Facing up to the £15 billion NHS maintenance backlog means taking control of data

John Clarke, director of project management, and a healthcare specialist within Pick Everard, said rather than being able to plan ahead, NHS estate managers are seeing their budgets raided to cover running costs and fix on-the-day maintenance emergencies.

It comes as the latest NHS Estates Returns Information Collection (ERIC) data shows a 16 per cent increase in the maintenance backlog over the last 12 months from £13.8 billion in 2023/24, up to £15.9 billion.

The maintenance backlog is the estimated cost of bringing NHS estates or buildings back to the minimum expected standard but John warns that if the scale of the backlog continues at the same rate year-on-year, the repair bill will be pushing £30 billion by 2030, driving many issues beyond safe or economical repair.

He said: “Every year maintenance is pushed down the list because budgets are stretched. Every day estate managers are firefighting, fixing what fails, rather than being able to plan ahead.

“If trusts had better visibility of their assets, they could make stronger cases for proactive investment, and a good place to start is looking at the data. Understanding exactly what’s in the estate, the condition it’s in, and how those assets are performing. Without that, it’s impossible to prioritise risk properly.”

Fears have been raised that levels of productivity, quality of care and patient safety are all under threat as a result of the maintenance backlog. The NHS Confederation has made the case for the Government to reconsider using private investment for new buildings so public funds can be ringfenced to tackle the maintenance backlog.

John said: “There’s a lot that can be done in the short term to stop costs from boiling over.

“Comprehensive condition surveys, accurate asset data, and prioritised maintenance programmes help trusts make better investment decisions. Small, well-timed interventions can prevent larger, disruptive failures later.

“However, Trusts need ringfenced operational funding for planned maintenance not just emergency repairs. There must be clear governance and accountability, with a team responsible for managing the backlog and reporting directly to the Trust Board. Without ownership at that level, the issue will never move up the agenda.”

Pick Everard is working with a number of NHS Trusts to try to prevent issues relating to ageing buildings and delayed repairs in the coming years. It also offers a free ‘health checks’ on buildings used for health and wellbeing services to identify risks and potential savings.

“We’re supporting trusts to gather the right data, make informed decisions, and plan for the future,” said John. “That’s how we slow the rise of the backlog, by helping organisations take control of their estates.

“But the message to the government is clear. If we continue treating backlog maintenance as a revenue burden instead of a strategic investment, we’ll keep repeating the same mistakes. The NHS deserves an estate that supports its ambition, not one that continues to crumble.”

To book a healthcare estate ‘check-up’ visit: https://www.pickeverard.co.uk/events/health-check-up