The NHS maintenance backlog reached £15.91bn in 2024/25 — £625/m² of occupied floor space. That national figure hides an enormous spread. This is PM Assist's own analysis of the NHS Estates Returns Information Collection, normalising every trust's backlog against the floor area it actually maintains, and ranking all 201 trusts with a substantial estate.
The headline figure
£625/m²
The NHS maintenance backlog works out at £625/m² of occupied floor space.
Dividing the £15.91 billion total backlog reported in ERIC 2024/25 by the 25.4 million m² of occupied floor area across 207 trusts gives £625/m². The median trust sits lower, at £431/m², so the national average is pulled up by a minority of badly affected estates.
How this was calculated: Sum of high, significant, moderate and low risk backlog across all trusts, divided by the sum of occupied floor area. · Link to this figure
Citing this analysis?
PM Assist, "NHS Maintenance Backlog by Trust: 2024/25 Analysis", analysis of NHS England, Estates Returns Information Collection (ERIC) 2024/25, 2026. https://pmassist.co.uk/nhs-maintenance-backlog-by-trust
Every figure below is derived from the ERIC trust-level return. Each states the calculation behind it, and has its own anchor link if you want to cite it directly.
At the 90th percentile a trust carries £1,240/m²; at the 10th, £116/m². Airedale NHS Foundation Trust tops the table at £4,457/m². The national conversation treats the backlog as a single number, but at trust level it is a distribution with an order-of-magnitude spread.
How this was calculated: Percentiles across the 201 ranked trusts. Trusts below 10,000 m² of occupied floor area, and the 4 reporting zero backlog against a substantial estate, are excluded from the ranking but remain in the national totals.
The 20 trusts with the highest backlog per square metre account for £4.51 billion of the £15.91 billion national total. The backlog is a concentrated problem, not an evenly spread one: fixing the worst twenty estates would clear more than a quarter of it.
How this was calculated: Trusts ranked by backlog per m²; the top 20 rows summed and expressed as a share of the national total.
London averages £1,010/m² against £404/m² in North West — a 2.5x gap between the most and least burdened regions.
How this was calculated: Trust backlog and floor area summed within each region, then divided.
Across 40 trusts where 25% or more of the floor area predates 1965, the median backlog is £447/m², against £431/m² across the 161 newer estates.
How this was calculated: Pre-1965 share is the sum of the ERIC age-profile bands up to 1964. Medians are used rather than means because both groups contain outliers.
All 201 trusts reporting at least 10,000 m² of occupied floor area in ERIC 2024/25, ranked by total backlog divided by that floor area.
| # | Trust | Region | Backlog | Floor area | Backlog per m² | High/significant risk |
|---|---|---|---|---|---|---|
| 1 | Airedale NHS Foundation Trust | North East and Yorkshire | £319m | 71,565 m² | £4,457 | 93.7% |
| 2 | Imperial College Healthcare NHS Trust | London | £902m | 283,605 m² | £3,180 | 96.4% |
| 3 | London North West University Healthcare NHS Trust | London | £463m | 198,177 m² | £2,337 | 40.6% |
