GP premises review 'critical' to success of networks, say GP leaders

NHS England's premises review will be key to the success of primary care networks, GPs leaders have said, warning that unless the current system is reformed GPs could be left facing increased financial risk.

Partnership review chair Dr Nigel Watson (Photo: Pete Hill)
Partnership review chair Dr Nigel Watson (Photo: Pete Hill)

Under the new five-year GP contract, NHS England will provide £1.8bn to support the formation of primary care networks. Practices will have to sign up to a new network contract DES that starts in July to access this funding and work collaboratively with neighbouring practices to cover a population of 30,000 to 50,000 patients.

As part of the deal, networks will receive funding to recruit additional staff, including social prescribing link workers, clinical pharmacists, physiotherapists, physician associates and paramedics.

However, partnership review chair Dr Nigel Watson told GPonline that the creation of networks could ‘expand the risk’ GPs face and said that NHS England's GP premises review would be 'critical in terms of de-risking premises’ and reducing the financial liabilities linked to premises.

'Clearly there is a relationship between the two because if we’re going to develop networks and we’re going to provide more services within the community and it’s going to be embedded in general practice, then we’ve got to have adequate premises to deal with it,' Dr Watson said.

GP premises review

The GPC has previously said that liabilities associated with premises ownership and long-term leases are one of the biggest issues facing general practice and and have been the deciding factor forcing some partners to hand back their contracts. NHS England’s premises review - launched in partnership with the GPC in August 2018 - is aiming to provide recommendations to ensure that GP premises policy is ‘fit for purpose both now and in the future’.

Dr Watson said that it was also vital that the review looked at overhauling the premises cost directions.

'The rules have changed over time and current premises cost directions do not really fit into the way we’re working today let alone the way we need to work for the future,' he said. 'So the premises review is important in terms of how you can de-risk premises but also about having the cost directions which enable the integrated working and creating [services] within the community.'

GPC chair Dr Richard Vautrey told GPonline that 'resolving some of the fundamental concerns about practice premises' was crucial to the development of general practice and primary care networks.

‘Too many practices are trying to cope in inadequate facilities or bursting at the seams without the support to expand. In addition, increasing numbers of doctors don't want to be left with the risk of long term leases or property ownership. The premises review is looking at these issues,' he said.

A BMA survey of over 1,000 practices this week revealed that only half were fit for purpose, while 80% predicted that their premises would not be fit for the future.

Primary care networks

Byfield Medical Centre in Northamptonshire is one practice that fears it will not benefit from the introduction of primary care networks unless funding for premises is addressed.

Practice manager Tracey Rymer said: ‘We simply do not have enough space to provide ample resources for residents here. NHS England is looking for practices to form primary care networks and share resources such as paramedics and other health professionals. We do not have room to share this resource – we are constantly having to juggle rooms to accommodate our staff.'

The BMA has said the government must use next month’s spending review to urgently invest in practice premises.

NHS England said that premises review was 'due to conclude shortly', however there is no timeframe for when its recommendations will be published.

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