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Invest £250m in premises or forget shifting care to GPs, GPC to tell NHS England

Exclusive GPC negotiators are stepping up their campaign for more investment in GP premises this year and will demand NHS England stump up at least £250m to improve surgeries across the country.

Dr Peter Holden, the GPC’s lead negotiator on premises, told Pulse that NHS England will be told to ‘wind their expectations in’ unless more funding is released for much needed work on GP premises.

The GPC will ask for a minimum investment of £250m in 2014, alongside a commitment to setting out longer-term surgery contracts that offer more stability to outside financiers.

Negotiators say that the shifting of more care out of hospitals and into primary care - as called for in NHS England’s high-profile ‘Call To Action’ campaign - will be impossible unless additional resources are invested in GP premises.

The GPC has four meetings scheduled in January with NHS England and NHS Property Services to discuss GP premises and will push on the need for greater premises funding as well as issues already raised last year, such as funding for disposal of trade waste.

Dr Holden said: ‘What I will be saying is that if you are not prepared to make this investment, then politicians keep your mouths shut and stop stoking demand, wind your expectations in - because without the right premises your expectations cannot be met.’

‘£250m is peanuts in the scale of things. When you look at the amount of money they are prepared to throw at short-term problems like A&E, you know, this is peanuts and it is time the Government got its priorities right.’

Dr Holden said that he will reiterate calls for NHS England to give surgeries longer-term contracts to encourage outside investment and use NHS Property Services’ existing property portfolio as collateral to set up a separate financing entity for GP premises.

He said: ‘NHS Property Services is an arm of NHS England and it holds a property portfolio of £3.6bn. I have been saying for some time that that property portfolio could be used as collateral with the banks to create a second-generation practice finance corporation.’

The push comes after several years of unsuccessful drives to boost investment. The GPC’s bid to make premises funding a key plank of the 2013 contract negotiations was cut short by the Government’s contract imposition.

But GPC chair Dr Chaand Nagpaul said the time was right for a push to ensure better investment in premises.

He said: ‘I think that the time for talking is over around premises. There is absolutely no doubt that premises are one of the greatest constraints in preventing GPs from providing an expanded provision of care. It is a block to delivering the Government’s agenda of moving care into the community and this has to be addressed.’

Readers' comments (9)

  • Bob Hodges

    "‘What I will be saying is that if you are not prepared to make this investment, then politicians keep your mouths shut and stop stoking demand, wind your expectations in because without the right premises your expectations cannot be met."

    Peter you are so right its criminal that no one else is saying this.

    Add in the GP workforce crisis already here and we're double-shafted.

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  • The time has come to end notional rent and provide a property rate per registered patient to all practices that covers the cost of maintaining an adequate estate for GMS services.

    The current arrangements are arcane, and lead to the industry abrogating its responsibilities. They are seen as dysfunctional by commissioners (rents rise when property prices crash, and they rise when property bubbles happen)

    In addition any extended services delivering a shift from secondary care should be priced to include the necessary premises costs.

    The GPC approach is a begging bowl which in the current financial climate is never going to work. The move to incorporate all costs into the capitation payment would be the strategic move.

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  • The NHS has traditionally provided a "last man standing clause" for GPs in leased premises, wherein the last partner left in the practice (holding the lease) is protected if he has to stop work (re health issues, retirement, etc).
    Now however, NHS England are refusing to provide this and are insisting that GP partnerships (even sole practitioners) are obliged to be responsible for the full term of any contractual lease. Practices due to re-new their leases are being asked to sign 25+yr contracts, making themselves personally liable, although many/all in the practice have substantially shorter times to retirement, and, in the present chaotic NHS environment, have no confidence in the long term future of the NHS. These practices are now left with effectivley no lease!

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  • I'm confused about GP premises funding.
    NHS Property Services were gifted the entire estate assets of the PCTs - but aren't most GP surgeries financed by loans taken out by GPs and serviced by notional (or cost) rent?
    Who is responsible for Notional/Cost Rent - especially when there is a discussion about developing new premises?
    (NHS PS seem to have needed rescuing - but FT article behind paywall! Pulse, is this true and if so what are the implications for general practice?)

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  • Surely there is 2 discussion points here
    1) Appropriate funding for premises
    2) Taking on secondary care wokload
    Please don't mix them together

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  • £250M is no where near enough to address the backlog in premises deficiencies built up by chronic underfunding , yet alone for the enhancements and expansion needed to facilitate Community Services and reduction in hospital use. ( For an expanding older population with LTCs ). Practices at risk of CQC closure through no fault of their own. The issues relating to who pays the rent for non GMS space is problematic . Let us hope Parking Charges are not introduced , as per hospitals , to fund this !

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  • £250 million RECURRENT will with appropriate guarantees in the current climate liberate about £2.5 BILLION of investment.IT WAS WHAT I NEGOTIATED IN 2004 BUT IT WAS STOLEN TO PAY FOR MPIG!!!
    Peter Holden

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  • Vinci Ho

    I can imagine what NHSE would say, 'kiss our a**es, you greedy GPs.'
    My crazy nightmare was all GPs needing new premises were forced to move inside Tesco, Sainsbury , Mark and Spencer, like Costa Coffee!!!!

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  • lets stop and think

    show me one business who are guaranteed the interest to create the building and then instead of that proportion of help going back to NHS is profited by the GP

    the NHS England might keep the funds and create purpose built buildings and that would mean the money will remain in the NHS

    the question of secondary care services coming to primary care is a different issue

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