England’s crumbling hospitals face a repair bill of almost £10 billion as infrastructure failures have led to sewage leaks and ceiling collapses in clinical areas, a new investigation into NHS data has revealed. At least 1,055 patients had their care impacted by infrastructure problems at NHS hospitals in England during the 2022/23 financial year.

The repairs to Greater Manchester hospitals total almost half-a-billion at least, as data available for some NHS hospital trusts in the region show a collective bill of just over £479m. The figures have come from an investigation by the BBC Shared Data Unit into the state of the country’s hospitals, uncovering the full scale of a backlog of repairs.

Figures have been published for five of Greater Manchester’s nine hospital trusts within the investigation. The repairs backlog at Manchester University NHS Foundation Trust (MFT) rose to over £254 million last year, meaning it faces one of the biggest repair bills in the country.

Only seven other trusts face larger repair bills, with Imperial College Healthcare NHS Trust (£735 million) and Guy’s and St Thomas’ NHS Trust (£452 million) leading the way.

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At least 1,055 patients had their care impacted by infrastructure problems at NHS hospitals in England during the 2022/23 financial year, such as cancellations or delays. Examples of some of the incidents caused by infrastructure failures which the investigation uncovered across England include:

• Patients awaiting kidney dialysis being sent home because of ventilation issues

• Sewage leaking into clinical areas for ophthalmology (eye care)

• Parts of ceiling collapsing in clinical areas

• Air conditioning failing in operating theatres

• Green algae growth in a hydrotherapy pool

• Power lost in an operating theatre

The BBC investigation also found that the amount of money it would cost to repair creaking hospital facilities has surged over the past year. Repairs in the backlog classed as ‘high-risk’ – those which must be urgently addressed to prevent catastrophic failure or major disruption to clinical services – are estimated at £2 billion. That’s a third higher than a year earlier.

Manchester

MFT would be likely to rank highly on the list of the most expensive repair bills as it is the largest hospital trust in the country, operating 10 hospitals around the region and employing nearly 30,000 staff.

The cost of general acute hospital repairs backlogs across MFT has risen 10 per cent from £231.2m to £254.5m in the last financial year, according to analysis of data released by NHS Digital. The backlog of high-risk repair costs has, however, fallen 40.9 per cent from £14m to £8.2m.

Hospitals operated by MFT include the Manchester Royal Infirmary, the Royal Manchester Children’s Hospital, North Manchester General Hospital, Trafford General Hospital, Wythenshawe Hospital, Saint Mary’s Hospital, and more.

North Manchester General Hospital faces the largest repair bill of any hospital on MFT’s estate, as the backlog there is worth an estimated £157 million. That’s followed by Wythenshawe Hospital at £47 million and Trafford General Hospital at £29 million.

The infrastructure problems at Manchester University NHS Foundation Trust caused nine incidents last year which impacted the treatment of 46 patients.

Over on Merseyside, Mersey Care NHS Foundation Trust had the highest number of patients affected by infrastructure problems of any trust to respond to the FOI requests about incidents affecting patients. A total of 143 patients were impacted across 15 separate incidents.

But back in Greater Manchester, there are more staggering figures.

Bolton

The cost of general acute hospital repair backlogs at Bolton NHS Foundation Trust, which operates the Royal Bolton Hospital, has risen 134.1 per cent from £33.9m to £79.5m in the last financial year, according to analysis of data released by NHS Digital. The backlog of high-risk repair costs has also risen 35.4 per cent from £7.1m to £9.7m.

However, in 2022-23, there were three ‘clinical service incidents caused by estates and infrastructure failure’, a drop compared to 264 such incidents in 2021-22.

Bury, Salford, Rochdale and Oldham

Northern Care Alliance NHS Foundation Trust (NCA) operates Salford Royal Hospital, Fairfield General Hospital, the Royal Oldham Hospital, Rochdale Infirmary, and Birch Hill Hospital. The cost of general acute hospital repairs backlogs across the NCA has fallen 16.9 per cent from £82m to £68.1m in the last financial year, according to analysis of data released by NHS Digital.

