Deteriorating infrastructure in NHS hospitals is putting patient safety at risk, report says

The ‘dilapidated’ state of NHS facilities is putting patients at risk, according to a new report.

Patients and staff are using buildings with “leaking roofs and broken boilers”, while some hospitals have been unable to replace old building materials at risk of “sudden collapse”, NHS providers have warned.

The organisation, which represents NHS trusts, said the “neglected” NHS estate in England needed to be brought “into the 21st century” to help both patients and staff.



Deterioration of NHS infrastructure and estates risks patient safety and quality of care.

NHS providers

“We highlight the extent of the dilapidated property and support strategic capital investments,” the authors wrote.

They added: “The deterioration of NHS infrastructure and estates is putting patient safety and the quality of care at risk.”

The new report, called No More Sticking Plasters, also calls on the government to speed up the replacement of the “unsafe” autoclaved aerated concrete reinforced boards used in construction between 1960 and 1980.

Precast concrete has an expected life of 30 years, but some trusts have had it in place for 50 years or more and the report calls for action to “mitigate the risk of sudden collapse”.

This includes 14 hospitals that will require extensive building work to avoid closure, NHS providers have said.

The report’s authors added: “Of the 14 hospitals, seven are at critical risk and only two of these are currently on the government’s New Hospitals programme.”

The report suggests that the poor state of infrastructure could mean that some of the goals to improve care could be compromised.

“The operational demand of the NHS cannot be delivered without sufficient capital investment,” the report’s authors wrote.

This could include a number of targets such as reducing A&E waiting times, improving ambulance response times and improving hospital bed capacity levels.

Critics said that although the NHS received increases in capital funding in the 2021 Spending Review, the investment fell short of what was needed.

NHS Providers’ new report claims capital investment has not kept pace with demand over the past 10 years.

The maintenance repair bill currently stands at £10.75 billion.



Trusts are committed to providing comprehensive, high-quality care but are not given the tools to do this.

Sir Julian Hartley

Sir Julian Hartley, chief executive of NHS Providers, said: “Capital investment in the NHS has simply not kept pace with the increasing demands on the NHS over the last ten years.

“Trusts have welcomed the multi-year capital budget set out in the October 2021 Spending Review and the contribution it will make to improving productivity and performance after years of underinvestment.

“But the fact remains that there is not nearly enough ‘giveaway’ within the system to cope with the increasing operational pressures on the capital budget.

“Government needs to make some important decisions on the rising maintenance backlog as well as the New Hospitals Program (NHP), which has been plagued by delays and indecision over funding.

“These delays are now leading to inflationary costs spiraling well above original forecasts and it is increasingly doubtful that the £3.7bn earmarked for the NHP will meet the demands of all the scheme’s trusts.

“Urgent decisions are also needed to replace the RAAC (reinforced autoclaved aerated concrete) boards, which present a significant and unjustified safety risk.

“Trusts are committed to providing comprehensive, high-quality care but are not being given the tools to do this. Strategic investment is vital if we are to transform healthcare delivery and modernize the aging NHS estate.”



Our record investment in the NHS is helping to reduce Covid delays – we have virtually eliminated two-year waits for treatment and cut waits of more than 18 months by over two-thirds since their peak

Department of Health and Social Care

A spokesman for the Department of Health and Social Care said: “We are investing record sums to upgrade and modernize NHS buildings so staff have the facilities they need to deliver world-class care to patients, with £4.2bn this year and £8.4 billion over the next two years.

“We will also deliver 40 new hospitals as part of the biggest hospital building program in a generation, as well as over 70 hospital upgrades across England and phase out the RAAC from the NHS estate by 2035.

“Our record investment in the NHS is helping to reduce Covid delays – we have virtually eliminated two-year waits for treatment and cut waits of more than 18 months by over two-thirds since their peak.”

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