NHS buildings across England are putting patient safety at risk due to deteriorating conditions, with the repair backlog reaching almost £16 billion. The maintenance bill has surged by more than 15 per cent in just one year, creating a crisis that now exceeds the entire cost of running the NHS estate.
The latest Estates Return Information Collection data reveals the repair backlog jumped to £15.9 billion in 2024/25, up from £13.8 billion the previous year. This staggering sum represents work that should already have been completed to restore buildings to acceptable standards, rather than planned future maintenance.
The total cost of operating NHS facilities also increased by 3.3 per cent to £14 billion in 2024/25. The repair backlog now outstrips this entire operational budget by nearly £2 billion.
Critical infrastructure failures
Hospital leaders report widespread structural problems that directly impact patient care and staff safety. Facilities are experiencing flooded corridors, reduced theatre capacity, and roofs at risk of collapse across hospital, mental health, community and ambulance services.
Daniel Elkeles, chief executive of NHS Providers, said: "Critical parts of the NHS are falling to bits, literally, after years of underinvestment nationally. The safety of patients and staff is at risk."
He added: "We can't keep wasting money propping up ageing buildings not fit for purpose."
Funding challenges persist
Chancellor Rachel Reeves announced a £29 billion annual increase in NHS funding during June's spending review. However, experts argue this welcome investment must prioritise modernising facilities and upgrading outdated technology.
Elkeles emphasised that "eye-watering sums are needed just to patch up buildings and equipment which are in a very bad way" across all NHS services. The waiting list for essential repairs continues growing while costs spiral upward.
Siva Anandaciva, director of policy at The King's Fund, noted the £15.9 billion figure exceeds "the entire capital budget for this year and £2.2 billion higher than last year."
Wider estate concerns
The crisis extends beyond hospital buildings to primary care facilities that struggle to meet modern patient needs. Many GP practices were constructed decades ago and fail to support current healthcare delivery models.
Anandaciva warned: "These outdated practices risk undermining the government's ambitions to shift more care closer to the community."
The New Hospital Programme, designed to rebuild outdated facilities, faces ongoing delays and rising costs that leave staff and patients uncertain about future improvements.
Additional estate costs
NHS car parking services generated £84.4 million in revenue, representing a 9.3 per cent increase from the previous year. The number of available parking spaces across NHS sites grew modestly by 1.1 per cent to 459,437 spaces.
Matthew Taylor, chief executive of the NHS Confederation, described the maintenance backlog increase as "deeply worrying but unfortunately not surprising given the health service has been starved of capital investment for more than a decade."
Sources used: "PA Media" Note: This article has been edited with the help of Artificial Intelligence.
