NAO report underlines urgent need for more NHS capital investment
22 January 2025
We respond to a National Audit Office (NAO) on public sector maintenance backlogs
A National Audit Office (NAO) report shows that public sector maintenance backlogs including hospitals are estimated to be at least £49bn.
Health leaders say it’s more proof of the urgent need to boost NHS capital investment after the government announced its review of the New Hospital programme (NHP).
Saffron Cordery, interim chief executive, NHS Providers, said:
"Almost £14bn is needed to plug a rocketing NHS repairs build-up.
"The safety of patients and staff is at risk. This can’t go on.
"The list of essential repairs across the NHS waiting to be done keeps getting longer and the costs are rocketing. Vital bits of the NHS are literally falling apart after years of underinvestment nationally.
"NHP trusts will also need to invest billions of pounds just to keep crumbling estates as safe as they can while they wait for new sites. Some NHS trusts in the NHP will be waiting almost 20 years from when schemes were promised to when construction will actually start.
"Lord Darzi’s government-commissioned diagnosis of the problems facing the NHS acknowledged what trust leaders have long called for. If we want to improve patient care and boost productivity, we need significantly more capital investment alongside wider reforms.
"We understand the government’s position on the need for planned and affordable spending and investment but more significant delays to vital improvement plans will affect patient care and hamper efforts to cut waiting lists – a government priority.
"We agree with the NAO that government departments should produce long-term property plans, setting out capital needs and a plan to reduce their backlog.
"Patients and staff need safe, reliable buildings, facilities and equipment for first-class, 21st century care."
Related articles
- News
Services remain severely stretched
19 Feb 2026Rory Deighton responds to the latest winter sitrep figures from NHS England.
Ambulance
Delivery and performance
- News
Supply disruption frustrating for patients and staff
18 Feb 2026Rory Deighton comments on disruption to supply of bone cement products, widely used in operations.
Delivery and performance
- News
Health leaders welcome government’s acceptance of Pay Review Bodies' recommendations for NHS staff
12 Feb 2026Rory Deighton, acute and community care director speaking on behalf of NHS Providers and the NHS Confederation, responds to government acceptance of pay recommendations for Agenda for Change staff.