Most run-down NHS hospitals named and shamed – as staggering £14billion is needed to fix crumbling wards that pose a ‘catastrophic’ risk to patients

Crumbling hospitals pose a ‘catastrophic’ risk to patients, top experts warned today as the Daily Mail names and shames Britain’s most run-down NHS hospitals.

Exposing the ballooning £13.8billion maintenance backlog, our investigation reveals that five sites urgently need at least £100m of work.

Airedale General Hospital in West Yorkshire needs to fork out £316m just to fix ‘high risk’ issues, although the total bill sits just below £340m when accounting for other necessary repairs.

Burst pipes, crumbling ceilings and broken lifts are among the problems that plague NHS hospitals up and down the country.

MPs and influential voices in the NHS sphere have demanded ministers invest extra cash to finally end the ‘shameful neglect’ laid bare in our audit of the health service’s entire estate, covering almost 2,900 facilities. 

Helen Morgan, Lib Dem health and social care spokesperson, said: ‘When someone goes into hospital their only focus should be on getting better, not fearing the roof is going to cave in on them. 

‘Countless patients who should be focusing on their health are instead grappling with crumbling masonry, burst pipes and water leaking through the ceiling.’

Ms Morgan added: ‘Ministers need to step up and grasp this nettle before we see yet more buildings falling apart and patients put at risk.’

She urged ministers to bring forward plans to construct new hospitals, many of which were originally built in the 1960s or before. Some are even nearly 180 years old. 

Deriding the ‘squalid, unsafe and degrading’ settings that patients have become used to, she said: ‘The Conservatives’ shameful neglect of our NHS brought us to this point – but Labour have kicked rebuilding our hospitals into the long grass. 

‘By delaying vital new hospital projects they these issues will only get worse.’

To repair the crumbling estate and carry out day-to-day maintenance, Rachel Reeves this summer vowed to invest £30bn over the next five years as she said the the NHS was ‘on its knees’. 

Critical building repairs, such as those highlighted in our audit, will be targeted with a specific £5bn pot, the Chancellor announced.

Dr Layla McCay, director of policy at NHS Confederation, said: ‘More than a decade of being starved of capital investment has left NHS leaders struggling to deal with a host of estate problems, including leaking roofs, sewage leaks and broken lifts, causing misery for patients and staff.

‘Having fit for purpose hospitals is vital to improving patient care and boosting productivity – getting better value for taxpayers’ money. 

‘We know that dilapidated buildings and faulty equipment can pose a risk to patient safety as well as hamper efforts to reduce waiting lists.’

Even with the Government’s ramped up funding, Dr McCay said the NHS still needs an extra £3.3bn a year over the next three years to tackle the maintenance backlog. 

The NHS already gets around £180bn per year.

Our investigation found three of the five hospitals with the biggest bills for high risk work were in London.

Behind Airedale General Hospital ranked Charing Cross Hospital (estimated cost of £186m) and St Mary’s Hospital (£152m), both of which are in the capital. 

Wycombe Hospital (£139m) and Croydon University Hospital (£113m) rounded out the top five.

Trusts are asked to assess their own maintenance backlog each year.

As per the NHS’s own definition, high risk means: ‘Where repairs/replacements must be addressed with urgent priority.’ 

This is ‘in order to prevent catastrophic failure, major disruption to clinical services or deficiencies in safety liable to cause serious injury or prosecution’.

In total, the NHS’s overall bill for high risk issues stood at £2.7bn in 2023/24 – nearly three times higher than the £1bn in 2015/16.

The backlog at eleven medical sites is entirely categorised as ‘high risk’.

The largest of these was University Hospital of North Durham, which treats over one million patients per year. Its estimated bill stood at nearly £2.6m.

When counting all four types of backlog monitored centrally by NHS bosses, Charing Cross Hospital had the biggest maintenance bill (£412m). It was followed by Airedale (£339m), St Thomas’ Hospital in central London (£293m), St Mary’s Hospital (£287m) and Northwick Park and St Mark’s in Harrow (£239m).

Financial data for hundreds of the 2,900 facilities was not available. Sites with no recorded maintenance backlogs were also excluded from our analysis.

Dennis Reed, director of the senior citizen campaign organisation Silver Voices, told the Daily Mail that the NHS estate did not meet 21st century standards. 

He said: ‘Money due to be spent on buildings has been used for current spending and pressures on staff and services, so it’s very shortsighted budgeting by the NHS and now they’re in a critical position.

‘Some wards closed because they’re not sufficiently funded and some have buckets lying around the place to collect water when it rains.

