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GPC admits additional premises funding looks remote

The GPC has admitted that any new investment in GP premises is looking remote after talks with the Government on how to equip practices for the future shift in services from hospital ‘fell apart’.

A GPC bid to secure a commitment from the Government to invest in GP premises for the future was meant to form a key plank of the 2013/14 GP contract negotiations, but Pulse can reveal discussions with NHS Employers were abruptly cut short when the Government announced plans to impose contract terms in October.

But Dr Bailey said the GPC is continuing to push for such a commitment, as Government plans for a shift of care from hospitals and into the community would otherwise be impossible.

He said: ‘The argument we repeatedly make is that there has been virtually no investment and you can only actually deliver services closer to patients’ home [in acceptable premises]. We actually have to have premises to deliver these services, you can’t just do them in the back of a broom cupboard.

‘I am afraid the whole thing (with the NHSE) rather fell apart before we got close to a response on that, but we are continuing to make representations to the Government that if you actually want to deliver this key element of public policy, then where you need to do that in all four nations is to start to look at an investment policy which makes us believe that you are going to provide the premises that makes delivering services closer to home actually work.’

But the GPC has secured negotiations with the DH on the handover of GP premises responsibilities from PCTs to the NHS’s new property management company amid fears that GPs may lose out in the move.

NHS Property Services, a standalone company wholly owned by the DH, will take over the role to reimburse practices for rents from 1 April when PCTs are abolished and will be responsible for costs totalling £1 billion each year.

But as revealed by Pulse earlier this month, there may be a £500m gap in premises funding following the abolition of PCTs after it emerged that half of the costs used to be covered by PCTs themselves, with the GPC vowing to fight any of the costs being passed onto GPs by the company, also known as PropCo.

The DH admitted that rents paid by tenants cover only half of the new company’s costs and that it was working with the NHS Commissioning Board to introduce a ‘new method’ of recovering the costs and, when pressed, said the possibility of recouping this from tenants has not been ruled out as an option.

GPC premises negotiator Dr David Bailey said the discussions focus on ensuring that the process continues to be fair for GPs, with a clear appeals process if GPs disagree with decisions made by the PropCo on reimbursements.

Dr Bailey said: ‘It is about how we continue to make that process fair for practices, make sure that it is even-handed between practice and Government. It is about refining the existing premises directions and making sure they are fit for 2013.

‘It is basically a changing landscape [and] we are obviously very keen that there is a proper appeals process to go through. We would like to see something that is completely clear and transparent, in particular as there seems to be more and more going on around notional rents and so on.’

’I would think that we would want to be getting somewhere close to agreement before when the new world starts in England. We may not have everything completely sorted out by then but certainly I think we will want to have some idea where we are going by April.’

 

Readers' comments (4)

  • What is happening about Notional Rent, Cost Rent and any developments which are either being built or have contracts to start construction?
    And where will premises expenses be managed when the practice is *not* a tenant of the PCT or, in the future, the NHS Property Company?

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  • Additional funding shouldnt be needed. Any price for the provision of a service will include an element for accomodating the service. As a result the provider will get funding via the service price for the accomodation needs.

    GP's, like any other provider, will have to invest up front to build the premises using commercial funding sources and then recoup the cost over time from the service. This is how any other provider who wants to bid for this work will be expected to do it so why not GP's. I know of some practices who are already at the planning permission stage of expanding using this approach.

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  • What about premises rent reimbursements that the NHS has already committed to fund, particularly where the premises are owned by a third party developer and the GPs are the tenants? Such agreements with the NHS are legally binding.

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  • It does seem anachronistic to even be funding accomodation costs separately from clinical service costs to GPs. It is not done for any other sector or even other parts of primary care. Why is it not just incorporated into a higher capitation payment?

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