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A hospital trust says a backlog of work to modernise its estate could cost more than £75 million.
Medway NHS Foundation Trust, which runs Medway Maritime Hospital in Gillingham, has begun looking at ways of updating its facilities to accommodate an expected population increase in the next 20 years.
It is estimated the backlog of work to bring them up to standard will cost £75.6million.
The site in Windmill Road caters for those living in the Medway Towns and Swale; some 4,000 staff work within the trust and some of its buildings date back to 1905.
A draft report presenting the hospital's estate strategy up to 2041 states: "Most costs relate to the building fabric and the plant and equipment which keep our hospital running.
"Some of the very outdated Nightingale wards do not offer the levels of privacy and dignity and infection control expected from modern healthcare facilities.
"It is vital that we improve the standard of our estate to meet national guidelines for good patient experience.
"We will also explore opportunities to relocate and or expand our services across two or more sites to enable us to meet the demands driven by population growth."
It sets out a roadmap for improvement which could include developing an additional multi-storey car park, creating a post-graduate and nurse education area and converting offices and non-clinical space to use for elective surgeries.
The goals for the first three years include clearing a backlog of maintenance, reviewing the car parking situation, and submitting a bid to get funding for a three-storey building to house three wards.
In presenting the plans to Medway NHS Foundation Trust's public board meeting this afternoon, Gary Lupton, director of estates and facilities, said: "The backdrop is over the next 20 years there's a potential for 29,000 houses being built, with a potential for each household to have 2.4 people."
He described: "(It's a) very sketchy outline in terms of the journey, in terms of key milestones, and we need to flesh these out in more detail."
The board also agreed that a level of engagement with the local community as well as patients and staff would be part of the upgrade process.
The trust recently dedicated to spend £17.7 million on fire safety upgrades, and launched its first ever green plan for sustainable healthcare which will take them up to 2026.
Read more: All the latest news from Medway
