The latest NHS estates data for 2025/26 showed the total cost of running the NHS estate was £14.4bn.

Director at The NHS Alliance, Matthew Hopkins, said: ‘It's a real concern to see the "high" and "significant" risk elements make up well over half the total backlog.

‘This should be a wake-up call for the Government to reconsider its decision to hold NHS capital investment flat over the current spending review period – at the upcoming Budget it has an opportunity to address this.'

Professor Frank Smith, vice president of the Royal College of Surgeons of England, said: ‘Seeing a nearly 9% increase, resulting in a £17.3bn NHS maintenance backlog, is a stark reminder of the deteriorating state of parts of the NHS estate and the growing challenge of keeping ageing buildings safe and fit for purpose.  

‘While we welcome the recent allocation of £1.5bn from the £6.75bn NHS Estate Safety Fund to improve NHS buildings, address maintenance issues and strengthen resilience to extreme heat, modernising NHS infrastructure is essential to bring down NHS waiting lists. This will require substantial additional investment in operating theatres and the buildings needed to treat more patients.'

Siva Anandaciva, director of policy, events and partnerships at The King's Fund, said: ‘The Government's 10-year capital plan for health and care aims to take a more joined-up view of how buildings across our health and care system can support people's wellbeing. It is welcome that this plan looks beyond fixing hospital settings to things like the NHS working closer with local authorities to address poor-quality housing, which might prevent children from ending up in A&E because they have developed respiratory conditions. This is the type of cross-Government action we need to see. 

‘But that ambition will count for little if NHS capital budgets continue to be raided, despite promises from the Government to buck this trend. There are reports that the Defence Investment Plan will draw from NHS capital budgets, which would likely lead to further delays to the New Hospital Programme. This means that the hospitals in the worst state of disrepair will keep swallowing cash for emergency repairs rather than being properly invested in.'