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GPs buried under trusts' workload dump

How I brought my premises into the 21st century

Dr Simon Gazeley describes how he secured a move from lovely but cramped millhouse premises to a purpose-built surgery

Dr Simon Gazeley describes how he secured a move from lovely but cramped millhouse premises to a purpose-built surgery

Last month, after 12 years of planning, we finally moved into a brand new health centre. It took a lot of time and effort, but we have ended up with premises that are a great improvement on the 19th-century millhouse we used to own.

We developed the modern building with the aid of the Government initiative LIFT. I was wary at first of this initiative and had a rather negative view of it. But after taking an active role in the project, I was able to shape the design of the building and we have ended up with premises that both patients and staff are pleased with.

The problem

Bingley is a small town on the edge of Bradford. We had seen a lot of investment in GP premises in the more deprived neighbourhoods in Bradford and Keighley, but Bingley – a largely affluent, middle-class area – had been overlooked.

We have a young and ever-increasing population because of the town's easy commuter links to Leeds, and although our old surgery had a lot of character, it was becoming overstretched and unfit to provide adequate healthcare.

We had three nurses and six doctors to fit into one nurse treatment room and three consulting rooms. Healthcare was spread out across Bingley, with four practices in three different buildings, and community services working out of the old Bingley Hospital.

Getting funding

Finances and early plans were agreed for a new health centre, until the local PCT changed structure, and in 2005 plans were put on hold while managers wrote a strategic development plan for premises upgrades.

The plan gave Bingley a high priority for new premises, but it was clear LIFT was the PCT's preferred option. We were told in no uncertain terms that Bingley would not get a new health centre by any other route.

We decided to go ahead with a LIFT project, even though local GPs had many reservations about whether it would deliver a suitable building.

Working with LIFT

To begin with, working with the LIFT team was not great. The constructor, architect and the PCT seemed to have their own way of doing things that they did not want to deviate from.

There were a number of LIFT buildings cropping up in the area, mostly in deprived areas of Bradford, and we were concerned that these buildings were characterless and impersonal, and would change the nature of our practice in a way neither we nor our patients wanted.

As the project progressed, there was an increasing understanding of what our practice and patients required. A lot of time was spent by the LIFT team looking at what was needed in Bingley.

Our meetings with LIFT were held monthly – although at times there were several a week – and there were frequent emails. With this much contact, we developed a good team approach, with only the odd strain along the way.

The GPs invested a lot of time and I don't think the end result would have worked so well without this. Thankfully, we were closely involved in the whole design process and our views and ideas were fully taken on board.

Seeing friends and colleagues going through third-party or self-funded builds elsewhere, it became increasingly obvious that the LIFT process saved us a lot of time.

Researching premises

We spent quite a lot of time in the early planning stages visiting other new-builds in the district. Some of these were LIFT schemes, some not. This research was invaluable in terms of identifying features that we thought would work well for us, and features that worked less well.

The LIFT team had been through this process several times before and had their own ideas, but the groundwork we did enabled us to illustrate with real examples how we could do things differently.

Patient involvement

There was extensive patient involvement throughout the process. The public consultation involved a mailshot to the 20,000 residents of Bingley, articles in the local newspaper and several evening events inviting patients to offer their views.

Questionnaires were posted to patients to give them the chance to influence planning at an early stage. Each practice had their own patient council involved with planning.

The PCT also set up a dedicated patient group who met regularly to give their input. The building's design reflected this – for example, with the addition of a pedestrian-only entrance at the top of the building so that those who were not driving could avoid a long walk.

The result

We have ended up with an amazing building. Outside is local stone in keeping with the conservation area, with many of the original trees, and the building blends in with the neighbouring canal. Inside there is an impressive, bright atrium with a bottle-green glass roof giving a calming, welcoming glow to the circulating spaces.

Our practice is a completely separate unit with its own entrance, waiting area and reception. It is a huge change, but the architects have managed to create the individual feel we were looking for.

The Canalside Health Care Centre holds a Boots pharmacy and two other practices downstairs. Upstairs is a community cafe, a shared library, meeting rooms and minor surgery suite.

The feedback from patients has been overwhelmingly positive, and they are already benefiting from other community services in the same building. For example, rather than waiting for their physio appointment to arrive by post, they can simply walk upstairs and book it directly.

We are subtenants of the PCT and although service charges are much higher, the cleaning costs per square metre actually work out cheaper than our old practice. Costs such as maintenance, repairs and redecoration are covered by LIFT and are not borne by our practice. There is information about the legal pitfalls of leasing new premises in another linked online article (see above).

We have already increased the provision of services for patients as a result of moving in, offering in-house phlebotomy and looking at adding a warfarin clinic, as well as ultrasound and telemedicine. There is room for our expanding population to grow, and plenty of opportunity to extend and improve services.

Dr Simon Gazeley is a GP at the Springfield Surgery, located in the Canalside Health Care Centre in Bingley, West Yorkshire

Canalside Health Care Centre

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