| 4 | Whittington Health NHS Trust | London | £185m | 84,800 m² | £2,177 | 82.4% |
| 5 | Croydon Health Services NHS Trust | London | £184m | 89,054 m² | £2,068 | 97.2% |
| 6 | The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust | East of England | £128m | 66,794 m² | £1,913 | 82.7% |
| 7 | James Paget University Hospitals NHS Foundation Trust | East of England | £119m | 62,440 m² | £1,906 | 86.7% |
| 8 | Homerton Healthcare NHS Foundation Trust | London | £132m | 69,412 m² | £1,901 | 82.6% |
| 9 | South London and Maudsley NHS Foundation Trust | London | £173m | 93,721 m² | £1,846 | 28% |
| 10 | The Hillingdon Hospitals NHS Foundation Trust | London | £146m | 82,896 m² | £1,765 | 91.2% |
| 11 | Bradford District Care NHS Foundation Trust | North East and Yorkshire | £60m | 34,378 m² | £1,740 | 26.8% |
| 12 | West Suffolk NHS Foundation Trust | East of England | £111m | 64,494 m² | £1,726 | 77.8% |
| 13 | Epsom and St Helier University Hospitals NHS Trust | London | £142m | 83,159 m² | £1,709 | 76.5% |
| 14 | Buckinghamshire Healthcare NHS Trust | South East | £259m | 178,472 m² | £1,454 | 87.6% |
| 15 | South Central Ambulance Service NHS Foundation Trust | South East | £59m | 42,099 m² | £1,405 | 73.1% |
| 16 | Bolton NHS Foundation Trust | North West | £129m | 92,088 m² | £1,401 | 20.4% |
| 17 | Royal Berkshire NHS Foundation Trust | South East | £161m | 115,858 m² | £1,390 | 58.7% |
| 18 | East Kent Hospitals University NHS Foundation Trust | South East | £240m | 180,953 m² | £1,326 | 65.4% |
| 19 | Nottingham University Hospitals NHS Trust | Midlands | £443m | 338,744 m² | £1,308 | 38.2% |
| 20 | North Tees and Hartlepool NHS Foundation Trust | North East and Yorkshire | £155m | 118,779 m² | £1,307 | 43.4% |
| 21 | Barts Health NHS Trust | London | £523m | 421,665 m² | £1,240 | 70.6% |
| 22 | Sheffield Childrens NHS Foundation Trust | North East and Yorkshire | £68m | 56,065 m² | £1,216 | 12.7% |
| 23 | University College London Hospitals NHS Foundation Trust | London | £253m | 212,704 m² | £1,190 | 71.1% |
| 24 | Bedfordshire Hospitals NHS Foundation Trust | East of England | £170m | 142,941 m² | £1,189 | 66% |
| 25 | East Sussex Healthcare NHS Trust | South East | £171m | 145,153 m² | £1,176 | 51.8% |
| 26 | Clatterbridge Cancer Centre NHS Foundation Trust | North West | £46m | 40,101 m² | £1,150 | 40.3% |
| 27 | Guy's and St Thomas' NHS Foundation Trust | London | £532m | 471,597 m² | £1,128 | 61.6% |
| 28 | The Mid Cheshire Hospitals NHS Foundation Trust | North West | £112m | 99,503 m² | £1,121 | 44.8% |
| 29 | Ashford and St. Peter's Hospitals NHS Foundation Trust | South East | £93m | 83,738 m² | £1,115 | 42.2% |
| 30 | West Hertfordshire Teaching Hospitals NHS Trust | East of England | £162m | 148,668 m² | £1,090 | 33.8% |
| 31 | The Princess Alexandra Hospital NHS Trust | East of England | £65m | 61,677 m² | £1,053 | 61.7% |
| 32 | Medway NHS Foundation Trust | South East | £108m | 102,547 m² | £1,051 | 50% |
| 33 | University Hospitals Birmingham NHS Foundation Trust | Midlands | £441m | 440,007 m² | £1,001 | 65.7% |
| 34 | Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust | North East and Yorkshire | £151m | 151,398 m² | £1,000 | 79.2% |
| 35 | Cambridge University Hospitals NHS Foundation Trust | East of England | £238m | 243,929 m² | £976 | 56.5% |
