The recent release of the 2024 Estates Returns Information Collection (ERIC) data highlights the significant challenges that the NHS faces with the condition of its estate and infrastructure. In the last year alone, the predicted cost of eradicating the risk has increased by £2.1bn to a staggering £13.8bn. Over 60% of this increase falls into categories of significant and high risk that need addressing in the short term.
A recent article by The King’s Fund underscores that the total predicted costs now outstrip the entire NHS annual capital budget of £11.8m (1). Moreover, there is no ERIC equivalent within the General Practice estate to fully understand the overall risks posed by the UK’s poor healthcare estate.
There is growing evidence that the increase in backlog maintenance is now directly impacting both patient safety and the NHS’s efficiency. Just this month, an article by the Observer highlighted the analysis of official data by the House of Commons into lost clinical days and the link between infrastructure and building condition (2).
There is precious little serious research into this link, but a small number of key NHS estates leaders are making strides. For instance, David Jones, Director of Estates, Facilities & Capital Development at University Hospital Southampton NHS Foundation Trust, is conducting PhD research at Southampton University on the topic. His research is focused on understanding the causal relationship between backlog maintenance and patient outcomes within the acute sector of the NHS in England (3).
While the government needs to recognise the growing risks to operational efficiency and clinical safety from this issue, the sheer scale of it means it will remain a problem for many years to come. Clear, useful, and transparent management information, associated with both clinical activity, outcomes, and infrastructure condition, can help NHS leaders minimise the impact of the significant risks associated with their backlog maintenance requirements.
