Gaps remain in Jersey's government's latest incarnation of the new hospital project, according to the Comptroller and Auditor General.
Lynn Pamment has done a follow up review of the long-running project that has so far cost more than £130 million.
She says the government spent £130.6 million on the Future Hospital and the Our Hospital Projects, both of which have been abandoned.
£38.6m of that has been written off.
In February the government announced that a further £28.5m has been made available to develop the 'New Healthcare Facilities Programme'.
Ms Pamment says there have been 'significant gaps' in the information and cost plan of the projects since 2017.
She also found that - in respect of the new project - 'there remains a lack of clarity on the ambitions for delivery of Jersey’s health services' as well as other gaps in its understanding of capacity needs, opportunities and risks to delivery.
During the Chief Minister's first 100 days in post, she commissioned a 100-day review into the 'Our Hospital Project', which concluded the previous £800m single site option was too expensive.
However, the Auditor General believed the review lacked rigour and was 'overly ambitious'.
"It is hard to see how the 100-day Review could have been expected to uncover new and meaningful information about the state of current healthcare facilities or future models of healthcare delivery, to help with the decision making process."
"Some of the stakeholder meetings held during the 100-day Review did not enable comprehensive consultation about all options set out in the Terms of Reference. Rather the meetings acted more like communication meetings than open consultation."
However, Ms Pamment thinks that the governance approach for the Healthcare Facilities Project 'appears to represent best practice'.
But she says that there are risks to the staged approach.
"If time is not taken in the New Healthcare Facilities Programme to properly evaluate the criteria to be used for decision making and to ensure they are properly applied, then inconsistencies like those identified in the work to date to provide Jersey with a new hospital, increase the risk of further issues and delays."
She warns there needs to be focus on strategy, programme management, value for money- and meaningful consultation with clinicians.
Ministers say they welcomed the findings and recommendations:
"As Ministers we strongly agree with the Comptroller and Auditor General that we must learn from the previous hospital projects to ensure that public money is not wasted and that we deliver the right healthcare facilities for Islanders, in the right locations, without further delay.
I welcome her Report and am pleased that she has noted the governance approach being proposed for the New Healthcare Facilities Programme represents best practice.
Many of the recommendations she has made have already been implemented. This includes the appointment of an independent member to advise and act as a critical friend to the Ministerial Group on decision making and governance.” - Chief Minister, Kristina Moore.
Health Minister Karen Wilson says, while pursuing a strict timeline, 'the needs of patients and clinicians remain foremost in the minds of all involved in the programme'.