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Hospital disrepair - a danger to patients?

View profile for Richard Wood
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Concern is growing about the safety of many NHS hospitals in England that have fallen into disrepair after years of neglect.

Figures from NHS Digital’s annual report into the condition of NHS estate show it would cost the health service in England £10.2bn to improve rundown buildings and out dated equipment.

This is an increase of 11% from £9.2bn in 2021 and has more than doubled since 2011-2012, when the cost stood at £4.7bn.

About £1.8bn - a rise from £1.6bn in 2020-2021 and £0.3bn in 2011-2012 - of the repairs backlog is now considered “high risk” and includes cases where the need to repair or replace facilities and equipment must be urgently addressed to prevent catastrophic failure, major disruption to clinical services or safety issues that could cause serious injury or prosecution.

The roofs of 30 hospital buildings at 18 NHS trusts are said to be in danger of collapsing because they include planks made from reinforced autoclaved aerated concrete (RAAC) which has become unstable.

One of these is The Queen Elizabeth Hospital, Norfolk, which installed 2,482 steel props to hold up its roof and had to close four of its seven operating theatres earlier this year so their ceilings could be strengthened in emergency repairs.

The hospital with the largest high-risk backlog is Charing Cross, London, where it will cost £155m to eradicate all the serious safety and maintenance issues. Next are St Mary’s Hospital (£126m) and Hammersmith Hospital (£68m), both in London. All three sites are run by Imperial College Healthcare NHS Trust.

The Queen Elizabeth had the fourth-largest high-risk maintenance bill totaling £66m. West Suffolk hospital had a high-risk backlog of £62m.

The NHS Digital annual report said that three safety incidents related to critical infrastructure risks occurred at the Queen Elizabeth and 10 at West Suffolk during 2020-2021.

Other trusts with large high-risk maintenance backlogs include Hillingdon Hospitals (£88m), Northumbria Healthcare (£81m), and Barts Health (£74m), also all in London.

Interim chief executive of hospitals group, NHS Providers, Saffron Cordery, said the repairs bill was growing at an alarming rate.

She said:  “Far too many NHS buildings and facilities are in very poor condition and the latest figures show the situation is getting worse. The costs of trying to patch up creaking infrastructure and out-of-date facilities are piling up.”

She urged ministers to clarify whether the delayed new hospitals programme to fulfil ex-prime minister Boris Johnson’s pledge to build 40 new hospitals was going ahead.

The government allocated £5.9bn in extra NHS capital funding for the three years to 2024-25.

This followed years of underinvestment, which meant capital funding from central government, which is mainly used to repair buildings and buy equipment, was diverted into paying for the NHS budget to cover its day-to-day running costs.

Experts have said it will cost £20bn to build the promised facilities, and construction costs have soared since Johnson made the commitment in 2019.

It is still unclear how much of the new capital budget will be allocated to the growing backlog of repairs required in England’s hospitals. The actual investment to reduce backlog maintenance in the NHS stood at £1.4bn in 2021-22, less than 14% of what is needed.

The Estates Returns Information Collection (ERIC) report also revealed that the health service was being badly hit by energy price rises. The NHS spent £790.3m on energy in 2021-2022 in England, a 21% increase on the previous year, despite using only three per cent more energy overall.