Asbestos still widespread among NHS trusts and boards

Table 1: NHS premises and buildings

Trusts and Boards in the survey	Total owned or used	Duty holder: number (percent of total)	Not duty holder: number (percent of total)	Surveyed: number (percent of duty-holder)*	Contain asbestos: number (percent of all surveyed)	Management plans: number (percent of those with asbestos)	Plans written or reviewed since 01/01/19: number (percent of those with a plan)	Public access: number (percent of all with asbestos)
All in the survey (London & Scotland)
48	2,923	1,814 (62%)	1,109 (38%)	1,718 (95%)	1,146 (67%)	1,153 (101%)	476 (41%)	753 (66%)
London
26	1,444	674 (47%)	770 (53%)	640 (95%)	451 (70%)	357 (79%)	266 (75%)	240 (53%)
Scotland
22	1,479	1,140 (77%)	339 (23%)	1,078 (95%)	695 (64%)	796 (115%)	210 (26%)	513 (74%)

* The number surveyed may exclude post-2000 buildings

Survey

The TUC commissioned the Labour Research Department to investigate the presence of asbestos in National Health Service premises. During the first half of 2022, 58 London Trusts and Scotland Boards were asked to provide information about the premises they own or use, and the extent to which they contain asbestos that has not yet been removed.

Excluding 2 that could not be counted 1 , the survey covered 56 NHS organisations, 34 in London and 22 in Scotland:

• all 22 Scottish Boards responded with information about asbestos in their premises
• 26 London Trusts responded with information about their asbestos, 8 did not respond including 2 that declined to provide the information as requested (arguing that it would take them too long to compile it)

Usable responses were therefore received from 48 NHS organisations, an overall response rate of 86%. However, the lack of information from some of the Trusts (and the limits of their duty-holding responsibilities, see below) mean that the figures in this report under-state the continuing extent of asbestos in NHS premises.

Premises in use

The number of premises or buildings owned or used by Trusts and Boards varies enormously and determines just how large or small their potential asbestos problem could be, among premises they are duty-holder for.

• Great Ormond Street Hospital for Children NHS Foundation Trust​ owns and uses a single premises although that includes multiple buildings, 2 of which still contain asbestos. On the other hand, Central London Community Healthcare NHS Trust owns or uses 317.

Looking at the spread (quartiles 2 ), in London a quarter of trusts owned or used 13 or fewer premises or buildings, half used 30 or more, and a quarter used 77 or more. The number of premises and buildings used in Scotland tends to be higher: a quarter of Boards owned or used 19 or fewer, half used 44 or more, while a quarter used 83 or more. However there is a lot of variation within Scotland too.

• the Golden Jubilee National Waiting Times Centre has just 1 premises, while NHS Lothian owns or uses 206.

Between them, these London Trusts and Scotland Boards owned or used a total of 2,923 premises or buildings. The survey asked about “premises” but some Trusts or Boards occupy lots of buildings within a small number of sites or campuses, and manage their asbestos on that basis. This report therefore provides information about asbestos in NHS premises and buildings.

• King’s College Hospital NHS Foundation Trust​ has 4 campuses and 23 sites, but uses a total of 114 buildings among which it is asbestos duty-holder for 86 (of which 28 have asbestos present).

Duty-holding

Whilst the Trusts and Boards in the survey owned or used 2,923 premises or buildings, they were not the asbestos duty-holder for all of them. In fact, where premises and building numbers were given, they were duty holders for only six out of ten (62%), 1,814 in total.

The degree to which Trusts or Boards regard themselves as responsible for asbestos in all the premises and buildings they use varies.

• NHS Grampian takes a comprehensive approach: 250 of 314 premises it uses are pre-2000 in construction (when asbestos use was still permitted). All premises are surveyed under its Asbestos Management Plan and a total of 180 have asbestos (counting multiple buildings per site).
• Barnet, Enfield and Haringey Mental Health NHS Trust uses 69 buildings but regards itself as duty holder for just 1 (although it has surveyed over 40). St George’s University Hospitals NHS Foundation Trust uses 77 premises and buildings but owns 4 "remaining as a tenant", and that is the number it says it is duty-holder for.
• In contrast, Tavistock and Portman NHS Foundation Trust owns or uses 10 primary sites (mainly outpatient clinics) for which it sees itself as the duty holder (it uses other premises but only on a sessional basis, owned by 3rd party landlords). London North West University Healthcare NHS Trust owns or uses 5 premises including 3 hospitals and sees itself as duty-holder for them all.
• The Royal National Orthopaedic Hospital NHS Trust is exceptional in identifying itself as duty holder for more premises (77) than it says it owns or uses (56).

At the lower quartile, London Trusts see themselves as duty-holder for 31% of premises owned or used. The median level is 66%, while at the upper quartile London Trusts see themselves as responsible for asbestos in almost all the premises and buildings they use (98%).

In Scotland, Boards are likely to see themselves as duty-holder for a higher proportion of the premises and buildings they use. At the lower quartile it’s 55%; at the median, 86%; and at the upper quartile it is 100%.

The limited scope of duty-holding means that overall there are a total of 1,109 premises and buildings in use in these two parts of the NHS for which the Trusts and Boards involved don’t see themselves as the duty holder.

Presence of asbestos

A total of 1,718 premises and buildings have been surveyed by Trusts and Boards responding to the survey, almost all of those for which they say they are duty holder (95%). Buildings constructed after the year 2000 may not have been surveyed as they should not contain asbestos.

Among those 1,718 premises and buildings, 1,146 contained asbestos, two thirds of those surveyed (67%). Understandably the position varies from one part of the NHS to another.

In London, the lower quartile 3  in the proportion of surveyed premises and buildings that have asbestos is 51%, the median is 85% and the upper quartile is 100%. 

Scotland has some Boards with little or no asbestos, but the lower quartile in the proportion of surveyed premises and buildings with asbestos is 42%. At the median it is 53% and at the upper quartile it is 87%.

Detailed information about the presence of asbestos in different NHS Trusts and Boards is given in the appendix.

Management

Survey responses suggest that premises and buildings with asbestos are highly likely to be covered by a management plan, but it may not necessarily be a recent one: only 476 (41%) are covered by plans written or reviewed since 01/01/2019. However, a number of Trusts and Boards emphasised that they have overall plans that ensure all asbestos is monitored.

• NHS Tayside says it has an overall asbestos management plan and all recommendations from surveys are recorded in its Estates Asset Management system to be progressed as required. However, no management plans have been written since 1 January 2019 due to Covid-19 interrupting these activities.

Public access

Two thirds of these premises and buildings containing asbestos are open to public access (753, 66%). Trusts and Boards are however keen to point out that the asbestos may not be in ‘public areas’ of buildings with public access.

• Lewisham and Greenwich NHS Trust​ has asbestos in 3 of the 18 premises and buildings it uses, but points out that one of those is Lewisham Hospital’s mechanical plant area which is not open to public access.

In conclusion

These results cover just two parts of the National Health Service but reveal a substantial level of asbestos presence, even without including premises owned or used by NHS Trusts and Boards for which some other body is deemed to be the asbestos duty holder.

The Labour Research Department (LRD) would like to thank NHS Trusts and Boards for providing information for this report.

• 1 One of the 58 trusts contacted had merged into another London trust; a second did not receive their FOI inquiry
• 2 QUARTILE.INC
• 3 QUARTILE.INC