Reaction to the publication of the latest ERIC data has, not surprisingly, focused on the condition of the estate, with service providers and analysts united in emphasising that although the government’s recent pledges of capital investment for ‘new’ hospitals are of course welcome, they are not nearly enough.
Niall Dickson, Chief Executive of the NHS Confederation says: “Behind the figures showing a sharp rise in the NHS maintenance backlog are Trusts up and down the country struggling with inadequate, inappropriate wards, hospitals and equipment.
“This maintenance backlog combined with underinvestment over many years in infrastructure, IT and tech more generally in hospitals presents a barrier to what is possible to transform care and ensure the safety of patients.
“The government’s recent pledges to invest in capital are welcome but we should be under no illusion – they are woefully short of what is required. We need a co-ordinated, long-term programme of capital investment and key decisions about where the money is spent should be devolved to local systems rather than subject to national and indeed sometimes political determination.”
The latest data reveal an increase in backlog of maintenance of 8.4% to £6.5bn, of which £3.4bn is high risk.
However, as the Kings Fund points out, the situation could be even worse than the ERIC data suggests. “First, we only know the ‘works costs’ of tackling these maintenance issues, and the true costs will be higher once fees, VAT and the costs of displacing and disrupting clinical services are included. Second, the ERIC data does not include the maintenance needs of buildings and equipment in primary care, where only half of GP practices report their premises as fit for present needs, or social care, where it has been estimated that 85% of the UK care home stock is more than 40 years old. And finally, ERIC data only records the costs of restoring the existing NHS estate. The capital costs of modernising and transforming the estate - through new community hubs for primary care networks or improved diagnostic facilities that will improve early detection of cancer - are additional to (and competing with) these maintenance costs.”
Saffron Cordery, Deputy Chief Executive of NHS Providers says the cost of capital neglect is now staring us in the face. The ERIC figures reveal an increase in clinical service incidents of 25% over the previous year. As an example, NHS Providers cites a serious power failure that led to the closure of almost all clinical services at a Trust for eight hours, resulting in the cancellation of 1,788 outpatients appointments and 99 elective procedures.
"These figures are deeply disturbing. NHS backlog maintenance bills have climbed to record levels and we’ve seen a really worrying jump in clinical safety incidents. Patients are now paying the price for years of capital neglect, and the scale of the problem is gathering pace,” she says.
"The recent investment we have seen from the Prime Minister, and funding for six new hospitals, has been very welcome, but these figures make it clear we need much more to rebuild our NHS. We need to start making real progress in tackling the NHS backlog maintenance, or we continue storing up problems for the future.
"We will need a multiyear settlement on capital that brings spending into line with other comparable economies, together with a better way of ensuring the money gets to where it's needed most."
A capital spending review has been promised, but it is still unclear when this will happen and what the outcome will be.
