Councils across England are using planning powers to take millions of pounds from developers to help fund GP infrastructure.
But lack of integration between NHS bodies and councils could mean valuable potential funding is not reaching practices that need it.
Analysis by GPonline found wide gaps between local authorities in use of powers to demand contributions from developers for healthcare infrastructure. Data obtained under the Freedom of Information Act showed that of 173 councils examined in detail, 110 had not used these powers in the four years from 2010/11 to 2013/14.
Primary care premises
However 29 councils had obtained funding once or twice, while a small number had made widespread use of the powers, in some cases requiring millions of pounds from developers for health infrastructure.
Under section 106 of the Town and Country Planning Act 1990, planning authorities are able to require a financial or other contribution to mitigate the effects of a development. Traditionally this has been used mainly to require contributions to roads infrastructure, affordable housing and schools, but it has been increasingly used to fund local health services.
A newer system called the Community Infrastructure Levy works in a similar way, but has yet to be adopted by many councils and has been used by only a handful for health infrastructure.
GPonline has identified around £46.5m secured by 53 councils over the last four years for local healthcare infrastructure.
Many agreements specify that money paid will be, or has been, used for local GP practices or primary care centres. Some identify individual practices or projects that will benefit.
No surprise that impenetrable NHS estates system is making it hard for councils to invest in primary care."
Dr Brian Balmer, GPC premises lead
The council among those analysed with the highest level of developer obligations for local health facilities is the east London borough of Tower Hamlets which agreed obligations of £15.4m from 47 development projects. St Catherine's Practice in Wapping, for example, benefited from around £195,000 obtained by the council from a developer of an 18-storey block of luxury apartments.
North-east London borough Waltham Forest came second with £4.5m required across 64 developments. Barnet in north London came third with £2.75m over 217 agreements.
Information from some councils suggested that money had been collected from developers but may not have been spent. Many councils indicated money had been collected for a general healthcare fund, rather than for specific facilities or projects. Specialist healthcare premises lawyers told GPonline that weak integration and communication between councils and fragmented NHS bodies could mean potential funding was not reaching practices that need it.
Nathan East, a partner at law firm Weightmans, said local authorities' links to the NHS were often through CCGs, many of which have little involvement in premises funding.
GPC executive lead for premises Dr Brian Balmer said he would be unsurprised if the ‘impenetrable’ NHS estates system was making it difficult for councils to know how best to funnel funding into primary care infrastructure.
GP premises information
Mr East added that information held by councils about local infrastructure requirements was often out of date. He added that the lack of new premises approved by NHS leaders in recent years had also made section 106 funds difficult to deploy.
Edwina Farrell, also a partner at Weightmans, added: ‘It is possible that [councils] want to put some money aside for healthcare, but don't have fully formed plans.
‘They may have very good intentions, but not have earmarked the relevant projects, because they don't have the connections with the [NHS] commissioner. If they had that, they might be better placed.’
Dr Balmer said CCGs, as local membership organisations, were well placed to inform councils of local requirements and to help practices access funding. Ms Farrell said linking up with developers at an early stage could help practices access the funds.
New care models and greater integration could help bring NHS bodies and local councils closer together, the lawyers agreed.
Last week GPonline revealed that NHS England and DH have ordered a new estates strategic planning regime. NHS Property Services and Community Health Partnerships are set to take on a new estates planning co-ordination role supporting local commissioners.
An NHS England spokeswoman said: ‘The benefits of Section 106 and Community Infrastructure Levy funding have been identified as key support facilities for a range of project opportunities which will be recognised as part of our local strategic estates planning work. '