Poor ventilation leaves hospitals ‘not ready’ for another covid

Just four years after the peak of the pandemic, four in five NHS acute trusts are concerned their ventilation systems may be inadequate, according to an investigation by HSJ. 

Maintaining a flow of fresh air into a room is considered an important measure to reduce the spread of airborne infections, such as coronavirus and flu. However, an analysis of trust risk registers reveals that many are operating with ageing ventilation systems which pose a risk to patient safety. 

HSJ asked all 118 acute trusts whether a lack of adequate ventilation was on their risk register. Just under 80% of the 91 who replied said yes. 

This does not mean the risk has necessarily materialised, but is significant enough – either in likelihood, potential impact, or both – to require regular review by managers.

HSJ also asked for trusts to estimate the cost of reaching full compliance with the latest ventilation standards. Twenty-six trusts responded with data which suggested the average cost per trust was around £13m.

One trust estates director contacted by HSJ said: “Based on this research, it is clear the NHS is not ready for another respiratory outbreak.” They added that ventilation was “one of the biggest risks” in managing healthcare estates and a “huge chunk” of their trust’s repair backlog. “One of the reasons these risks exist is because it is so expensive to replace.”

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Source: HSJ, 29 October 2025