| 36 | Surrey and Sussex Healthcare NHS Trust | South East | £96m | 100,469 m² | £956 | 44% |
| 37 | Dorset County Hospital NHS Foundation Trust | South West | £57m | 59,330 m² | £953 | 66% |
| 38 | Sandwell and West Birmingham Hospitals NHS Trust | Midlands | £187m | 204,801 m² | £915 | 14.3% |
| 39 | Somerset NHS Foundation Trust | South West | £185m | 204,563 m² | £903 | 35.3% |
| 40 | Coventry and Warwickshire Partnership NHS Trust | Midlands | £58m | 64,716 m² | £903 | 71% |
| 41 | Salisbury NHS Foundation Trust | South West | £82m | 92,810 m² | £883 | 9.8% |
| 42 | Oxford University Hospitals NHS Foundation Trust | South East | £265m | 306,209 m² | £866 | 59.9% |
| 43 | University Hospital Southampton NHS Foundation Trust | South East | £165m | 192,190 m² | £858 | 38.9% |
| 44 | The Walton Centre NHS Foundation Trust | North West | £22m | 27,240 m² | £825 | 34.1% |
| 45 | Essex Partnership University NHS Foundation Trust | East of England | £115m | 139,714 m² | £823 | 13.4% |
| 46 | Hampshire Hospitals NHS Foundation Trust | South East | £111m | 136,141 m² | £819 | 53.5% |
| 47 | Gateshead Health NHS Foundation Trust | North East and Yorkshire | £74m | 93,000 m² | £795 | 27.2% |
| 48 | Birmingham Women's and Children's NHS Foundation Trust | Midlands | £72m | 91,435 m² | £790 | 61.5% |
| 49 | Queen Victoria Hospital NHS Foundation Trust | South East | £21m | 27,007 m² | £789 | 63.2% |
| 50 | United Lincolnshire Teaching Hospitals NHS Trust | Midlands | £126m | 163,927 m² | £769 | 38.3% |
| 51 | St George's University Hospitals NHS Foundation Trust | London | £106m | 142,464 m² | £743 | 74.4% |
| 52 | Bradford Teaching Hospitals NHS Foundation Trust | North East and Yorkshire | £110m | 150,328 m² | £734 | 55.6% |
| 53 | Countess of Chester Hospital NHS Foundation Trust | North West | £52m | 73,724 m² | £704 | 65.3% |
| 54 | Royal Devon University Healthcare NHS Foundation Trust | South West | £168m | 240,867 m² | £698 | 30.2% |
| 55 | Norfolk Community Health and Care NHS Trust | East of England | £30m | 43,576 m² | £691 | 21.8% |
| 56 | York and Scarborough Teaching Hospitals NHS Foundation Trust | North East and Yorkshire | £115m | 170,448 m² | £672 | 71.3% |
| 57 | Royal United Hospitals Bath NHS Foundation Trust | South West | £75m | 113,242 m² | £662 | 45.1% |
| 58 | South Warwickshire University NHS Foundation Trust | Midlands | £56m | 86,200 m² | £654 | 62.2% |
| 59 | Stockport NHS Foundation Trust | North West | £68m | 104,265 m² | £651 | 66.1% |
| 60 | Kingston Hospital NHS Foundation Trust | London | £35m | 53,284 m² | £649 | 96.3% |
| 61 | Humber Teaching NHS Foundation Trust | North East and Yorkshire | £30m | 46,790 m² | £647 | 21.9% |
| 62 | Kettering General Hospital NHS Foundation Trust | Midlands | £54m | 83,729 m² | £643 | 51.4% |
| 63 | Royal National Orthopaedic Hospital NHS Trust | London | £34m | 53,476 m² | £642 | 49.4% |
| 64 | Royal Free London NHS Foundation Trust | London | £152m | 238,904 m² | £635 | 86.2% |
| 65 | The Newcastle upon Tyne Hospitals NHS Foundation Trust | North East and Yorkshire | £182m | 294,937 m² | £618 | 55.9% |
| 66 | Frimley Health NHS Foundation Trust | South East | £105m | 171,058 m² | £613 | 52% |
