One in three GP partners say premises 'not fit for purpose'

A third of GP partners say the premises they work in are not fit for purpose, a GPonline survey has found.

The same proportion of respondents said their practice premises had not been updated in more than a decade, the survey reveals.

GP leaders hit out at the failure of funding schemes for primary care premises and bureaucratic barriers to support, calling on NHS England to address ‘fundamental issues’ facing premises policy.

The findings come just months after NHS England launched a premises policy review that will feed into contract negotiations for 2019/20.

Among all GPs, a quarter of the 450 who responded to the survey described their premises as ‘not fit for purpose’ and the same proportion said their premises had not been updated in over 10 years. A total of 144 respondents were partners.

Findings from the GPonline poll are broadly in line with an earlier BMA survey that found four in 10 GP practices in England did not have adequate facilities to deliver services to patients and more than half had received no investment in their premises for more than a decade.

GPC workforce lead Dr Krishna Kasaraneni said: ‘Many practice buildings are dated and in a poor state of repair due to the considerable bureaucracy associated with improvement grants and the failure of revenue support schemes.

‘This lack of investment and over-regulation stifles innovation. We want to expand the practice team, but without the space and facilities to accommodate staff, patients will not be able to access the full range of services they need.’

Cost directions

One GP who took part in the GPonline survey wrote: ‘We own a hopelessly inadequate old house and have merged with our neighbours in similar accommodation. We desperately need a modern building to co-locate to but are unable [to do this] due to cost directions.’

Another added: ‘In the main [GP practices] are ageing buildings designed for a period of general practice we have long moved away from and huge investment is required to make these relevant.’

Some respondents were happy with their premises, while one locum GP said that practice staff are more important than premises, arguing: ‘I can say that the premises (quality, condition, location) make a big difference. But a bigger difference is made by the staff working in those premises, the organisation of the rooms and the cleanliness of the rooms.

‘I have worked in new buildings which are not clean and disorganised, and I have worked in old buildings with the opposite. Too much focus is given [to] the superficial things - what really matters is how things are looked after, maintained, cleaned, organised and updated.’

Premises review

Dr Kasaraneni described the ongoing premises review as a ‘welcome step’, but added that it must ‘address the fundamental issues facing partners, including last person standing, difficulty in accessing investment and all the added regulatory aspects that have turned premises from an asset into a liability’.

NHS England launched its Estates and Technology Transformation Fund (ETTF) as part of the GP Forward View (GPFV) in 2016. The ETTF aims to deliver £900m into practice facilities and technology between 2015/16 and 2019/20.

An NHS England spokesperson said: ‘This survey does not reflect the £160m invested in 2017/18 through the ETTF, a 17% increase from the previous year, in new consulting rooms, bigger buildings to house a wider range of staff and facilities for treatments like minor surgery.’

However, a BMA assessment of the GPFV in June found that many schemes funded by the ETTF have been delayed and that securing funding for large-scale projects has been difficult. This was reinforced by the RCGP's latest assessment of the GPFV, which found that there was ‘more demand on the ETTF than it can deliver’.

The BMA is due to release the findings of its latest premises survey imminently.

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