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Hospital maintenance report

25 November 2009

AMA has published a review of the Healthcare RMI (Repair, Maintenance and Improvement) market across the healthcare sector in the UK.

According to the AMA report, Healthcare RMI Market – UK 2009-2013, growth in the market for healthcare RMI (Repair, Maintenance and Improvement) activity is primarily underpinned by investment in buildings and M & E maintenance by NHS Trusts in England, which account for around 60 percent of RMI output. NHS Trusts from the other three countries account for around 15 percent of demand, while independent hospitals and private nursing homes also have significant RMI budgets.
The AMA report estimates that for the financial year ending March 2009, the healthcare RMI market was worth over £1.2bn, approximately 4 percent of the non-residential buildings RMI market and around a third of the size of the healthcare newbuild market. The key driver across NHS estates in UK has been chronic building maintenance backlogs. In England, this is currently valued at around £4bn and at around £450m each in both Wales and Scotland.
Total ‘support services’ expenditure costs for NHS England alone were over £6bn in 2008-09, which includes all estates services, FM provision, ‘hotel’ services etc. Building maintenance and engineering services account for around 12 percent of the combined estates and hotel services costs – equivalent to around £740m - and cover a comprehensive range of activities - building fabric, sanitaryware, drainage, plant and materials etc. Acute hospitals are the key cost area accounting for around 70 percent of expenditure.
The private healthcare sector is also reviewed in the report and includes independent hospitals and private nursing homes and AMA estimates that the sector accounts for over 25 percent of demand for RMI services.
From 2011, growth in investment among the NHS Trusts is expected to slow down following the next Comprehensive Spending Review, but essential RMI works are likely to be both unavoidable and unacceptable to the public.  The report suggests that as capital budgets come under increasing pressure, there will be a shift away from newbuild towards increased levels of planned maintenance, which are currently low.
AMA Research’s report Healthcare RMI Market – UK 2009-2013 is available in hard copy or electronic format for £625 and can be ordered online at

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