NHS backlog maintenance bill in England rises to GBP 17.3 billion

The estimated cost of eradicating backlog maintenance across NHS trusts in England reached GBP 17.3 billion in 2025/26, up from GBP 15.9 billion a year earlier, according to the Estates Returns Information Collection (ERIC) published by NHS England on 15 October 2026. The figure is the investment needed to restore buildings to a defined condition based on assessed risk, and excludes planned maintenance.

All 205 trusts required to complete an ERIC return for 2025/26 did so, according to the publication’s data quality report. The collection covers NHS trusts and ambulance trusts for the year from 1 April 2025 to 31 March 2026, and is released as official statistics with trust, site and PFI-level data files.

Running costs and data caveats

The total cost of running the NHS estate rose to GBP 14.4 billion from GBP 14.0 billion in 2024/25. Energy consumption was 11.2 billion kWh, against 11.3 billion kWh the year before. Cleaning services cost GBP 1.6 billion and inpatient food GBP 0.8 billion, the same rounded figures as in 2024/25.

The headline summary does not split the backlog by risk category. NHS England says some data fields are currently marked as unreliable because of recent changes in definitions, and that metrics labelled experimental should not be used for comparisons over time. Its data quality report says the inflation element of the backlog cost field drew 268 validation queries, and that trusts were asked to review fields showing large changes from the previous year or from peers. Responsibility for accuracy rests with the trusts that submit the data, with each return signed off by a director of estates.

Reaction to the figures

Matthew Hopkins, director of The NHS Alliance, said the high and significant risk elements made up well over half of the total backlog, and called on the government to reconsider its decision to hold NHS capital investment flat over the current spending review period, Healthcare Management UK reported on 15 October. Professor Frank Smith, vice president of the Royal College of Surgeons of England, described the rise as nearly 9 per cent and said modernising NHS infrastructure was essential to reducing waiting lists, the same report said.

Siva Anandaciva, director of policy, events and partnerships at The King’s Fund, warned that ambitions for the NHS would count for little if capital budgets continued to be raided, citing reports that the Defence Investment Plan could draw on NHS capital budgets and delay the New Hospital Programme, according to Healthcare Management UK. The publication also reported that GBP 1.5 billion has been allocated from a GBP 6.75 billion NHS Estate Safety Fund for building improvements, maintenance and heat resilience.

Our reading

• The Healthcare Daily’s reading: the backlog grew by GBP 1.4 billion in a year, much more than the GBP 0.4 billion rise in total running costs. The cost of running the estate rose in 2025/26, and the estimated cost of restoring it rose faster.
• For estates, construction and facilities suppliers, the backlog measures deferred work, not funded demand. Spending depends on capital allocations such as the Estate Safety Fund, and the GBP 1.5 billion reported as allocated from it is less than a tenth of the GBP 17.3 billion total.
• Trust boards and investors should look past the national total to the trust and site files published alongside it. The split by risk category, not the headline total, shows where building failures are most likely to affect clinical services.