| 67 | Tameside and Glossop Integrated Care NHS Foundation Trust | North West | £61m | 99,736 m² | £608 | 72.7% |
| 68 | Leeds Teaching Hospitals NHS Trust | North East and Yorkshire | £254m | 429,104 m² | £592 | 54.3% |
| 69 | North West Ambulance Service NHS Trust | North West | £36m | 62,069 m² | £574 | 21.6% |
| 70 | Torbay and South Devon NHS Foundation Trust | South West | £64m | 111,757 m² | £574 | 38.7% |
| 71 | Kent Community Health NHS Foundation Trust | South East | £29m | 50,148 m² | £573 | 35.3% |
| 72 | East Suffolk and North Essex NHS Foundation Trust | East of England | £122m | 215,900 m² | £567 | 42.9% |
| 73 | Royal Surrey County Hospital NHS Foundation Trust | South East | £50m | 89,667 m² | £555 | 53.9% |
| 74 | Worcestershire Acute Hospitals NHS Trust | Midlands | £72m | 131,145 m² | £548 | 54.5% |
| 75 | Sheffield Teaching Hospitals NHS Foundation Trust | North East and Yorkshire | £180m | 328,495 m² | £548 | 33.6% |
| 76 | University Hospitals Bristol and Weston NHS Foundation Trust | South West | £121m | 223,148 m² | £541 | 54.9% |
| 77 | Harrogate and District NHS Foundation Trust | North East and Yorkshire | £33m | 62,392 m² | £535 | 50.4% |
| 78 | University Hospitals Sussex NHS Foundation Trust | South East | £186m | 359,520 m² | £518 | 58.6% |
| 79 | Isle of Wight NHS Trust | South East | £32m | 60,998 m² | £518 | 71.4% |
| 80 | Manchester University NHS Foundation Trust | North West | £278m | 537,714 m² | £517 | 48.2% |
| 81 | Wirral University Teaching Hospital NHS Foundation Trust | North West | £61m | 119,584 m² | £511 | 54.3% |
| 82 | Surrey and Borders Partnership NHS Foundation Trust | South East | £26m | 52,763 m² | £499 | 22.3% |
| 83 | Hertfordshire Community NHS Trust | East of England | £11m | 21,485 m² | £497 | 35.3% |
| 84 | Wrightington, Wigan and Leigh NHS Foundation Trust | North West | £66m | 132,677 m² | £497 | 55.3% |
| 85 | Hull University Teaching Hospitals NHS Trust | North East and Yorkshire | £93m | 187,183 m² | £495 | 54.9% |
| 86 | Oxleas NHS Foundation Trust | London | £34m | 69,686 m² | £489 | 100% |
| 87 | South Tyneside and Sunderland NHS Foundation Trust | North East and Yorkshire | £96m | 195,825 m² | £488 | 44.8% |
| 88 | Sheffield Health and Social Care NHS Foundation Trust | North East and Yorkshire | £19m | 39,939 m² | £486 | 61.1% |
| 89 | Gloucestershire Hospitals NHS Foundation Trust | South West | £83m | 173,114 m² | £479 | 66.7% |
| 90 | Royal Cornwall Hospitals NHS Trust | South West | £55m | 115,328 m² | £479 | 33.8% |
| 91 | Warrington and Halton Teaching Hospitals NHS Foundation Trust | North West | £45m | 94,226 m² | £474 | 56.4% |
| 92 | Milton Keynes University Hospital NHS Foundation Trust | East of England | £34m | 72,295 m² | £470 | 81% |
| 93 | University Hospitals Plymouth NHS Trust | South West | £84m | 180,454 m² | £466 | 52% |
| 94 | East and North Hertfordshire NHS Trust | East of England | £56m | 120,647 m² | £464 | 78.7% |
| 95 | The Royal Marsden NHS Foundation Trust | London | £43m | 92,452 m² | £462 | 23% |
| 96 | Shrewsbury and Telford Hospital NHS Trust | Midlands | £55m | 123,212 m² | £450 | 73.4% |
| 97 | Herefordshire and Worcestershire Health and Care NHS Trust | Midlands | £35m | 77,804 m² | £449 | 32.8% |
| 98 | Hertfordshire Partnership University NHS Foundation Trust | East of England | £24m | 53,328 m² | £444 | 46.5% |
