Conclusion 16

NHSE&I acknowledged that over the last few years, trusts have had to use some of their capital budgets to sustain day-to-day services (£1.2 billion in 2016–17, £1 billion in 2017–18, £500 million in 2018–19 and £470 million in 2019–20). NHSE&I told us that its aim is that this falls to zero this year.35 As at October 2019, trusts reported an estimated total backlog maintenance cost of £6.5 billion to restore their estates to an appropriate standard, of which £1.1 billion was high-risk, indicating an increased risk of harm to patients. NHSE&I acknowledged that having well-maintained hospitals is highly desirable, and the Department noted that there is now a clearer focus on directing capital funds to local areas with the greatest need.36