Dilapidated NHS buildings need attention, says UNISON

Leaking sewage, rats and insect infestations are widespread in hospitals, clinics and ambulance stations, while staff and patients are often left without access to clean toilets, according to new figures published today (Tuesday) by UNISON.

Around one in seven health service staff (14%) say they’ve been aware of vermin inside their workplaces within the past 12 months. A similar proportion (13%) report other infestations such as silverfish, ants, bedbugs and cockroaches.

A survey* of more than 19,000 NHS staff working in all areas of the health service gives a concerning snapshot of a dangerous and dilapidated NHS estate, says UNISON. As many as 15% think their place of work is unsafe because of the physical state of the buildings.

The findings are being released to coincide with the union’s annual national delegate conference, beginning in Brighton today (Tuesday).

At least two in five NHS employees (40%) say they’ve seen buckets on floors to catch leaking water, while around one in six (16%) have experienced sewage leaks.

Nearly one in five (19%) say public toilets in their hospitals have been out of order for extended periods. For employees themselves, the situation is worse, with unusable staff loos reported by a quarter (25%).

One third of those polled (33%) reported broken or out-of-order equipment, while more than a quarter (28%) told of defective lighting both inside and outside NHS buildings. More than two in five (22%) were aware of cracked walls or floors.

A small proportion (5%) of health service staff reported asbestos had been discovered in their workplace.

One NHS worker told UNISON dead rats had been found rotting in an aircon unit. Another revealed they and colleagues were bitten relentlessly by fleas as they worked, and the situation was worse for those on the night shift.

Other reports from NHS workers included an infestation of flies in a staff toilet with an open sewage pipe, a roof leaking into a mortuary fridge, and flies and mice in operating theatres.

At one site, family and staff had to provide patients with blankets because the heating on wards had broken. At another, patients were looked after in a corridor, which in turn caused a fire exit to be blocked.

Nearly three in ten (29%) say conditions in their place of work had worsened over the past year, almost two thirds (64%) said they remained the same and only 7% had noticed an improvement.

Three in 10 (29%) staff said their employers had closed wards and buildings because the poor state meant there were maintenance and safety issues.

The situation is also affecting staff health and wellbeing. Almost half (49%) said they had no access to affordable, healthy food while on their shifts, and around one in seven (15%) reported they were unable to get drinking water in the workplace.

UNISON head of health Helga Pile said: "No patient should be cared for in filthy, insanitary and unsafe conditions. Staff shouldn’t have to work in such shocking surroundings either.

"This survey demonstrates how lack of funding has left the NHS estate in a dreadful mess. Hospitals should make people better, not expose them to harm from rotting rats, raw sewage and dilapidated buildings.

"Recent cuts to staffing and maintenance budgets are adding to the long-term effects of underfunding. To use scarce resources patching up ceilings and doing other short-term fixes to protect patients isn't good enough.

"Those with the worst problems need immediate access to additional financial support so they can stop the waste and begin putting things right. Investment is essential to bring the NHS up to modern standards and stop it drifting into further decline. "

Notes to editors:
–* Between 27 January and 27 February 2026, UNISON polled 19,356 NHS staff on the state of the premises where they work in England, Scotland and Northern Ireland. The findings are part of a wider survey of health staff.
– UNISON’s annual national delegate conference runs from Monday 16 to Wednesday 19 June 2026 at the Brighton Centre, Kings Road, Brighton BN1 2GR. The union’s general secretary Andrea Egan will be giving her keynote speech tomorrow (Wednesday) at noon.
– UNISON is the UK’s largest union with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.

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