| 99 | North West Anglia NHS Foundation Trust | East of England | £70m | 161,862 m² | £435 | 42.9% |
| 100 | The Lewisham and Greenwich NHS Trust | London | £66m | 152,269 m² | £432 | 23.7% |
| 101 | University Hospitals of Leicester NHS Trust | Midlands | £136m | 315,205 m² | £431 | 70.6% |
| 102 | Liverpool Heart and Chest Hospital NHS Foundation Trust | North West | £13m | 31,062 m² | £431 | 59.2% |
| 103 | Midlands Partnership University NHS Foundation Trust | Midlands | £48m | 113,400 m² | £426 | 79.9% |
| 104 | East Midlands Ambulance Service NHS Trust | Midlands | £17m | 39,715 m² | £423 | 61.4% |
| 105 | Devon Partnership NHS Trust | South West | £23m | 54,419 m² | £422 | 74% |
| 106 | Pennine Care NHS Foundation Trust | North West | £30m | 71,744 m² | £413 | 22.3% |
| 107 | Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust | Midlands | £15m | 37,987 m² | £407 | 25.3% |
| 108 | Sussex Partnership NHS Foundation Trust | South East | £31m | 75,914 m² | £403 | 37% |
| 109 | Northern Care Alliance NHS Foundation Trust | North West | £121m | 303,182 m² | £398 | 37.1% |
| 110 | Northern Lincolnshire and Goole NHS Foundation Trust | North East and Yorkshire | £66m | 166,976 m² | £397 | 78.6% |
| 111 | University Hospitals Dorset NHS Foundation Trust | South West | £66m | 165,981 m² | £396 | 42.5% |
| 112 | Central and North West London NHS Foundation Trust | London | £45m | 118,343 m² | £383 | 62.3% |
| 113 | Derbyshire Community Health Services NHS Foundation Trust | Midlands | £23m | 59,851 m² | £377 | 37.9% |
| 114 | Rotherham Doncaster and South Humber NHS Foundation Trust | North East and Yorkshire | £19m | 50,043 m² | £375 | 42.1% |
| 115 | Northampton General Hospital NHS Trust | Midlands | £41m | 111,131 m² | £372 | 43.7% |
| 116 | Barking, Havering and Redbridge University Hospitals NHS Trust | London | £58m | 155,255 m² | £372 | 43.9% |
| 117 | West London NHS Trust | London | £46m | 125,754 m² | £362 | 32.7% |
| 118 | Northumbria Healthcare NHS Foundation Trust | North East and Yorkshire | £67m | 185,149 m² | £361 | 57.7% |
| 119 | Lancashire Teaching Hospitals NHS Foundation Trust | North West | £66m | 187,123 m² | £354 | 61.2% |
| 120 | Maidstone and Tunbridge Wells NHS Trust | South East | £47m | 133,097 m² | £350 | 56.6% |
| 121 | East Cheshire NHS Trust | North West | £17m | 48,841 m² | £348 | 49.8% |
| 122 | Calderdale and Huddersfield NHS Foundation Trust | North East and Yorkshire | £44m | 126,420 m² | £346 | 79.9% |
| 123 | Walsall Healthcare NHS Trust | Midlands | £33m | 96,513 m² | £342 | 27.8% |
| 124 | The Royal Wolverhampton NHS Trust | Midlands | £65m | 191,871 m² | £341 | 63.8% |
| 125 | East London NHS Foundation Trust | London | £35m | 101,469 m² | £340 | 52% |
| 126 | Norfolk and Suffolk NHS Foundation Trust | East of England | £27m | 82,576 m² | £328 | 30.7% |
| 127 | Mid Yorkshire Teaching NHS Trust | North East and Yorkshire | £70m | 217,702 m² | £323 | 46.1% |
| 128 | Barnsley Hospital NHS Foundation Trust | North East and Yorkshire | £23m | 72,369 m² | £322 | 66.5% |
| 129 | North London NHS Foundation Trust | London | £24m | 76,854 m² | £317 | 52.5% |
| 130 | University Hospitals of Morecambe Bay NHS Foundation Trust | North West | £43m | 136,574 m² | £313 | 63.8% |
