• HSJ has tracked cancelled operations due to infrastructure failures at trusts awaiting hospital rebuilds
  • It reveals the extent of disruption caused by buildings and equipment for first time
  • Trusts say ageing infrastructure continues to cause disruption amid uncertainty over schemes

Infrastructure failings have led to over 1,000 operations being cancelled in the past two years at just 14 trusts whose rebuilding plans have been placed under review by the new government, HSJ can reveal.

Ceiling leaks, flooding, broken ventilation systems, pest infestations and many other issues have caused the disruption. 

HSJ has tracked cancelled operations caused by infrastructure incidents across trusts in the 40 "new hospitals" programme since 2019, the year the plan was first announced by former health secretary Matt Hancock. The programme has been plagued by delays and rising costs ever since. 

Many schemes remain in limbo five years on and are facing the threat of even more delays after Labour announced it was reviewing the programme and planned to come up with a new "realistic" delivery timetable. Health secretary Wes Streeting has promised to reveal the outcome “in the coming weeks”. 

HSJ’s investigation identified more than 1,000 cancelled operations due to building and equipment issues at just 14 NHP trusts since 2023. (see below for research methodology).

While disruption is not unique to these trusts, HSJ decided to focus on them due to the range of infrastructure issues affecting them and the continuing uncertainty over the future of the schemes. HSJ contacted all of the larger "new" schemes in NHP, none of which have undertaken construction beyond preparation works.

Epsom and St Helier University Hospitals Trust experienced one of the most disruptive incidents this summer when nearly 300, mainly ophthalmology, operations were cancelled due to the failure of the theatre ventilation system. Ageing valves and pipework meant repairs took an extended period. 

An Epsom and St Helier University Hospitals Trust spokeswoman said: "Our ageing hospitals are deteriorating faster than we can fix them.”

Roof problems caused flooding at Imperial College Healthcare Trust – which has the largest repair backlog in the country – this year with 200 operations cancelled or relocated as a result. Chief executive Tim Orchard has said building failures are “increasingly common” despite spending tens of millions a year on essential maintenance. The trust even had to cancel some operations after people became trapped in a lift. 

Water supply was temporarily shut off at Leicester General Hospital this year when a faulty valve caused a leak and 40 operations had to be cancelled. Flooding in an anaesthetic room caused downtime at the same hospital the year before.

Patients at Princess Alexandra Hospital in Essex suffered from the failure of air handling units. Two theatres were closed for weeks at the end of this summer, and 36 operations were cancelled as a result.

Other infrastructure failings exposed by HSJ’s research include a pest infestation at West Hertfordshire Hospitals Trust, a “strong smell of sewage” leading to cancelled operations at Kettering General Hospital FT, while Leeds Teaching Hospitals said it experienced several hundred incidents each year related to the age and poor condition of its estate.

Torbay and South Devon FT said it was unable to fully regulate the temperature and humidity in its main operating theatres due to the age of its infrastructure.

Royal Berkshire FT said its facilities were steadily deteriorating, and a delay in its new hospital would result in maintenance costs running into the tens of millions.  

Saffron Cordery from NHS Providers said it was “worrying, though not surprising” that operations were being cancelled due to the poor condition of NHS estate.

She said: “Years of underinvestment has left too many NHS buildings in a dire state with leaks, floods and electrical failures disrupting patient services.”

A Department of Health and Social Care spokesman said: “This government inherited a broken NHS, which has been starved of investment and left with crumbling hospitals... It will take time, but we are rebuilding the health service to make it fit for the future.”

The health secretary is expected to announce the outcome of the NHP review in the coming weeks. 

How the investigation was approached

Clinical incidents that disrupt patient care are routinely reported but not the number of operations cancelled as a result. 

HSJ approached 27 trusts who had been included in the later cohorts of NHP or were added last year due to risks posed by failing Reinforced Autoclaved Aerated Concrete (RAAC). Information was requested for cancelled operations across the trust rather than specific rebuild sites. 

Out of the 20 trusts that replied, 14 were included in the government review of NHP this summer. The other six are exempt from the review due to the presence of RAAC. 

Five NHP schemes were not included in HSJ’s investigation because of their smaller size.

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