1.6 Trusts we spoke to gave examples of the difficulties they experience with estates and backlog maintenance:
• A large NHS trust with an ageing estate told us it had to temporarily relocate a maternity suite as it could not source the parts to repair a lift. The trust said: "Our capital issues do impact on our productivity, through downtime of the machinery and clinical space not being set up for modern care and so requiring a greater number of staff."
• A mental health trust gave an example of high-risk maintenance to remove the threat to health from ligature points (features which could support a noose or strangulation device). It had been unable to resolve all these potential threats and so had to employ more staff to observe patients to keep them safe. These extra staff were usually employed through an agency.
• An acute trust told us: "Capital is deferred year-on-year, which means a gradual accumulation of risk. We are forced into under-investing in medical equipment, increasing the likelihood of a major loss of service which will impact on patient safety."