Growing structural fault line in the cost to repair NHS buildings and kit

Commenting on provisional figures for Estates Returns Information Collection 2024/25, Siva Anandaciva, Director of Policy, Events and Partnerships at The King’s Fund, said:

‘The latest provisional data reveals a growing structural fault line in the cost to repair NHS buildings and equipment to the standard that patients and staff deserve. The cost of clearing the maintenance backlog for the NHS estate in England has risen to £15.9 billion, more than the entire capital budget for this year and £2.2 billion higher than last year.

‘Decrepit NHS buildings have a real and detrimental impact on patient care, with regular examples of flooded corridors, reduced theatre capacity, and roofs at risk of falling in.

‘The New Hospital Programme was meant to be the centrepiece of plans to update and rebuild outdated estates, but changes to the programme alongside long delays and rising costs continue to leave staff and patients in limbo.

‘Today’s data only covers NHS providers of secondary care – including hospitals, mental health trusts and ambulances. There is also recent evidence of the deteriorating conditions of GP practices, many of which do not meet patients’ needs today and were built in a different century. These outdated practices risk undermining government’s ambitions to shift more care closer to the community.

‘After many years of capital budgets being raided, the Chancellor’s commitment to protect these budgets from being diverted to day-to-day spending is welcome, particularly at a time when the NHS is grappling with rising costs and industrial action. To develop a more preventative and community-based NHS, the government may need to focus any future growth in capital investment into the new neighbourhood health service, while being honest that more hospital estates may continue to go into managed decline in the meantime as a result. But these are exactly the type of tough trade-offs that face the government – they will need to both make some bold choices on where funding should be prioritised and then explain what these changes mean for the care we receive.’

Notes to editors

For further information, please contact The King's Fund media team on 020 7307 2585 or [email protected].

The King's Fund is an independent charity working to improve people's health. Our vision is a world where everyone can live a healthy life. Our mission is to inspire hope and build confidence for positive change. We achieve this through expert insights and original research, developing leaders and their organisations, convening, and strategic, collaborative partnerships.