Maintenance backlog for ‘decrepit’ NHS buildings jumps to almost £16 billion

Patient safety is being put at risk by “decrepit” NHS buildings, experts have warned, as new figures show the maintenance bill has risen by more than 15% to almost £16 billion.

The sum outstrips the total cost of running the NHS estate, which was £14 billion in 2024/25, according to NHS England data.

Health commentators warned that hospitals with “flooded corridors” and “roofs at risk of falling in” are impacting care and patient safety.

The latest Estates Return Information Collection (Eric) shows that the cost to eradicate the backlog of NHS repairs in England increased to £15.9 billion in 2024/25.

This is up by 15.7% on £13.8 billion reported a year earlier.

The backlog bill is a measure of how much funding is needed to restore buildings to a good state.

It refers to maintenance work that should already have taken place rather than any that is planned.

The figures also show the total cost of running the NHS estate rose by 3.3% to £14 billion in 2024/25.

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.

“We can’t keep wasting money propping up ageing buildings not fit for purpose.”

In June’s spending review, Chancellor Rachel Reeves announced a £29 billion-a-year rise in NHS funding.

Mr Elkeles said this was “welcome” but said the health services must “be able to spend more of the NHS budget on modern facilities and up-to-date technology”.

He added: “Eye-watering sums are needed just to patch up buildings and equipment which are in a very bad way right across hospital, mental health, community and ambulance services.

“We need to make the NHS as modern and winter-proof as possible, but the waiting list of essential repairs keeps getting longer and costs are soaring.”

Siva Anandaciva, director of policy, events and partnerships at The King’s Fund, said the £15.9 billion figure is “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,” he added.

“The New Hospital Programme was meant to be the centrepiece of plans to update and rebuild outdated estates, but changes to the programme alongside long delays and rising costs continue to leave staff and patients in limbo.”

Matthew Taylor, chief executive of the NHS Confederation, described the hike in the maintenance backlog bill as “deeply worrying but unfortunately not surprising given the health service has been starved of capital investment for more than a decade”.

“This has left the NHS with crumbling buildings and ageing infrastructure and estate in desperate need of extensive repairs that can be unsafe for patients and staff,” he said.

Meanwhile, Mr Anandaciva said that while the Eric data only covers secondary care settings, there are also reports of “deteriorating” GP practices.

He said: “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 the government’s ambitions to shift more care closer to the community.”

Elsewhere, figures show the cost of NHS car parking services rose to £84.4 million, up by 9.3% on 2023/24.

The number of parking spaces available across the NHS estate rose by 1.1% to 459,437.

A Department of Health and Social Care spokesperson said: “This government inherited a broken NHS, with the hospital estate left to crumble.

“We’re investing £30 billion over five years for maintenance and repairs, with over £5 billion specifically for the most critical cases, to make inroads into the backlog across the NHS estate.

“We will provide the investment and reform needed to get patients the care they deserve, in hospital buildings fit for purpose.”