Much of the UK’s healthcare estates are ‘in an appalling condition to the detriment of staff, patient care, and the environment'. according to a BMA report.

The Building the Future – Brick by Brick: The Case for Urgent Investment in Safe, Modern, and Sustainable Healthcare Estates report urges the Government to see improving the bricks and mortar of health services as ‘an investment, not a cost’.

It found that an ‘alarming’ 38% of doctors consider the physical condition of their workplaces is poor or very poor, and that 43% believe workplace conditions have a negative effect on patient care.

‘Crumbling’ buildings and infrastructure often force wards to close, it concluded, ‘compounding a wider lack of space’ and ‘contributing to ever-expanding waiting lists’ while insufficient space at hospitals and GP practices is hindering doctors’ training and preventing recruitment of additional staff.

Doctors also reported concerns ventilation would be inappropriate for reducing infection in a future wave of COVID or other pandemic, and that they were too often left out of planning of estates projects.

Sewage leaks, burst pipes, leaking roofs, and mites in neonatal units were among the issues reported.

The report quoted one doctor working in secondary care saying: ‘Every day I go to work in a ratty, smelly building with peeling paint, loose handles, poorly ventilated and baking hot offices, and loose and pock-marked toilet seats is another day closer to leaving this decaying system for good.’

Another added: ‘The hospitals are disgusting. Paint peeling, ceilings leaking, break spaces revolting. Canteens tiny and gross. Woeful parking. Everyone is miserable as a result and of course that leads to poor patient care.’

A doctor working in general practice said the site was ‘damp’ with ‘poor ventilation’, and that they were working with the windows open which ‘distracts from patient care’.

The report notes how 83% of respondents say the condition of NHS estates limits their ability to use modern equipment and technology, hindering the recommendations of a separate BMA report on IT infrastructure released this week.

Recommendations include a national review of hospital and GP estates across the UK, dedicated funding for improvements and retrofitting and urgently clearing existing maintenance backlogs and making sites accessible for all.

‘Substantial’ capital investment is needed to make the improvements, the report says, with funding made available to GP practices and hospitals via a ‘transparent’ application process. It encourages buying out or removing PFI contracts where possible.

Involving doctors in the planning of improvements would also boost morale and retention of staff, it adds, recommending quiet spaces for them to work and rest in, and offering free car parking and sustainable public transport options.

Progress to reduce the NHS’s carbon footprint has also ‘stalled’, the report found. It calls for ringfenced funding for sustainability improvements.

‘Healthcare estates should be well-designed, fit for purpose, accessible and safe for all staff, patients, and visitors,’ the report concludes. ‘The condition of these essential buildings cannot be allowed to deteriorate further.’