Watford General, via Wikimedia Commons
The cost of repairing NHS buildings is on course to exceed £16 billion, according to new analysis by inspection software specialist Property Inspect. The National Audit Office has warned that the wider maintenance backlog across the UK’s public estate is around £50 billion.
The company noted that hospitals and other NHS facilities account for £13.8 billion of the government’s estimated £48.6 billion maintenance backlog, meaning almost 30% of all outstanding public-sector repair costs are linked to NHS properties.
It added that the findings come amid continued concerns about the condition of NHS buildings across the country, with reports in recent years highlighting issues ranging from mouldy maternity wards and gas exposure to, most recently, crumbling hospitals, all of which create severe safety risks affecting both patients and staff.
Property Inspect’s analysis also shows that the NHS maintenance backlog has increased dramatically over the past decade, rising from £5.6 billion in 2014-15 to £13.8 billion in 2023-24, the latest available data.
Based on historic growth trends, the company estimates that, by the end of the 2026-27 financial year the NHS backlog could reach £16.2 billion, allowing for an annual increase of 6%.
According to the data, the NHS is now one of the largest contributors to the government’s maintenance liability, second only to Ministry of Defence properties.
The company’s analysis of the latest available figures shows:
- Ministry of Defence properties account for £15.3bn of the maintenance backlog
- Hospitals and NHS sites account for £13.8bn
- Schools account for £13.8bn
- Prisons and probation facilities account for £1.8bn
- Courts and tribunals account for £1.3bn
- Even jobcentres and assessment centres have maintenance liabilities of £1.1bn
In total, the estimated cost of bringing public buildings up to the required standard now stands at £48.6 billion.
Sián Hemming-Metcalfe, Operations Director at Property Inspect, said:
The NHS is now carrying a repair bill that would have seemed unimaginable a decade ago. With the backlog approaching £15 billion, the scale of the challenge facing healthcare estates teams is enormous. Behind these figures are buildings that patients, doctors, nurses, and support staff rely on every day. Nobody receiving treatment or providing care should have to worry about the condition of the building around them or whether maintenance issues could pose a risk to their health and safety.”
She warned that the sum represents the cost of deferred maintenance. She said:
No organisation can avoid maintenance indefinitely without consequences. By the time a roof is leaking, damp has spread through a building, ventilation systems are failing, or structural defects require urgent attention, the cheapest opportunity to resolve the issue has usually already passed. Regular inspections, detailed condition reporting and proactive maintenance programmes are essential because they allow problems to be identified and addressed before they escalate into major remediation projects. Catching issues early not only helps protect building users but can save significant amounts of public money over the long term.”
