BMA leaders warned earlier this year that GP practice premises needed urgent investment, after a poll found half were no longer fit for purpose.
Speaking to GPonline, senior King's Fund health policy fellow Beccy Baird said that inadequate premises could also be a barrier to success of PCNs - warning that ‘there is going to have to be a lot of work on premises’ to ensure networks can be effective.
‘There are areas of the country that are going to struggle and there is a lot to sort out,’ she said, adding that problems ranged from there ‘not being enough room’ for the additional 20,000 allied health professionals promised under PCNs, to ‘complexities around VAT, cross charging and rent reimbursement’.
Ms Baird argued that ‘bringing GPs together’ through PCNs via the local integration of ‘the general practice estate, the community services estate, the pharmacy estate and so on’ could go some way to tackling existing premises problems.
Premises and technology
A recent King’s Fund report, Clicks and mortar: Technology and the NHS estate, found that integrated care systems (ICSs) and sustainability and transformation partnerships (STPs) - under which PCNs will be developed - have the potential to ‘address a number of the challenges’ with premises ‘by taking a strategic view across the estate and technology and bringing these areas together as part of wider plans for change’.
According to the King’s Fund report, by integrating both the NHS estate and technology across primary care, PCNs could benefit from:
- Interoperable sharing of health records, enabling expertise and resources ‘to be accessible across organisational and geographical boundaries’. This makes it easier for different services to be co-located - for example, by supporting continuity of information for patients accessing different services within a single ‘hub’.
- Different ways of working for healthcare professionals, for example ‘enabling staff to book work spaces digitally across the estate’ to support a more flexible use of space.
- Managing activity and demand in the way that best utilises the estate.
- Smaller premises. The report says that technology may have the potential to reduce the estate footprint, even if it is as simple as ‘moving physical space into digital space - for example, where electronic health records are removing the need for paper storage’.
However, GPC executive team member Dr Krishna Kasaraneni told GPonline that - while PCNs ‘could help practices make the most of available space across an area’, without major investment the ‘fundamental problems’ with GP premises would continue.
‘We cannot respond to the growing needs of our patients or expand practice teams if we don’t have premises fit for the future and the government must act,’ he said.
The King’s Fund report - described by NHS property services chief information officer Roslyn Churchill as highlighting the importance of delivering ‘a transformative strategic vision for the future estate’ - has been published ahead of NHS England's premises review, which is expected to be completed in the coming months.
Speaking earlier this year, partnership review chair Dr Nigel Watson told GPonline that the review would be ‘critical’ to the success of primary care networks and warned that GPs could be left facing increased financial risk unless the current system is reformed.
Dr Kasaraneni added: ‘We are still waiting for the promised review of premises… It is critical that this issue is addressed now.’ Ms Churchill said earlier this year that both technology and the NHS estate would be ‘vital’ to the delivery of the NHS long-term plan.