The backlog of high-risk repair costs has also fallen 51.4 per cent from £8m to £3.8m. In 2022-23, there were 28 ‘clinical service incidents caused by estates and infrastructure failure’, a drop compared to 55 such incidents in 2021-22.

The total backlog repair costs for all risk levels at each site as of 2022/23 is:

• Royal Oldham Hospital – £31.6m

• Fairfield General Hospital – £21.4m

• Rochdale Infirmary – £9.4m

• Salford Royal Hospital – £5.6m

• Birch Hill Hospital – £0

Stockport

Stockport NHS Foundation Trust runs Stepping Hill Hospital. The cost of general acute hospital repairs backlogs at the hospital has risen 2.5 per cent from £52.5m to £53.9m in the last financial year, according to analysis of data released by NHS Digital.

The backlog of high-risk repair costs has, however, fallen 34.2 per cent from £4.5m to £2.9m.

In 2022-23, there were 73 ‘clinical service incidents caused by estates and infrastructure failure,’ an increase compared to 32 such incidents in 2021-22.

Tameside

Tameside and Glossop Integrated Care NHS Foundation Trust operates Tameside General Hospital. The cost of general acute hospital repairs backlogs has fallen 0.3 per cent from £23.6m to £23.5m in the last financial year, according to analysis of data released by NHS Digital.

The backlog of high-risk repair costs has also fallen 21.4 per cent from £6.4m to £5m.

In 2022-23, there were 11 ‘clinical service incidents caused by estates and infrastructure failure,’ a drop compared to 91 such incidents in 2021-22.

Repairs long overdue

There are some hospital trusts in Greater Manchester that do not have data available within the investigation. They include Wrightington, Wigan and Leigh trust, Pennine Care trust, Greater Manchester Mental Health trust, and The Christie trust.

But many Greater Manchester hospitals have already shared their need for major refurbishments. The Manchester Evening News has reported how several have areas built with dangerous, crumbling RAAC concrete.

The Victorian-era North Manchester General Hospital has long been left crumbling and awaiting a decision about a potential rebuild, with the M.E.N. revealing in summer of last year that huge transformation project would finally go ahead. An approximate start date for ‘major works’ is 2025, with a completion date of 2030.

Both Stepping Hill and the Royal Bolton Hospital have had to relocate patients and even close major departments in recent weeks and months because of safety fears about their buildings.

‘Eye-watering cost of having to patch up creaking buildings’

The estimated cost to repair all infrastructure issues in the backlog reached more than £9.5 billion in England in 2022-23. There has been a rise of £867m over five years, adjusting for inflation.

Sir Julian Hartley, chief executive of NHS Providers, said: “The eye-watering cost of trying to patch up creaking buildings and out-of-date facilities is rocketing. The £11 billion-plus bill for a long ‘to do’ list of essential repairs across the NHS keeps growing at an alarming rate.

“Safety of patients and staff is at stake. More than half of the repairs backlog is of ‘high or significant risk’.

“Far too many NHS buildings and equipment are in a very bad way. To provide first-class care trusts – mental health, community and ambulance services as well as hospitals – need major capital investment from government to give patients and staff safe, efficient and reliable buildings, facilities and equipment.”

What does the government say?

A Department of Health and Social Care spokesperson responded to the investigation’s findings by saying: “We have invested significant sums to upgrade and modernise NHS buildings – including £4.2 billion this financial year – so staff have the facilities needed to provide world-class care for patients.

“Trusts are responsible for prioritising this funding to maintain and refurbish their premises, including the renewal and replacement of equipment.

“This is on top of the expected investment of over £20 billion for the New Hospital Programme, a further £1.7 billion for over 70 hospital upgrades across England, and a range of nationally funded infrastructure improvements in mental health, urgent and emergency care and diagnostic capacity.”

NHS Greater Manchester declined to comment further on the findings.

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