‘We hear this a lot of talk from this Government about timeframes that extend into the next Parliament but it needs urgent treatment now because the NHS is in a state of accident and emergency.’

One of the primary concerns around the collapsing NHS estate is that of the presence of reinforced autoclaved aerated concrete (RAAC).

Builders used it extensively in roofing between the 1950s and 1990s, when dozens of hospitals were built or upgraded. 

The material is structurally weaker than traditional concrete and has been likened to a ‘chocolate Aero bar’. Being prone to moisture absorption and collapse has led to fears ceilings could collapse. 

Schools with RAAC present have already been forced to shut buildings over fears that ceilings could collapse.  

While in charge, the Tories vowed to eradicate RAAC from the NHS estate by 2035 in a pledge backed by an extra £700m.

Seven hospitals most affected by RAAC, including Airedale, were put under the New Hospital Programme (NHP) over fears they were ‘structurally unsound’.

The scheme – first launched under Boris Johnson in 2020 – vowed they would get a ‘full replacement’ by 2030. 

Forty new hospitals were also promised in the NHP, although the definition of ‘new’ was later clarified to mean upgraded.

But Labour Chancellor Rachel Reeves said last year that they would need to set out a ‘thorough, realistic and costed timetable’ for delivering the scheme. 

Health Secretary Wes Streeting in January accused the Tories of failing to fund their original plan, saying it had been ‘built on the shaky foundation of false hope’. He said: ‘To put it simply – there were not 40 of them, they were not all new and many were not even hospitals.’

Setting out a new timetable to complete a reviewed list of work encompassing both repairs and new projects, Mr Streeting said construction would proceed in four ‘waves’.

The first wave is already under construction, set to be completed within three years.

Under Department of Health and Social Care plans, construction work won’t start at Charing Cross Hospital until 2035 at the earliest. 

Upgrades there will cost up to £2bn, it is expected, with plans for a new 800-bed site and redevelopments of the wider campus. Some repair work is already ongoing, said the trust which runs the hospital.

Eric Munro, director of estates and facilities at Imperial College Healthcare NHS Trust, said: ‘Much of our estate pre-dates the NHS – some of our buildings are nearly 180 years old.

‘We’re spending £115m this year to reduce estate risks and make improvements, and we’re working hard with partners to try to accelerate our redevelopment programme, with all three of our main hospitals in the Government’s NHP.’

A Department of Health and Social Care spokesperson said: ‘The NHS estate we inherited is crumbling but repairing and rebuilding our hospitals is a key part of our ambition to create a health service fit for the future.

‘This Government has confirmed a funding plan and an honest, realistic timetable to deliver all schemes in the NHP, ensuring schemes are ready to enter construction as quickly as possible and that taxpayers get maximum value for money.’

What the hospitals said

A spokesperson for London North West University Healthcare NHS Trust said: ‘LNWH Trust has an ongoing programme of works to make sure our buildings remain safe for patients, but maintaining a large estate, much of which dates back to the 1970s, is a considerable drain on resources. Managing this challenge requires a constant cycle of monitoring, maintenance and prioritisation of works. We will continue to seek additional investment for our sites wherever we can, with recent new builds including a 32-bed ward to improve patient flow at Northwick Park Hospital and the community diagnostic centre at Ealing Hospital, which offers rapid access to a wide range of tests and scans.’

A spokesperson for Buckinghamshire Healthcare NHS Trust said: ‘Buckinghamshire Healthcare NHS Trust is committed to the redevelopment of Wycombe Hospital. Unfortunately, Wycombe has not been included in the New Hospital Programme, so we are looking at alternative ways of delivering the changes that are so desperately needed.  This will probably mean that any new building to replace the Tower will need to be constructed in a phased way, as and when funding becomes available. We have already completed the first stage of preparatory work, including things like ground investigations and utilities surveys, and are now working on detailed designs ahead of submitting a planning application at the end of this month. In the meantime, we are continuing to undertake essential maintenance work to ensure the safety of our patients and our colleagues. We would like to thank everyone for their patience as we continue to do our best to deliver outstanding care in an environment that we know is less than ideal.’

A spokesperson for Croydon Health Services NHS Trust said: ‘We are working hard to improve our estate to support the delivery of high-quality care, and through a planned maintenance regime we continuously monitor our buildings and infrastructure to ensure these remain safe and compliant with the required standards for healthcare settings. We know that there are parts of our estate that require significant investment to bring their condition to a satisfactory standard and we are continuing to explore all possible funding routes to secure the investment we need to make these improvements.’