Backlog repairs strain London hospitals as discharge data lands
London’s acute estate is carrying some of England’s heaviest repair bills, with the latest ERIC release for 2024/25 showing a larger national backlog and several London trusts at the top of the list; at the same time, NHS England has formalised a metric tracking the time from discharge-ready status to actual discharge, tying estates risk to patient flow.
Across England, the 2024/25 Estates Return Information Collection reports a £15.9bn maintenance backlog, up 15.7% year on year, including £3.5bn classified as high-risk and £5.6bn as significant-risk, while the total cost of running the estate reached about £14bn in 2024/25, underscoring the scale of capital need alongside day-to-day spend.
Within London, trust-level figures drawn from the same dataset place Imperial College Healthcare at an estimated £902m backlog, Guy’s and St Thomas’ at around £532m, Barts at roughly £523m and London North West Healthcare at about £463m, illustrating how liabilities cluster around large multi-site providers.
The operational consequence shows up in discharge logistics: NHS England’s “discharge ready date” measure became an official statistic in September 2025 and tracks the interval between when a patient is clinically ready to leave and when they actually depart, a window that hospitals try to compress through staffed discharge lounges and better-coordinated patient transport.
Read together, the counts and rates point to a system balancing risk and flow: a £15.9bn national backlog with £3.5bn high-risk exposure, estate running costs near £14bn, and London trusts carrying several hundred million pounds each in deferred works, while a standardised discharge timing metric concentrates attention on the hours lost between readiness and departure.
All figures are attributable to NHS England/NHS Digital’s Estates Returns Information Collection 2024/25 (published October 2025, covering 1 April 2024–31 March 2025) and trust-level analyses of that dataset highlighting London providers, alongside NHS England’s discharge ready date statistical series confirmed as official in September 2025.
