planning status
The St Mary’s Hospital redevelopment sits within the Government’s New Hospital Programme, but changes to that programme had pushed delivery of the Trust’s major schemes into the 2040s.
Imperial College Healthcare has secured funding to continue design and town planning work at St Mary’s Hospital and has formed a redevelopment funding taskforce with Westminster City Council, local MPs, Imperial College London and Imperial Health Charity to explore alternative financing routes.
A Trust update published on 28th September said those routes could potentially enable the new hospital to be delivered around 2036 if main building work can begin soon after planning consent. An earlier version of the project website referred to 2035, so the precise target should be treated as provisional rather than a fixed completion date.
The same update said planning consent is currently anticipated in 2028. Again, that is a programme assumption rather than a decision already made by Westminster.
The immediate planning milestone for St Mary’s Hospital is much closer. The Trust wants a whole-site planning application ready for spring 2027, after this consultation and a further engagement stage.
What happens next for the hospital redevelopment?
The next few months should turn the emerging masterplan into something much closer to an application-ready scheme as part of the hospital redevelopment.
Feedback from the third consultation will be considered alongside detailed technical work before the Trust returns with further designs in spring 2027. Only after that will Westminster receive and validate the formal planning application, publish the submission documents and begin the statutory consultation process.
The current proposals are significant because they show how the Trust intends to reconcile three competing demands: replacing an ageing major hospital, keeping healthcare services running throughout construction and using the land released by consolidation to support a much larger life-sciences district.
For Paddington, the result could be one of the most substantial pieces of regeneration in central London. But the project has not yet crossed the planning application threshold, let alone secured consent.
The third-round consultation material can be viewed through the St Mary’s redevelopment consultation website, while the Trust’s 30th September announcement sets out the latest design changes and consultation arrangements.
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