| 131 | Cambridgeshire Community Services NHS Trust | East of England | £10m | 31,312 m² | £309 | 59.1% |
| 132 | Liverpool Women's NHS Foundation Trust | North West | £10m | 32,556 m² | £296 | 58.2% |
| 133 | George Eliot Hospital NHS Trust | Midlands | £18m | 60,232 m² | £291 | 36.5% |
| 134 | North Middlesex University Hospital NHS Trust | London | £24m | 83,303 m² | £289 | 52.4% |
| 135 | South Western Ambulance Service NHS Foundation Trust | South West | £16m | 55,436 m² | £283 | 51.3% |
| 136 | Dorset Healthcare University NHS Foundation Trust | South West | £29m | 103,631 m² | £282 | 50.7% |
| 137 | County Durham and Darlington NHS Foundation Trust | North East and Yorkshire | £44m | 158,141 m² | £278 | 35.9% |
| 138 | University Hospitals of Derby and Burton NHS Foundation Trust | Midlands | £83m | 298,509 m² | £277 | 31.3% |
| 139 | Royal Orthopaedic Hospital NHS Foundation Trust | Midlands | £7m | 25,453 m² | £277 | 31.4% |
| 140 | Hampshire and Isle of Wight Healthcare NHS Foundation Trust | South East | £41m | 153,210 m² | £268 | 24.8% |
| 141 | Kent and Medway NHS and Social Care Partnership Trust | South East | £17m | 63,415 m² | £267 | 16.9% |
| 142 | Avon and Wiltshire Mental Health Partnership NHS Trust | South West | £20m | 77,163 m² | £263 | 24.6% |
| 143 | King's College Hospital NHS Foundation Trust | London | £71m | 272,955 m² | £261 | 30.6% |
| 144 | Greater Manchester Mental Health NHS Foundation Trust | North West | £30m | 117,966 m² | £253 | 9.7% |
| 145 | Sussex Community NHS Foundation Trust | South East | £17m | 69,758 m² | £249 | 36.7% |
| 146 | Birmingham and Solihull Mental Health NHS Foundation Trust | Midlands | £21m | 86,274 m² | £248 | 23.7% |
| 147 | North Bristol NHS Trust | South West | £42m | 176,394 m² | £241 | 64.9% |
| 148 | University Hospitals of North Midlands NHS Trust | Midlands | £51m | 214,872 m² | £238 | 29.3% |
| 149 | Gloucestershire Health and Care NHS Foundation Trust | South West | £16m | 68,756 m² | £235 | 35% |
| 150 | Nottinghamshire Healthcare NHS Foundation Trust | Midlands | £43m | 186,128 m² | £230 | 46.3% |
| 151 | Yorkshire Ambulance Service NHS Trust | North East and Yorkshire | £14m | 59,550 m² | £229 | 24.4% |
| 152 | Derbyshire Healthcare NHS Foundation Trust | Midlands | £10m | 44,743 m² | £227 | 21.6% |
| 153 | Blackpool Teaching Hospitals NHS Foundation Trust | North West | £32m | 141,380 m² | £227 | 69.5% |
| 154 | The Rotherham NHS Foundation Trust | North East and Yorkshire | £19m | 84,790 m² | £225 | 50.1% |
| 155 | East of England Ambulance Service NHS Trust | East of England | £15m | 68,618 m² | £223 | 49.1% |
| 156 | Leicestershire Partnership NHS Trust | Midlands | £22m | 99,369 m² | £221 | 64.9% |
| 157 | East Lancashire Hospitals NHS Trust | North West | £45m | 202,551 m² | £220 | 35.6% |
| 158 | South Tees Hospitals NHS Foundation Trust | North East and Yorkshire | £39m | 183,210 m² | £215 | 40.2% |
| 159 | Mid and South Essex NHS Foundation Trust | East of England | £65m | 320,741 m² | £201 | 47.9% |
| 160 | Shropshire Community Health NHS Trust | Midlands | £6m | 29,405 m² | £200 | 28.6% |
| 161 | Liverpool University Hospitals NHS Foundation Trust | North West | £59m | 297,359 m² | £199 | 20.1% |
