22 February 2019 | Herpreet Kaur Grewal
Only half of GP practice buildings in England are fit for purpose, with surgeries too small to meet the demands of growing populations, finds a major survey on practice premises from the British Medical Association (BMA).
The survey of more than 1,000 practices in England asked doctors and practice managers about their experiences with property ownership and management.
One of the main findings is that eight out of 10 GPs said their premises are not fit to meet anticipated future needs.
The findings present a snapshot of the GP premises landscape, as well as the issues faced by family doctors, staff and their patients.
Key findings include:
Only half of the practices said their premises were suitable for present needs.
Around eight in 10 practices said their practices were not suitable for future needs or anticipated population growth.
GP premises are on average 35 years old, having been first built or converted in 1984.
Eight in 10 practices are in purpose-built premises.
The last significant modification or extension to premises took place in the mid-2000s (2005), on average, predating many of the increases in patient demand and population growth witnessed over the past decade.
When asked what would make premises more suitable for present needs, most practices noted that more space is needed, including by extending the premises, more consulting rooms to manage a growing patient list, improving access including for disabled patients, and expanded and improved patient waiting and reception areas.
Of those respondents who said they had applied to NHS England for improvement grants, most reported waiting in the region of three to six months to receive information on the status of their application. However, some reported waiting more than two years with the process ongoing.
Eight in 10 practices leasing from an NHS organisation said they had been invoiced with charges that were inaccurate in the past 12 months, with only 5 per cent reporting that these issues had been resolved.
In light of the survey's findings, the BMA is now urging the government to use next month's spending review to invest in GP premises. The body is also calling for health bosses to remove bureaucratic barriers that can often prevent practices carrying out the improvements needed.
Dr Richard Vautrey, BMA GP committee chair, said: "Without more space and the ability to add rooms and facilities easily, patients will continue to face long waits for appointments, as GPs and their wider practice staff can only work with what they have.
"The BMA recently came to a significant agreement with NHS England as part of contract negotiations to expand the primary care workforce - with groups of practices employing pharmacists, physiotherapists and other professionals - but for patients to benefit from this expanded team, they too will require space to work.
"Our research shows that the solution to this problem is not as simple as partners adding rooms or extending their surgeries to meet demand, with approval processes arduous and NHS grant applications not always running smoothly.
"GPs who lease their buildings from the NHS face their own set of problems, with rocketing and unwarranted service charges and management fees often not met with adequate maintenance. At a time when GPs are facing extreme financial pressures, these unilateral price rises could push practices to the brink.
"NHS England is due to publish the findings of its major review into GP practice premises, and we hope that it will provide some solutions to the problems persistently raised by our members.
"More broadly, the government must use next month's spending review to urgently invest in practice premises - as well as wider NHS infrastructure - to bring facilities up to 21st century standards and ensure that GPs and their colleagues throughout the health service can guarantee the best care now and in the future."