In 1826, the London University began emphasising the importance of having medical schools attached to hospitals.

[9] A new 75,822 m2 hospital, procured under the Private Finance Initiative in 2000, designed by Llewelyn Davies Yeang[10] and built by a joint venture of AMEC and Balfour Beatty at a cost of £422 million, opened in 2005.

[11][12] The sculpture Monolith and Shadow made from a large polished piece of Brazilian granite was placed outside the main entrance to the new hospital in 2005.

[13] In October 2006, the hospital was nominated and made the Building Design shortlist for the inaugural Carbuncle Cup, awarded to "the ugliest building in the United Kingdom completed in the last 12 months",[14] which was ultimately awarded to Drake Circus Shopping Centre in Plymouth.

[16] In 2024, King Charles III became patron of the hospital, a role Queen Elizabeth II had filled until her death in 2022.