Commissioners from Newcastle Gateshead CCG are in talks with officials from the area's two local authorities over proposals to help pay for new primary care hubs.
Some local practices have already expressed an interest in moving into three multi-practice primary care hubs proposed to support local sustainability and transformation plan (STP) ambitions to provide more care outside of hospitals.
Local LMC leaders say the plans are at a very early stage but discussions have begun with practices about moving into the new facilities.
Primary care premises
CCGs officials have said the Estates and Technology Transformation Fund (ETTF, formerly the primary care transformation fund) will not cover the full cost of the planned hubs. A cap on ETTF funding means it can only pay for 20% to 30% of the total cost of projects worth over £1m.
Commissioners are therefore seeking additional funding from the two local authorities which ‘have access to capital at low interest rates’, they revealed in proposals submitted to NHS England last month.
Alternatively, commissioners said, the developments could be funded through GP practices’ own equity, public/private LIFT deals, or third party developers.
Newcastle and North Tyneside LMC executive officer Dr Ken Megson said GPs getting third party funding for premises development could be difficult and being tied to long leases with developers was unattractive. ‘Local authorities can borrow money cheaper than the NHS. They have a lot of empty estate. I suspect they won't want to build something unless they can use it as well,' he said.
But Dr Megson warned that while there had been tentative expressions of interest in the scheme, GPs and patients may not want practices consolidated and moved away from their existing sites.
Premises experts said the possible deal with local councils was unusual, although such financing collaboration between the NHS and local authorities could become more common in future.
Leading medical premises consultant John Hearle of surveyors Aitchison Raffety said he had not come across a similar proposal, but he expected STP collaboration and greater integration of health and care services to mean more joint working on premises.
‘There are lots of benefits from the council point of view,’ said Mr Hearle, with opportunities to co-locate services such as community centres, and social care with health centres as well as boosting regeneration. If CCGs are doing their jobs properly they are liaising with councils, because they are meant to be working together to provide health, community and social care as one package,’ he said.
Health property lawyers Edwina Farrell and Nathan East from Weightmans said the STP process and government estates policy meant there would be more collaboration between the NHS and local authorities over premises development. ‘I think there will have to be because it's one of the reasons behind these [STP] plans in the first place,' said Ms Farrell. ‘The idea is to look at a health and care economy for a particular region and look at sharing resources and maximising what you can for the community.’
Mr East said that councils have a greater ability to generate income through property development, so may be attracted to such schemes to help them raise funding for their own services. ‘There is no reason, if they were making some kind of margin on investment in an NHS scheme, why they wouldn't,' he said. ‘It is a fairly cautious investment. It is probably at the more conservative end of the kinds of investments local authorities may get involved with. So, it is possible, but I'm not sure that is on a broad scale on their horizon.’
Newcastle Gateshead CCG already includes other public sector bodies on its estates steering group, while central government provides financial support for public sector bodies to collaborate on estates through the One Public Estate programme. The Cabinet Office scheme aims to use estates collaboration increase service integration, regenerate, release land and property and boost growth.