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Gold, incentives and meh

Rise in admissions to speed roll-out of community matrons

NHS LIFT is a 'value for money' way to build new GP premises but is not suitable for every area of the country, a report by Government spending watchdogs concludes.

The National Audit Office report released this week said LIFT ­ Local Improvement Finance Trust ­ would be a success because it was flexible, took a long-term approach and could be adapted to meet local needs.

LIFT, which involves PCTs and private developers forming a joint venture, helped bring more primary care services under one roof and could help with recruitment of GPs, the NAO found.

But it concluded that the scheme would not work in areas with a low population or in deprived areas where there was not enough potential return to attract developers.

The audit office also cricitised the Government for not setting up a framework to evaluate the impact of LIFT on patient services.

Patricia Leahy, a director at the National Audit Office who worked on the report, said the concept of LIFT was 'very difficult to criticise'.

She said: 'It's a long-term initiative and there's plenty of time for lessons to be learnt.'

Ms Leahy added that getting GPs 'on board' was the biggest problem.

Dr Bhupinder Kohli, who practises in the first LIFT-financed surgery, which opened in east London last year, said it gave GPs the 'clout' to build bigger premises offering more services. He said: 'You can't carry on with the terraced house model ­ it just isn't going to work.'

But Dr Peter Swinyard, chair of the GPC premises sub-committee, said LIFT caused 'incredible time delays' in premises projects.

He added: 'In some areas almost all the funding going into premises is going into LIFT, so all the other practices in the area will find it difficult to do anything. LIFT has vacuumed up every single penny of the few that are available.'

Dr John Havard, a GP in Saxmundham, Suffolk, who is battling to get his PCT to fund a new one-stop shop, said LIFT was not suitable for his area.

He added: 'Our scheme is seriously cheap compared to LIFT with all its associated legal costs.'

Audit Office findings

·LIFT is effective, flexible and value for money

·Could indirectly help resolve GP recruitment and retention problems

·Supports patient choice by offering more services under

one roof

·May not be the best procurement method for all areas

·No framework exists to evaluate its impact

·Many projects slow to get off the ground, but this will improve

·Independent-minded GPs may not find the idea of co-location appealing

By Rob Finch

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