NHS Confederation Chief Says £750m Infrastructure Investment is ‘Small Downpayment’ on Maintenance Backlog

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03 June 2025

Newly allocated funding to help fix “crumbling” infrastructure at NHS sites has been described as “a small downpayment on the £14 billion maintenance backlog that remains” by the CEO of the NHS Confederation.

A joint statement from the Department of Health and Social Care, Department for Education and NHS England revealed that NHS sites including hospitals, mental health units and ambulance sites will receive £750 million in funding to tackle leaky pipes, poor ventilation and electrical issues.

The government has published a list of NHS trusts that have been successful in securing funding and a summary of their planned projects and the facilities in scope.

NHS services were disrupted over 4,000 times between 2023-2024 due to building safety issues. 

The government also announced that 656 schools and sixth forms will receive a share of £470 million for building maintenance projects.

The maintenance backlog for the government estate in general, affecting hospitals, schools, job centres, courts, prisons, museums, research facilities, offices and warehouses, is estimated to be worth at least £49 billion. 

‘It Would Take Almost 20 Years to Clear the Backlog’

Matthew Taylor, Chief Executive of the NHS Confederation, welcomed the announcement of which NHS Trusts would receive funding but urged the government to look at other ways of raising capital to fix the maintenance backlog.

He said: “We welcome the news detailing which hospitals will receive funding and the projects that will be delivered to address high-priority estate issues across the NHS. This funding announced at the Autumn Budget is crucial for tackling infrastructure issues such as crumbling buildings, essential repairs and safety hazards that require urgent attention. It should contribute to efforts to improve NHS productivity and towards cutting waiting times for elective care, as outlined in the Plan for Change.” 

"However, £750 million is a small downpayment on the £14 billion maintenance backlog that remains. At £750 million a year, it would take almost 20 years to clear the backlog, assuming it does not continue to grow. 

“In the meantime, our members are committed to exploring other ways of raising the capital investment it needs. To significantly improve capacity and ensure healthcare facilities in the NHS are efficient and fit for purpose, the forthcoming Spending Review needs to address the capital funding gap of at least £3.3 billion a year. 

“It must also give the NHS the ability to secure additional investment over and above this through private investors and the adoption of a new model of private investment.”

Picture: a photograph of the exterior of a hospital building, with a sign showing the words "emergency". Image Credit: Pexels

Article written by Ella Tansley | Published 03 June 2025

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