The King’s Fund responds to the latest ERIC data

Commenting on the latest Estates Returns Information Collection data for 2023/24, Charlotte Wickens, Policy Adviser at The King’s Fund, said: 

‘Many patients and staff alike will be familiar with the issues that come with the poor condition of the NHS estate, such as slow scanners, broken lifts, leaking roofs, and the relocating of services to work around dilapidated buildings. The neglect of the NHS estate led to 751 dangerous incidents to patients and staff, such as through equipment failures or infection outbreaks. 

‘The latest NHS maintenance backlog data shows £13.8 billion will need to be invested to restore buildings and equipment to acceptable levels. That figure is higher than the entire Department of Health and Social Care capital budget for this financial year. And today’s data only covers hospitals, much more would be needed to restore outdated GP practices and other primary and community care buildings.  

‘The poor physical state of the NHS has now become a severe hindrance to its productivity. The government has said it is reviewing the New Hospital Programme but has not yet been clear on when this will happen or what the result will be, leaving patients and health care leaders in limbo.  

‘A welcome sign is that ministers have set about changing how NHS capital budgets are planned and set. The recent budget earmarked a rise in capital spending, including £1 billion for critical maintenance issues with NHS buildings, and a promise to set longer-term capital budgets so that NHS organisations can better plan for future modernisation. 

‘However, the scale of the maintenance backlog means there will have to be some difficult decisions about which buildings and what equipment is prioritised for investment at the upcoming comprehensive spending review.’ 

Notes to editors

Case study: 

This year, The King’s Fund has teamed up with Epsom and St Helier University Hospitals NHS Trust to shine a light on what the capital backlog means for them on a local level.  

Impact on care while waiting for long-term investment 

Every year Epsom and St Helier University Hospitals invest millions in improving its buildings so that staff can provide safe care to patients. However, its buildings are deteriorating faster than the trust can fix them, and the outdated infrastructure causes significant disruption to teams and patients.   

In the last year the trust has had to postpone hundreds of operations due to ventilation issues in its theatres. Even though the trust has fixed the issue, it anticipates this happening repeatedly due to the deteriorating buildings. 

The hospitals have to regularly contend with broken lifts and flooding, and there have been multiple times this year where teams have had to hire patient transport ambulances to move patients from one part of the hospital to another because corridors that would normally be used have been flooded and lifts are out of action.   

How plans will help the system 

The trust’s plans will help deliver on the recommendations in Lord Darzi’s review to shift care closer to home and cut surgery waiting times faster. This includes: 

• 85% of services staying at Epsom and St Helier hospitals with care closer to home, including urgent treatment, frailty and ambulatory care services, which will better support the population immediately around St Helier, outpatient appointments and scans.  

• reducing waiting lists faster because Epsom and St Helier theatres will be dedicated to planned surgeries. 

• the trust’s new specialist emergency care hospital will be located next to The Royal Marsden hospital, helping to improve access to specialist oncology services and reduce the need for local patients to travel. 

For further information, or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585. 

The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.