More than 15 months of pandemic have taken their toll on the healthcare sector, leaving a record 5 million people on England’s NHS waiting lists for hospital treatment. At the same time, many of the NHS’s buildings are themselves waiting for attention.

The state of the NHS estate in England is measured by NHS Digital’s annual Estates Returns Information Collection (ERIC), which gathers data on the costs of providing and maintaining buildings and services from 224 trusts across more than 10,000 sites. Its 2019/20 data collection puts the cost of dealing with the maintenance backlog for buildings at £9bn, a 40% increase on 2018/19’s figure of £6.46bn and double the level of five years ago.

More than half of those maintenance issues are categorised as presenting a “high” or “significant” risk to patients and staff. Risks in the “high” category “must be addressed as an urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution”, according to NHS Estates’ own methodology.

This rising maintenance backlog results from years of government austerity policies. “Covid exposed the challenges created by such an outdated estate, such as difficulty in expanding capacity at pace to adhere to strict infection prevention and control measures,” says Amelia Chong, policy adviser at NHS Providers, which represents NHS trusts and foundation trusts. Now, as the healthcare sector takes stock of the experiences of the pandemic, attention is focused on investment for the future.

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