7 Parts of the NHS estate do not meet the demands of a modern health service. NHS hospitals include Victorian-era buildings, and 14% of the NHS estate predates the formation of the NHS (1948). The NHS Long Term Plan acknowledges that elements of the estate do not meet the demands of a modern health service (paragraphs 1.2, 1.3 and Figure 1).
8 The growth in backlog maintenance indicates that there is an increased risk of harm to patients. In October 2019 NHS Digital reported that the backlog of maintenance work to restore buildings to an appropriate standard was around £6.5 billion. An appropriate standard includes the physical condition of the estate, as well as compliance with fire safety and health and safety standards. High-risk backlog maintenance currently stands at £1.1 billion, and grew by 139% between 2014-15 and 2018-19, indicating an increased risk of harm to patients. Individual NHS providers told us about specific risks from failing operating theatres and dangerous ligature points1 (paragraphs 1.4 to 1.9).
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1 A ligature point is anything which could be used to attach a cord, rope or other material for the purpose of hanging or strangulation. Care Quality Commission, Brief Guide: Ligature Points, 2015.