| 162 | Lancashire & South Cumbria NHS Foundation Trust | North West | £23m | 115,866 m² | £198 | 52.7% |
| 163 | London Ambulance Service NHS Trust | London | £15m | 74,548 m² | £197 | 35.6% |
| 164 | Leeds Community Healthcare NHS Trust | North East and Yorkshire | £5m | 27,660 m² | £194 | 70.4% |
| 165 | The Christie NHS Foundation Trust | North West | £17m | 95,247 m² | £183 | 24.4% |
| 166 | Oxford Health NHS Foundation Trust | South East | £15m | 80,047 m² | £183 | 64.9% |
| 167 | South East Coast Ambulance Service NHS Foundation Trust | South East | £7m | 43,890 m² | £167 | 36.9% |
| 168 | North Staffordshire Combined Healthcare NHS Trust | Midlands | £4m | 23,187 m² | £165 | 33.5% |
| 169 | Chelsea and Westminster Hospital NHS Foundation Trust | London | £23m | 139,289 m² | £163 | 9.1% |
| 170 | Black Country Healthcare NHS Foundation Trust | Midlands | £11m | 65,813 m² | £163 | 95.3% |
| 171 | South West London and St George's Mental Health NHS Trust | London | £11m | 72,186 m² | £157 | 49.7% |
| 172 | Mersey and West Lancashire Teaching Hospitals NHS Trust | North West | £32m | 213,941 m² | £148 | 34.6% |
| 173 | Mersey Care NHS Foundation Trust | North West | £22m | 153,760 m² | £146 | 33.1% |
| 174 | University Hospitals Coventry and Warwickshire NHS Trust | Midlands | £25m | 174,807 m² | £142 | 71.6% |
| 175 | Lincolnshire Partnership NHS Foundation Trust | Midlands | £6m | 42,990 m² | £139 | 18.6% |
| 176 | Tees, Esk and Wear Valleys NHS Foundation Trust | North East and Yorkshire | £18m | 132,429 m² | £135 | 93.4% |
| 177 | Great Ormond Street Hospital for Children NHS Foundation Trust | London | £14m | 105,003 m² | £132 | 40.8% |
| 178 | South West Yorkshire Partnership NHS Foundation Trust | North East and Yorkshire | £9m | 71,880 m² | £123 | 42.8% |
| 179 | Central London Community Healthcare NHS Trust | London | £6m | 49,651 m² | £121 | 37.3% |
| 180 | Moorfields Eye Hospital NHS Foundation Trust | London | £6m | 49,125 m² | £120 | 11.3% |
| 181 | Cambridgeshire and Peterborough NHS Foundation Trust | East of England | £7m | 60,565 m² | £116 | 32.7% |
| 182 | North Cumbria Integrated Care NHS Foundation Trust | North East and Yorkshire | £16m | 144,796 m² | £112 | 46.9% |
| 183 | Great Western Hospitals NHS Foundation Trust | South West | £8m | 75,763 m² | £108 | 48.3% |
| 184 | Cheshire and Wirral Partnership NHS Foundation Trust | North West | £6m | 57,748 m² | £106 | 45.6% |
| 185 | Birmingham Community Healthcare NHS Foundation Trust | Midlands | £7m | 71,734 m² | £104 | 47.6% |
| 186 | Cornwall Partnership NHS Foundation Trust | South West | £5m | 61,342 m² | £81 | 29.8% |
| 187 | Wye Valley NHS Trust | Midlands | £5m | 66,641 m² | £76 | 42.3% |
| 188 | Chesterfield Royal Hospital NHS Foundation Trust | Midlands | £6m | 102,008 m² | £62 | 74.2% |
| 189 | North East Ambulance Service NHS Foundation Trust | North East and Yorkshire | £2m | 33,474 m² | £54 | 63.8% |
| 190 | Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust | North East and Yorkshire | £9m | 170,829 m² | £52 | 46.9% |
| 191 | Portsmouth Hospitals University NHS Trust | South East | £8m | 166,884 m² | £50 | 23.8% |
| 192 | Berkshire Healthcare NHS Foundation Trust | South East | £3m | 61,334 m² | £50 | 47.4% |
