Ageing infrastructure biggest barrier to tackling backlog maintenance across NHS estate

Two-thirds of estate leaders warn ageing infrastructure is the biggest barrier to tackling backlog maintenance.

NHS Property Services (NHSPS) has surveyed estate leaders to find out how to improve building maintenance across their estates. The results reveal management of NHS sites is changing due to advances in how data is collected and technology is used to tackle backlogs.

While short-term decisions are often required to keep buildings operational, these are not able to provide long-term improvements.

 The survey found that:

• 63 per cent of estate leaders identified the ageing infrastructure the biggest barrier to reducing the backlog maintenance
• 53 per cent of estate leaders identified funding as the biggest barrier
• 38 per cent of estate leaders identified the scale of the backlog maintenance itself as the biggest barrier
• 26 per cent of estate leaders prioritise maintaining and improving compliance – legal requirements for estates as well as enforcing best practice standards
• 25 per cent of estate leaders prioritise reducing the backlog maintenance

In a single year, there has been a 15.7 per cent increase in the cost of the backlog, with it now standing at £15.9 billion – more than it costs to run the entire NHS Estate annually.

To help estate leaders create the best structure to start to modernise the existing estate and ensure it is efficiently used, NHSPS has published a new guide ‘Maintaining the NHS Estate‘.

The guide provides estate leaders with practical considerations as to how to reduce their backlog maintenance. The backlog maintenance consists of bringing estate assets that have fallen below minimum acceptable standard – Condition B – back to a safe compliant and operational condition.

This should include building a complete backlog view and categorising the entire estate into core flex and tail. This places buildings into those that are essential, those that are acceptable but may not be fit for long-term use and those that are sub-optimal and outdated.

It also considers how the NHS commitment to achieving Net Zero by 2040 (and direct emissions by 2045) is reshaping how buildings are operated and upgraded.

 Simon Taylor, Director of Policy, Strategy and Capital Projects at NHS Property Services at NHS Property Services said: “Estate leaders are determined to tackle the ageing NHS estate they manage, and their message is loud and clear, they want the tools to help them improve compliance and take advantage of the latest technologies to harness useful data and increase utilisation.”

“The NHS already possesses much of the expertise, framework and data required to improve estate performance. The task is achievable; success depends on how decisions are made, how evidence is used and how effectively leaders are aligned from board level through to operational teams. When these are in place, strategy becomes action, leading to better patient care.”

The guide also recommends that the condition of the estate should be reviewed regularly; planned investment is cheaper than reacting on an ad-hoc basis. By releasing capacity and improving utilisation, as well as modernising space, estate leaders can also reduce the long-term cost of maintaining their buildings. Finally, maintaining a rolling five-year forecast of assets and bringing clinical leaders into the discussions avoids the costs associated with inaction.