NHS Estates Report

Innovation and a sustainable future.

It is widely accepted that there is a £6 billion maintenance backlog for our NHS estates, £3 billion of which is safety critical. This backlog arises as a result of years of austerity; whereby £4.3 billion of capital funding, together with receipts from the sale of NHS assets, have been diverted to keep day-to-day NHS spending in balance.

The primary care and community estates are in particularly poor order, with aged and decaying buildings, many of which are contaminated with asbestos, that are wholly unsuitable for hub working, new technology or the housing of multi-disciplinary teams. All of these are key elements of the NHS Long Term Plan (LTP).

Capital spending to address these issues has seen a 7% real-terms decline from £5.8 billion in 2011 to £5.3 billion last year, according to a Health Foundation report.1 To compound this list of problems, the report's authors calculate that capital to revenue budget transfers have led to the capital budget falling as a share of the total departmental health budget from 5% in 2011, to less than 4% in 2015/16.

Private finance initiative (PFI) schemes have also fallen out of favour. These build-and-maintenance deals with private sector partners, that built over 125...