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Published: 06/11/2026
NHS England’s annual Estates Returns Information Collection (ERIC)(1) brings together data reported by NHS trusts in England on the condition, running costs and maintenance of the estate used to deliver secondary care and ambulance services. It does not cover primary care premises. The figures include the estimated cost of eradicating backlog maintenance and annual investment to reduce that backlog.
Cost to clear NHS backlog maintenance rises to over £17.3 billion
The estimated cost of eradicating backlog maintenance across the NHS estate in England rose by 9.1% to £17.35 billion in 2025/26, according to the latest ERIC figures.
This represents an increase of £1.44 billion on the £15.91 billion reported in 2024/25.
The increase came despite a substantial rise in spending to address outstanding work. Investment to reduce backlog maintenance reached £1.65 billion, up 62.2% from £1.02 billion the previous year.
Dr David Crosthwaite, chief economist at BCIS, said: ‘The increase in spending is welcome, but the continued growth in the backlog shows the scale of the challenge facing NHS estates teams. They are having to address urgent repairs while planning improvements across an estate with substantial outstanding maintenance needs.’
More than half the backlog is high or significant risk
Backlog maintenance measures the estimated investment needed to restore buildings to a defined condition based on assessed risk. It covers work that should already have taken place and excludes planned maintenance.
Works classified as significant risk accounted for the largest share of the backlog, at £6.03 billion, followed by moderate risk work at £5.61 billion.
| Risk category | Estimated cost in 2025/26 | Annual change |
| High | £3.71bn | +5.8% |
| Significant | £6.03bn | +8.0% |
| Moderate | £5.61bn | +11.8% |
| Low | £2.00bn | +11.3% |
| Total | £17.35bn | +9.1% |
Source: NHS Estates Returns Information Collection
High and significant risk work together accounted for £9.74 billion, or 56.1% of the total estimated backlog.
The reported inflation element of the estimated backlog cost rose by 39.6%, from £401.6 million in 2024/25 to £560.5 million in 2025/26.
Dr Crosthwaite said: ‘With more than half the estimated backlog cost relating to high or significant risk work, prioritising investment requires a clear understanding of asset condition and the consequences of delaying repairs. Rising costs add to that pressure by increasing the funding needed to deliver outstanding work.’
Investment increased, particularly in critical infrastructure
Of the £1.65 billion spent reducing backlog maintenance, £1.22 billion was directed towards assets with critical infrastructure risk, an increase of 71.5% on the previous year. Investment in non-critical infrastructure risk work rose by 40.5% to £429.9 million.
Dr Crosthwaite added: ‘Higher spending does not automatically mean the reported backlog will fall. Further deterioration, newly identified work and changes in estimated costs can offset progress in addressing existing problems.’
NHS figures also show 6,697 clinical service incidents caused by estates and infrastructure failure in 2025/26, compared with 4,100 the previous year.
Rising maintenance costs add to the challenge
The latest BCIS maintenance, cleaning and energy forecast projects a 15.3% increase in maintenance costs over the five years to 2Q2031. Cleaning costs are expected to rise by 23.6% over the same period, driven primarily by labour costs. These indices cover the movement of maintenance costs in the wider economy rather than the NHS specifically, though BCIS publishes several specific health service maintenance cost indices as part of BCIS OpX.
Dr Crosthwaite said: ‘Budgets need to account for the cost of delivering work when it is scheduled to take place. Without that allowance, funding agreed today could pay for less work further down the line.
‘A sustained approach to maintenance, supported by reliable condition and cost data, can help estates teams plan programmes, test budgets and make the case for investment before problems become more disruptive and expensive to resolve.’
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(1) NHS- Estates Returns Information Collection - here