| 193 | Leeds and York Partnership NHS Foundation Trust | North East and Yorkshire | £3m | 56,015 m² | £47 | 63.9% |
| 194 | North East London NHS Foundation Trust | London | £5m | 120,697 m² | £41 | 27.1% |
| 195 | Norfolk and Norwich University Hospitals NHS Foundation Trust | East of England | £5m | 138,235 m² | £37 | 33.6% |
| 196 | Northamptonshire Healthcare NHS Foundation Trust | Midlands | £3m | 77,724 m² | £32 | 1.6% |
| 197 | Wirral Community Health and Care NHS Foundation Trust | North West | £395,542 | 13,447 m² | £29 | 72.4% |
| 198 | Alder Hey Childrens NHS Foundation Trust | North West | £3m | 92,594 m² | £28 | 23.1% |
| 199 | Lincolnshire Community Health Services NHS Trust | Midlands | £548,223 | 19,866 m² | £28 | 15% |
| 200 | Bridgewater Community Healthcare NHS Foundation Trust | North West | £350,000 | 22,182 m² | £16 | 8.6% |
| 201 | West Midlands Ambulance Service University NHS Foundation Trust | Midlands | £413,600 | 61,634 m² | £7 | 0% |
Every trust, with backlog by risk band, occupied floor area, backlog per m² and the risk-weighted share, as JSON. Free to reuse under the Open Government Licence v3.0 — please credit PM Assist for the analysis and NHS England for the source data.
Download JSONThe source data is NHS England's Estates Returns Information Collection (ERIC), a mandatory annual return from every NHS trust in England. We take the trust-level release and compute the figures on this page from it. We do not adjust, model or estimate any value: every number here is arithmetic on the published return, and the calculation is stated alongside each finding.
NHS England, Estates Returns Information Collection (ERIC) 2024/25 — published 16 October 2025. Contains public sector information licensed under the Open Government Licence v3.0.
Backlog maintenance is the estimated cost of work needed to bring NHS buildings and engineering systems up to an acceptable condition. NHS England collects it annually through the Estates Returns Information Collection (ERIC), banded by the risk each defect poses. In 2024/25 it totalled £15.91bn across 207 trusts.
Airedale NHS Foundation Trust, at £4,457 per m² of occupied floor area in ERIC 2024/25. Ranking by floor area rather than by cash total is what separates genuinely under-maintained estates from trusts that are simply large.
A large teaching trust will always report a bigger cash backlog than a small district hospital, so the raw total mostly measures estate size. Dividing by occupied floor area shows how heavily maintenance debt actually sits on each estate, and makes trusts of different sizes comparable.
Yes. The underlying data is NHS England's, published under the Open Government Licence v3.0. The analysis, rankings and derived figures on this page are PM Assist's own — please credit PM Assist and link to this page, and credit NHS England ERIC for the source data. The full derived dataset is available to download.
Estates teams can only plan against the condition data they can find. When O&M manuals, condition surveys and commissioning records are scattered across shared drives, deferred work goes unrecorded until it becomes a failure. See the wider UK facilities management statistics, our gateway 2 approval times tracker and all our research, or try searching an O&M manual with AI.