The government has confirmed funding and a realistic timetable to put the New Hospital Programme on track to deliver all of its hospital projects.
This credible timeline for delivery will ensure that staff and patients have access to the facilities they desperately need around the country as soon as possible.
It follows a review of the scheme which found that the previous government’s commitment to deliver ‘40 new hospitals’ by 2030 was behind schedule, unfunded and therefore undeliverable.
But the public spending watchdog has estimated that the government’s maintenance backlog is at least £49 billion; government will need to consider the best way to manage its assets alongside its long-term investment plans, in addition to the cost of ongoing maintenance, to bring property condition to a satisfactory level.
The National Audit Office (NAO) found that Ministry of Defence properties, schools and NHS properties have a backlog totalling more than £10 billion each and make up 88% of the total backlog. Sites including prisons, job and assessment centres, courts, and museums and galleries have backlogs less than £2 billion each and make up the remaining 12%.
“Allowing large maintenance backlogs to build up at the buildings used to deliver essential public services is a false economy,” said Gareth Davies, head of the NAO.
“Government needs better data on the condition of its operational assets and should use it to plan efficient maintenance programmes to deliver better services and value for money.”
The true cost of full remediation is not known, but the Office of Government Property (OGP) believes it could be substantially higher than estimated. This is because the government’s data on the condition of its properties is incomplete and out of date. The combination of incomplete data and the lack of a comprehensive strategy around asset management hinder the government’s ability to make effective funding decisions.
Building failures have affected the delivery of public services, government’s productivity and its ability to withstand shocks. On average, between 2019-20 and 2023-24, approximately 5,400 clinical service incidents occurred in the NHS every year due to property and infrastructure failures. Poor property condition can also negatively affect civil service productivity, staff retention, and the government’s ability to meet environmental targets.
The NAO is recommending that government implements a series of measures to address the backlogs. These include:
- mandating to departments and arms-length bodies a standardised definition of the maintenance backlog, so the true figure across government can be calculated.
- including data on the maintenance backlog in the State of the Estate report from 2026-27 onward.
- departments producing long-term property plans, setting out capital needs and a plan to reduce their backlog.
- considering ahead of the next and subsequent spending review periods, how the backlog could be tackled, by for example, where feasible, agreeing longer-term settlements for property investment and ring-fencing maintenance funding, or encouraging a thematic approach to bids that tackle similar problems across government property.
The government said it is committed to rebuilding our NHS and to rebuilding trust in government. The new plan, which is affordable and honest, will be backed with £15 billion of new investment over consecutive 5-year waves, averaging £3 billion a year.
Wes Streeting, Health and Social Care Secretary, said: “The New Hospital Programme we inherited was unfunded and undeliverable. Not a single new hospital was built in the past 5 years, and there was no credible funding plan to build 40 in the next 5 years.
“When I walked into the Department of Health and Social Care, I was told that the funding for the New Hospital Programme runs out in March. We were determined to put the programme on a firm footing, so we can build the new hospitals our NHS needs.”
The government said it had inherited buildings and equipment across the NHS that had been left to crumble, disrupting patient care and hindering staff.
As Lord Darzi found in his investigation, the NHS was starved of capital in the last decade, with £37 billion under-investment over the 2010s, leaving some hospitals with roofs that have fallen in, and leaking pipes which freeze over in winter.
Building an NHS estate that is fit for the future is key to the government’s Plan for Change that will get the health service back on its feet and see waiting times slashed. At the budget, the Chancellor announced that health capital spending in the NHS is set to increase to record levels of £13.6 billion in 2025 to 2026.
