Badly maintained buildings can be a risk for all

David Jones, director of Estates, Facilities and Capital Development at the University Hospital Southampton NHS Foundation Trust, argues that more thought must be given to the potential risk to patient, staff, and visitor well-being of operating out of hospital buildings that are neither ‘sound’, nor ‘operationally safe’. He also questions why there is not more published research on the impact of an often ageing and poor quality healthcare estate on both quality of care and patient outcomes. 

The recent global pandemic caused by SARS-CoV-2 highlighted significant shortcomings in the infrastructure of healthcare estate across the National Health Service. A report commissioned by the Institute for Government, ‘How Fit were Public Service for Coronavirus’, stated that ‘The NHS could have entered this crisis with a more resilient health infrastructure if it had invested more in recent years’.¹ However, while the pandemic has added additional stressors to the estate, this is not a new issue. 

In 2021, the National Patient Safety Agency (NPSA) released data which states that clinical service incidents citing work and environmental factors in 2019/20 had doubled to over 115,000 incidents since 2011/12,² accounting for 5.3% of all reported incidents. In the same year, the latest Estates Returns Information Collections (ERIC)3 highlighted that for five years in a row the cost to eradicate backlog maintenance within the NHS had grown, reaching an all-time high of £9.034 bn in 2020/21.