40% rise in cost of backlog maintenance

The latest Estates Return Information Collection (Eric) data said backlog maintenance stood at £9bn, whereas in 2018/19 the figure was just over £6.45bn.

NHS Digital explained backlog maintenance is a measure of how much funding would be needed to restore buildings to ‘a certain state based on a state of assessed risk criteria. It does not include planned maintenance work (rather, it is work that should already have taken place)’.

There were increases in the most critical maintenance backlogs, with high-risk backlog rising from just over £1bn in 2018/19 to £1.5bn a year later. Significant risk backlog maintenance increased from £2.3bn to almost £3.2bn over the same period.

Siva Anandaciva (pictured), chief analyst at The King’s Fund, said that, even before the pandemic, the NHS was ‘in the midst of a staffing crisis and having to make do with poorly maintained buildings’.

He added: ‘In the last financial year, the maintenance backlog rocketed by 40% to £9bn and the poor condition of buildings and equipment led to nearly 6,000 cases where clinical services for patients were delayed or interfered with.

‘This is a symptom of the wider underinvestment in health over the past decade, which has seen the NHS going into the pandemic with 100,000 staff vacancies and deteriorating facilities and equipment. Pre-pandemic, the government focused on eye-catching promises to build new hospitals. But this data shows that as the NHS begins to rebuild, it desperately needs certainty on the funding it will have to fill the maintenance backlog and tackle long-term staff shortages.’

Chris Hopson, chief executive of NHS Providers, said the increase was ‘alarming’.

‘It shows how rapidly our very old NHS estate is falling into disrepair, putting patient lives at greater risk and making it much more difficult for frontline staff to provider the right quality of care.

‘The backlog is now broadly equivalent to the annual cost of running the entire NHS estate. More worrying still, over half of this is for work of high or significant risk. In short, this problem poses an increasing threat to safety.’

Older buildings directly affected hospitals’ ability to provide Covid care, for example limiting the ability to expand capacity at pace or provide appropriate oxygen support, he added.

‘There are particular concerns over the need to modernise or replace many mental health facilities that are no longer fit for purpose. Unfortunately, it is patients and service users who are paying the price for this backlog, reflected by the sharp rise in clinical service incidents.’

The Eric data covers a range of other information. There was a 2.55% increase in the overall cost of running the NHS estate, which stood at £9.7bn in 2019/20. This included a 3.99% rise in estates and facilities financing costs. While almost £2.4bn was spent on hard facilities management (FM) costs, soft FM cost more than £3bn.

Experimental figures on contribution to costs (included in previous returns as income) show a net contribution of £300m from leasing and car parking. This includes gross income generated from car parking of £199m from patients and visitors, and £90m from staff.