Key points:

  • Since 2013/14, the maintenance backlog for NHS hospitals has risen substantially, with most of this from an increase in high and significant risk backlog.
  • This has occurred during a period where funding has been transferred from the NHS capital budget to the revenue budget to fund frontline services.
  • The current maintenance backlog is now larger than the annual capital budget. To eliminate all high and significant risk backlog would cost over £3bn. This compares to annual capital expenditure in hospitals of around £3bn.

Since 2013/14 NHS trusts have seen a rising maintenance backlog, from £4.3bn in 2013/14 to almost £6bn in 2017/18 in 17/18 prices.

This has occurred at the same time as significant transfers have been made from the Department of Health and Social Care’s (DHSC) capital to revenue budget to fund frontline services.

The backlog is categorised into risk ratings which relate to clinical service and safety. High risk is where repairs or replacement must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety, which are liable to cause serious injury and/or prosecution. Since 2013/14, most of the increase in the total backlog is in high and significant risk maintenance, the two highest risk categories.

As at 2017/18, the total backlog is larger than the annual total capital budget of the DHSC, which is £5.2bn. Investment to reduce the backlog rose from £330m in 2016/17 to £404m in 2017/18.

References

Further reading

Research report

False economy

May 2018

The latest report in the Health Foundation’s annual series on NHS finances.

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