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4 days ago
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Hospital buildings in England are in such a dilapidated state they risk fires, floods and electrical faults, internal NHS trust documents reveal, with leaders saying conditions have become “outright dangerous”.
Official papers from NHS trust board meetings show how staff and patients are being put at risk by an alarming array of hazards due to weaknesses in hospitals’ infrastructure.
The findings come as Matthew Taylor, the chief executive of the NHS Confederation, said parts of the health estate were so rundown “some patients are being treated in unsafe and sometimes outright dangerous facilities”.
Taylor pinned the blame on “decades of underinvestment” in the health service’s capital budget – used to repair and replace buildings and equipment – which meant the NHS received “woefully” less funding than comparable countries.
A Guardian analysis of hospital board papers found that Stepping Hill hospital in Stockport is in such a state of rapid decline that 13 different parts of it are classed as “at serious risk of imminent breakdown”. They include the pathology unit, mortuary, Bobby Moore cancer unit, chest clinic, datacentre and electricity substation.
Minutes from the hospital’s board meeting in October also reveal that its intensive care unit is at “risk of service disruption from leaks from the plant room above”, that 15% more of the hospital poses a “significant risk” than did so in 2021 and that it is likely to face a growing number of lawsuits because its worsening disrepair will cause “increased health and safety incidents”.
Doncaster and Bassetlaw trust is facing major safety risks at the three hospitals it runs, its board was told last month. Among the most serious is the “increased risk to life and property in the event of fire due to current inadequacy of fire compartmentation” – fire-resistant material that is intended to stop flames and smoke from advancing to other parts of a building.
A paper presented to the board added that “fire compartmentation has been identified as being inadequate in each of the trust’s properties”. Although fire compartmentation is required, its inadequacy means that “as a result there is currently an increased risk to life and property in the event of a fire”. A suspected fire on 22 October led to a full evacuation, the paper adds.
The trust’s cold water storage tanks are so old and in such need of remedial work that they could produce legionella, the bacteria that causes legionnaires’ disease, which could affect staff and patients.
In addition, the ventilation systems serving “operating theatres and other critical areas” at the South Yorkshire trust “are not fit for purpose” and could break down because they are “aged, life-expired [and] unsuitable”. There is also a “risk of electrical failure due to [the] age and condition” of the electrical infrastructure and also a “risk of critical lift failure”, which could disrupt clinical care.
Croydon hospital has run into problems after it outsourced to private firms the preparation of chemotherapy for cancer patients after shutting its aseptic unit, where such drugs are usually put together, for refurbishment. Hospital bosses are concerned that supply of the chemotherapy may not be enough to meet the need from cancer patients. And the timescale of the refurbishment is uncertain because of “insufficient agreed capital funding and increasing costs of outsourcing”.
The hospital is also facing the “risk of malfunction or loss of critical medical equipment due to failure of electrical sockets” in eight of its operating theatres, critical care unit, high dependency unit, special care baby unit and X-ray department because of their “environmental condition”.
Papers presented to the hospital’s board last month also show that the physical condition of the hospital is such a concern that there is a “risk of partial or whole loss of infrastructure due to the inability to renew or repair the estate in a timely manner”. Over the past year, the cost of tackling its huge backlog of repairs has shot up to £267m as the site has deteriorated.
Barts Health trust in London is facing major challenges related to the crumbling estate at some of the five hospitals it runs, board papers show. It has “insufficient body freezer spaces to prevent the decomposition of patients in storage” while water leaks pose a “risk of loss of pathology services and staff safety”.
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In addition, fire is a hazard at the trust’s Newham general hospital because cladding there is “non-compliant to building regulations”. As a result there is a risk of “suspension of core services and prosecution from non-compliance of the fire safety order”.
Problems at Whipps Cross hospital, which Barts also runs, include “drainage issues … leading to potential floods and loss of services”, a “risk of serious harm and prosecution due to the failure to manage electrical safety” and also a risk of “delays in care and possible harm to babies due to the age and state of repair of our fleet of ventilators in [the] neonatal unit”.
The cost of repairing crumbling NHS facilities in England has soared to £13.8bn, with £2.7bn of the works needed classed as posing a “high risk” to safety, the latest NHS figures show. That is more than the service received every year in capital funding.
The NHS will need an extra £6.4bn a year each year between 2025 and 2028 in order to keep its estate in good working order and improve productivity by the expected 2%, Taylor added.
Patients should not be treated in dangerous hospitals, said Andrew Gwynne, a health minister. He blamed the deepening problems with the NHS’s estate on the previous government. He said: “Years of neglect and underinvestment left NHS buildings crumbling, staff forced to use outdated creaking equipment, and patients paying the price. It is unacceptable for patients to be treated in these conditions.
“Lord Darzi diagnosed the problem, and now this government is providing the medicine the NHS needs. The budget provided an additional £13.6bn to invest in new buildings, equipment, and technology, the largest capital investment in the NHS for over 15 years.
“It will take time to rebuild our NHS, but with our plan for change this government is providing the investment and reform needed to make the service fit for the future.”
