NHS maintenance backlog reaches £17.3 billion, latest ERIC data shows

The cost of clearing the NHS maintenance backlog in England has reached £17.3 billion, up from £15.9 billion a year earlier, according to the latest Estates Returns Information Collection (ERIC) that was published yesterday (15 October).

NHS England Digital published the 2025/26 figures, which cover the year from 1 April 2025 to 31 March 2026. Every NHS trust, including ambulance trusts, must submit its own ERIC returns, making this data the most complete picture of the NHS’s condition and what it would cost to fix it.

What the headline ERIC figures show

• Clearing backlog maintenance would cost £17.3 billion, a rise of nearly 9 per cent.
• Running the NHS estate cost £14.4 billion, up from £14.0 billion.
• The estate used 11.2 billion kWh of energy.
• Cleaning services cost £1.6 billion.
• Inpatient food cost £0.8 billion.

The backlog figure is the investment needed to bring buildings up to an acceptable condition, based on assessed risk. It doesn’t include planned maintenance, so the true cost of keeping the estate in working order over time would be even higher.

How does this backlog compare to other figures?

The backlog figures have been larger than the annual cost of running the whole estate since 2023/24, and the gap is increasing. It is now rising roughly three times faster than running costs.

This is not a new issue, however. The backlog stood at £6.5 billion in 2018/19, so it has more than doubled in seven years. NHS England Digital has stated that definitions and limitations have changed and some fields are new to the collection, but the direction is clear.

There is a small sign that growth is easing. The backlog rose by 16 to 19 per cent a year in the previous two collections, against nearly 9 per cent this time.

What this means for NHS trusts

With capital budgets tight, trusts are being asked to make £17.3 billion of repairs stretch further. That makes accurate condition data, a clear view of risk and a long-term maintenance plan essential.

Chris Soar, director and head of public sector valuations at BTG Eddisons, said: “The backlog has now hit £17.3 billion, and trusts can’t afford to tackle all of it at once. Working out which buildings are in poor condition is the easy part. The harder question is which ones justify the spend, and that depends on what each site is worth and how critical it is to service delivery.

“A current valuation helps answer that. It can show you which assets are surplus to requirements, put figures behind an investment case, and free up capital from buildings that no longer suit how services are run. The backlog is now higher than the annual cost of running the estate, so I’d encourage trusts to get valuation advice early rather than leave it until the plan is already set.”

Energy use has also become a key focus. Retrofit work and fabric-first initiatives can reduce running costs and tackle backlog items at the same time, while supporting the NHS’s net zero commitments.

What happens next?

The data published alongside the summary will show which trusts carry the highest-risk backlog and how the burden is spread across the country. Whether capital settlements keep pace with that risk, or whether the gap between running costs and the backlog keeps growing is one to watch.

If you manage an NHS trust or one of its estates and would like to understand more about how we can support your maintenance backlog, complete the form below and a member of the BTG Eddisons team will be in touch.