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Bill for urgent repairs at NHS hospitals reaches almost £1bn

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By: Health policy editor

 Report finds crumbling state of hospitals is putting staff and patients at risk and could lead to health and safety prosecutions

Hospitals are at growing risk of “catastrophic failure” because the bill for urgent repairs for problems that threaten staff and patient safety has soared to almost £1bn, an NHS report reveals.

The cost of undertaking urgent “high-risk” maintenance in hospitals jumped last year from £775.5m to £947.1m – a rise of 22% – according to figures published by the NHS’s statistical arm.

The crumbling state of many hospitals is putting staff and patients at such risk of serious injury that some NHS trusts could be liable to prosecution under health and safety law, the report says.

The statistics, compiled by NHS Digital, show that in England hospital buildings, operating theatres and scanners used to diagnose diseases are increasingly showing their age. The money needed to address the backlog has more than doubled from £458m in 2014-15 to last year’s £947.1m.

The figures are contained in the agency’s annual estates return information collection report. The official definition in it of “high risk” repairs says: “High risk is where repairs/replacement must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury and/or prosecution.”

Dr Nick Scriven, president of the Society for Acute Medicine, which represents hospital doctors who look after patients admitted through A&E who do not need surgery, said: “Clearly this is a major risk to patient safety, given the nature of these repairs.

“It covers the very fabric of healthcare provision and can severely alter both the safety and the experience of patients and staff being cared for and working throughout the NHS, whether it be outdated buildings with leaky plumbing, out-of-date fire prevention or less obvious things such as windows that won’t open or faulty heating systems,” added Scriven, who is a consultant in acute and general medicine at Calderdale and Huddersfield NHS foundation trust.

St Mary’s hospital in west London – renowned for its key role in the BBC’s acclaimed Hospital series – has been hit by major operational problems recently after some of the first floor and a ceiling fell down at its 147-year-old Cambridge wing. That led to the loss of 31 beds and will cost £1m to fix. It also meant that Imperial College Healthcare, which runs the trust, had to declare a black alert – an official admission by a hospital that it has run out of beds and cannot cope with demand – no fewer than 20 times in six months.

Undone maintenance has also led to the trust having to close the birth centre at St Mary’s, which has forced almost 100 pregnant women to give birth elsewhere within the hospital or several miles away at the Queen Charlotte’s and Chelsea hospital.

Ian Dalton, Imperial’s chief executive, said in a report to his board that all five hospitals run by the trust had “significant problems” with repairs and the trust had one of the largest backlogs of buildings maintenance in the NHS. It is spending £16m a year on repairs in order to keep its five hospitals running.

The bill for urgent repairs has risen as Jeremy Hunt, the health secretary, has staged a series of raids in recent years on the NHS’s capital budget to generate more money for day-to-day NHS activities. For example, last year he switched £1.2bn from the £4.8bn capital budget into the revenue budget, which is used to pay for the normal functioning of increasingly cash-strapped hospitals.

The National Audit Office warned last year that the tactic was short-term and unsustainable.

“For year after year we have seen investment in NHS buildings and equipment reduced. Funding set aside for this purpose has been used instead to relieve day-to-day financial pressures, which is reflected in these rapidly growing maintenance backlog figures,” said Chris Hopson, chief executive of NHS Providers, which represents most hospital trusts in England.

“As the National Audit Office has pointed out, this is a false economy.”

A spokesperson for NHS Improvement, the health service’s financial regulator, said: “We are working with trusts to help them reduce the backlog of estates works to ensure that patients receive safe, high-quality care in an environment fit for the 21st century, as well as helping them plan what type of facilities they may need in the future.”