NHS England Estates Returns Information Collection data shows the backlog bill rose to £15.9bn in 2024/25 from £13.8bn in 2023/24.

Matthew Taylor, chief executive of the NHS Confederation, said: ‘The continued rise in the NHS maintenance backlog bill is deeply worrying but unfortunately not surprising given the health service has been starved of capital investment for more than a decade. This has left the NHS with crumbling buildings and aging infrastructure and estate in desperate need of extensive repairs that can be unsafe for patients and staff.'

Taylor urged the Government to explore private capital investment opportunities to build new facilities to free up public funding to tackle the maintenance backlog.

Siva Anandaciva, director of policy, events and partnerships at The King's Fund, said: ‘Today's data only covers NHS providers of secondary care – including hospitals, mental health trusts and ambulances. There is also recent evidence of the deteriorating conditions of GP practices, many of which do not meet patients' needs today and were built in a different century. These outdated practices risk undermining Government's ambitions to shift more care closer to the community.'

Anandaciva warned of ‘tough trade-offs' in the years ahead with the potential that hospital estates go into ‘managed decline' as future capital investment focuses on a new neighbourhood health service.

Daniel Elkeles, chief executive, NHS Providers, said: ‘Eye-watering sums are needed just to patch up buildings and equipment which are in a very bad way right across hospital, mental health, community and ambulance services. We need to make the NHS as modern and winter-proof as possible but the waiting list of essential repairs keeps getting longer and costs are soaring.

‘Our new report with PA Consulting shows how we could sort this problem - led by changes to government capital spending rules. We can make the most of other sources of investment so that we use Government funding for repairs while unlocking billions of pounds more to transform care for patients and to bring big benefits for wider economic growth and productivity.'