Exclusive: GPs demand premises funding

More than a third of GP practices across the UK have been unable to take on new services because their practice premises are inadequate, a GP magazine survey suggests.

Dr Deborah Colvin: premises development is a ‘really serious issue’ for many practices.
Dr Deborah Colvin: premises development is a ‘really serious issue’ for many practices.

The finding reveals the scale of the challenge for DH plans to shift work from hospitals to primary care.

GPC chairman Dr Laurence Buckman warned there had been ‘no serious investment’ in GP premises in a decade and urged ministers to find new sources of funding.

Of 427 GP partners who responded to the poll, 57% said their practice premises needed improvement.

A total of 40% of 230 GP partners responding to a separate question said their practice had been unable to expand services because their premises were inadequate (see graph).

More than a quarter (27%) said they did not believe their premises would comply with CQC requirements.

City & Hackney LMC chairwoman Dr Deborah Colvin said premises development was a ‘really serious issue’ for many practices.

She hit out at the lack of investment in premises at a time when practices were being asked to take on more work.

‘It’s another example of the government asking us to jump through hoops we can’t jump through,’
Dr Colvin said.

She added: ‘The real problem in London is, the cost of land is so phenomenal that unless PCTs can support doctors to get land in the first place, it is almost impossible.’

Cramped premises
Responding to the poll, Liverpool GP Dr John Caldwell said: ‘We have been in cramped premises and seeking to move for more than 10 years. Our premises are a major limiting factor on the services we provide.’

Kent GP Dr Mary Hawking wrote that her practice had been seeking a move to larger premises since 1998, and plans had twice been close to being signed off, until they were ‘killed off’ by NHS reorganisations. She added: ‘We need more space and that means moving.’

Partners seeking premises funding said they had been told that any change in their premises must be ‘cost-neutral’, or that when funding was available it was non-recurrent.

Some partners said they had made ‘huge investments’ from their own pockets to improve premises, while others said they had no idea who to approach for funding.

Dr Buckman told GP that the survey findings were an accurate reflection of the situation GPs now face.

‘There has been no serious premises development in general practice in 10 years,’ he said.

‘Many are too small and not fit for the 21st century. Many would like to offer more services but their premises won’t allow it – that applies to me too.’ He urged the government to develop a ‘reliable method for GPs to borrow to develop premises’.

In an interview in this issue of GP, he says the government is showing ‘considerable willingness’ to address the question, but has yet to identify a solution.

Dr Buckman explained: ‘The situation is getting serious. The government knows this – if you want to move work into primary care, you have to have somewhere to do it. It hasn’t got a solution but is interested in talking about it.’

A DH spokeswoman said: 'PCTs are responsible for helping GP practices provide suitable facilities for their patients. GPs can apply for improvement grants and PCTs decide whether to grant them based on priority, value for money and available funding. This responsibility will pass to the new NHS Commissioning Board from April. They will explore how services can be best made available for the local community. They will also make sure premises costs are reflected in any services GPs provide.'

Expert view: The chartered surveyor

John Hearle, chairman of chartered surveyors Aitchison Raffety, on GPs’ premises problem

‘The survey findings confirm what we thought. There are forces acting against each other: because of CQC audits, GPs are being told to improve their premises. Technically if they don’t, rent reimbursement could be affected.

‘They also have to have larger premises to take services on from secondary care – and that is one way the NHS is hoping to save lots of money. But working directly against that is the reorganisation of the NHS.

‘If people don’t get property plans signed off before PCTs disappear, nothing’s going to happen for two years because it’s such a huge change. Then there will be a mad rush to catch up.

‘People are underestimating how big the delay is going to be.

‘Politically, something could happen to speed up premises development.

‘For a new £5m centre, it doesn’t cost that amount, it costs £300,000 a year – all they have to commit to is putting the rent in.’

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