Patients at risk from 'dilapidated' NHS buildings, says report

NHS Providers says patients and staff are using buildings with "leaking roofs and broken boilers"

Author: Jon BurkePublished 1st Mar 2023

The "dilapidated" state of NHS facilities are putting patients at risk, according to NHS Providers.

In a new report, the organisation warns patients and staff are using buildings with "leaking roofs and broken boilers" while some hospitals have not been able to replace old building materials which are at risk of "sudden collapse".

The body, which represents NHS trusts, said the "long neglected" NHS estate in England needs to be brought "into the 21st century" to help both patients and staff.

"We highlight the extent of the dilapidated estate and make the case for strategic capital investment," the authors wrote.

They added: "Deteriorating NHS infrastructure and estates risk patient safety and quality of care."

The new report, called No More Sticking Plasters, also calls upon the Government to expedite the replacement of "unsafe" reinforced autoclaved aerated concrete planks used in construction between 1960 and 1980.

The precast concrete has an expected lifespan of 30 years but some trusts have had them in place for 50 years or more and the report calls for action to "mitigate the risk of sudden collapse".

This includes 14 hospitals which will require extensive building work to prevent their closure, NHS Providers said.

The authors of the report added: "Of the 14 hospitals, seven are at a critical level of risk and only two of these are currently included in the government's New Hospital Programme."

The report suggests that the poor condition of the infrastructure could mean some of the targets to improve care could be at risk.

Capital investment needed

"The operational ask of the NHS cannot be delivered without adequate capital investment," the authors of the report wrote.

This could include some targets including reducing A&E wait times, improving ambulance response times and improving hospital bed capacity levels.

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

The new NHS Providers report claims that capital investment has not kept pace with demand over the last 10 years.

The maintenance repair bill currently stands at £10.75 billion.

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

"Trusts welcomed the multi-year capital budget set at the October 2021 Spending Review and the contribution this will make towards improving productivity and performance after years of under-investment.

"But the fact remains that there is not nearly enough 'give' within the system to meet rising operational pressures on the capital budget.

"The government needs to make some major decisions about the growing maintenance backlog as well as the New Hospitals Programme (NHP), which has been beset by delays and indecision over funding.

"These delays are now leading to spiralling, inflation-driven cost increases far above initial forecasts, and it is increasingly questionable whether the £3.7 billion set aside for the NHP will meet the demands of all the trusts in the programme.

Urgent decisions required

"Urgent decisions are also needed about replacing RAAC (reinforced autoclaved aerated concrete) planks, which present a major and unjustifiable safety risk.

"Trusts are committed to delivering integrated, high-quality care but they aren't being given the tools to do this. Strategic investment is vital if we are to transform the delivery of healthcare and modernise the ageing NHS estate."

A Department of Health and Social Care spokesperson said: "We are investing record sums to upgrade and modernise NHS buildings so staff have the facilities needed to provide world-class care for patients, backed by £4.2 billion 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 programme in a generation, as well as over 70 hospital upgrades across England, and will eradicate RAAC from the NHS estate by 2035.

"Our record investment in the NHS is helping to cut the Covid backlogs - we've virtually eliminated two-year waits for treatment and have cut waits of more than 18 months by over two-thirds from their peak."

History of the NHS in pictures:

NHS is established

The National Health Service was formally established in 1948 at what is now Trafford General Hospital in Manchester. The service was started by Aneurin Bevan under the government of Clement Atlee. Its aim was to create a system of free healthcare to all. One of the first patients was Sylvia Diggory, aged 13, who was suffering from a liver condition.

Prescription charges introduced

Soon after its inception, charges for prescriptions and dental care were introduced. Each prescription would cost one shilling, while dental care would require a £1 payment. Charges would eventually be dropped and then reinstated in 1968.

NHS discoveries

Throughout the 1950s, thanks to the pioneering technology the NHS was using, a number of medical advancements were made. Polio vaccinations were rolled out in the UK, the structure of DNA was found and the link between smoking and cancer was proven.

Treating new diseases

As time went on and the NHS grew, so did its capacity to look after those who were unable to be treated before. The Mental Health Act in 1983 was the first time the concept of consent was raised in treating those with mental health issues. Nurses also treated people suffering from AIDS in the late 1980s and, together with the government, helped to reduce the stigma of the disease, which primarily affected gay men.

Opening to the public

In order to cope with the increasing demand for the NHS, the structure of the service changed. In 1991, NHS Trusts were established in the first of a wave of reorganisation for the service. People would later be able to donate organs more easily with the introduction of the NHS Organ Donor Register.

Stretched resources

In the 21st century, the NHS came under pressure as a result of stretched resources. With the rising cost of medicines, the government voted to bring in longer working hours and minimal increases in pay for NHS staff in 2015. This resulted in a mass picket of junior doctors around the country for better working conditions. It was the first general strike in the NHS' history and the first instance of industrial action in 40 years. There have been further strikes in 2023

NHS during coronavirus

In 2020, a new disease named COVID-19 began to spread around the world, eventually reaching the UK at the end of January. The resulting pandemic led to NHS workers being on the frontline of the disease. Support for the NHS grew massively and during lockdowns, so-called "Claps for Carers" would take place every Thursday to thank the NHS and its staff for protecting the public during the pandemic.

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