The 2025/26 Estates Return Information Collection (ERIC), has confirmed another, not unexpected rise in backlog maintenance, which has exceeded £17bn but stopped short of the £18bn that was widely predicted.
The estimated cost to eradicate backlog maintenance has risen to a new record high of £17.3bn. High risk and significant risk backlog have both risen, but as a percentage of the overall backlog they have collectively fallen by one percentage point compared with 2024/25 figures, with higher percentage change in the moderate and low risk categories.
The total cost of running the NHS estate has risen to £14.4bn from £14bn and total energy consumption has fallen to 11.2bn kWh from £11.3bn kWh. The cost of cleaning services and providing inpatient food remain the same at £1.6bn and £0.8bn respectively.
Healthcare experts respond
Not surprisingly, it is the rise in backlog maintenance that has drawn most comment from healthcare experts and leaders. Matthew Hopkins, Acute and Ambulance Network Director at the NHS Alliance, describes the condition of the NHS estate as “a deeply worrying issue with real consequences for patients and staff.”
He added that the ERIC figures “should be a wake-up call for the government to reconsider its decision to hold NHS capital investment flat over the current spending review period – at the upcoming Budget it has an opportunity to address this.
“NHS leaders want to see further reforms to the NHS capital regime to provide them with greater flexibility so the capital investment that is available can be spent as effectively as possible.”
Siva Anandaciva, Director of Policy, Events and Partnerships at The King’s Fund says: “The government’s 10-year capital plan for health and care aims to take a more joined-up view of how buildings across our health and care system can support people’s wellbeing. It is welcome that this plan looks beyond fixing hospital settings to things like the NHS working closer with local authorities to address poor-quality housing, which might prevent children from ending up in A&E because they have developed respiratory conditions. This is the type of cross-government action we need to see.
“But that ambition will count for little if NHS capital budgets continue to be raided, despite promises from the government to buck this trend. There are reports that the Defence Investment Plan will draw from NHS capital budgets, which would likely lead to further delays to the New Hospital Programme. This means that the hospitals in the worst state of disrepair will keep swallowing cash for emergency repairs rather than being properly invested in.
“Without proper capital investment across all our healthcare settings, patients and staff will continue to pay the price and avoidable safety incidents will sadly remain rife. And if the government is not willing to fund the investment the NHS needs, it should be honest with the public about the consequences of this decision.”
Clinical service incidents
Matthew Hopkins cites a rise of more than 60% in clinical service incidents caused by estates and infrastructure failure over the course of a single year. However, Estates leaders believe these incidents to be even more prevalent than currently reported.
At Healthcare Estates this week, (October 13 & 14), NHS England’s Simon Corben, Director and Head of Profession, NHS Estates and Fiona Daly, Director of Workforce and Sustainability and National Deputy Director of Estates, repeatedly stressed the need for improved incident tracking. They urged a shift to an open culture of reporting what is going wrong and asked everyone to report any occasions where an estate failure has stopped clinical activity.
Estates failures resulting in disruption to clinical services remains one of the most powerful tools there is for making the case to the Treasury for more capital investment.
