The NAO report showed a total maintenance backlog of £49bn in schools, hospitals and prisons, while adding poor Government data meant the true cost was likely to be higher.
Gareth Davies, head of the NAO, said: ‘Allowing large maintenance backlogs to build up at the buildings used to deliver essential public services is a false economy. Government needs better data on the condition of its operational assets and should use it to plan efficient maintenance programmes to deliver better services and value for money.'
Estimates from the Cabinet Office suggest deferring backlog maintenance can increase costs by more than 50% over a two- to four-year period.
The report followed the Government's announcement that 18 hospitals will not begin construction until 2032 at the earliest under a revision to the New Hospital Programme.
The report found building failures had affected service deliver and productivity highlighting an average of 5,400 clinical service incidents occurred in the NHS every year due to property and infrastructure failures between 2019-20 and 2023-24.
NHS England's maintenance backlog increased at an average of £800m per year (in 2023-24 real terms) between 2013-14 and 2022-23.
Reaction
Saffron Cordery, interim chief executive, NHS Providers, said: ‘We understand the Government's position on the need for planned and affordable spending and investment but more significant delays to vital improvement plans will affect patient care and hamper efforts to cut waiting lists – a Government priority.
‘We agree with the NAO that Government departments should produce long-term property plans, setting out capital needs and a plan to reduce their backlog.'
Matthew Taylor, chief executive of the NHS Confederation, said capital funding allocated by the Government was £3.3bn short of what was required and called for a review of the upcoming Spending Review.
The NHS Confederation will be shortly publishing a report setting out proposals for reforming how existing capital spending for healthcare is allocated and spent.
A Government spokesperson said: 'We are taking immediate action to remedy the state of disrepair found across the public estate, which is the result of long-term underinvestment in maintenance and upkeep.
'As part of this, we are already investing billions of pounds to deliver critical repairs and rebuild our public services, to tackle maintenance backlogs and improve our hospitals, schools and prisons as we deliver on the Plan for Change.'
