How we got a £2.4m new surgery
This shiny new GP surgery reopened after a state-of-the-art makeover. Dr Surinder Chaggar explains how he got the NHS to fund it
Name Forum Health Centre, Coventry
List size 16,500
GPs 6 partners, 3 salaried GPs, 3 registrars
We applied for the money through the Primary Care Infrastructure Fund (PCIF)
Our 1990s surgery was a rabbit warren of rooms off the single claustrophobic waiting room. Consulting rooms and administration areas were unsuitable. The repair costs were mounting. Our six-partner practice had around 16,000 patients and could not accommodate more. So we decided to apply for wave one of the PCIF. This involved filling in two application forms, then ‘due diligence’ checks by NHS England, including project plans and valuations.
In our application, we described the problems that a new building would fix, but more importantly we also discussed what the new build would allow us to do in future, with close attention to the themes of the Five-Year Forward View. We are about half a mile from a large acute trust, so a key part of our application was the creation of an integrated working space to bring together GP services, hospital services and the community and social care teams. Our new meeting space will accommodate 40 people; previously we could take only 10. We also proposed creating a telehealth room for Skype consultations and remote monitoring.
Because the fund is for ‘refurbishment’ not rebuilding, we haven’t knocked the whole building down – we left one corner standing – but we altered the building as much as possible within the definition of reburbishment.
We were operating our practice from a Portakabin for a year
Our bid was submitted in February 2015, we got approval in April 2015, due diligence was done in May 2015 and the new premises were completed in June 2016. NHS England reimburses two-thirds of all invoices to the value of the agreed bid. While the building was being refurbished, we had to shoehorn our practice into an eight-room Portakabin on the car park, with all the noise and disturbance a building site creates. We ran morning, lunch and evening clinics rather than just morning and afternoon, and we worked on Saturdays to make the most of our limited space. We also only used consulting rooms for clinical contact, so GPs did paperwork from home, using the network.
The difference is incredible
We’ve got a new entrance foyer, with four separate waiting rooms, colour zoned so patients know where they are going. These waiting areas take the pressure off the main waiting room, improve patient flow and help ensure confidentiality. We have five additional consulting rooms (taking the total to 23), and the existing ones have been upgraded to proper sizes with hospital-style sinks and all the necessities of modern general practice. The building has Wi-Fi throughout, which supports community teams working with mobile devices. We now have a phone hub upstairs away from reception so the two reception staff downstairs are now just focused on customer service. The building uses about half the energy of the old building – there’s LED lighting everywhere. Although every room has air conditioning, the system saves energy by recycling the exhaust gases to heat our water.
It will allow us to expand, both patients and staff
We’ve added around 500 patients and the new building allows us to take a total of 20,000. Our new building will also help attract new staff, both because it is a more pleasant environment and because it has room for more trainees (we now have three registrar GPs and are in talks to take on medical students) – essential for recruitment of new doctors.
If other practices want to do the same
I recommend using a professional firm of architects and project managers, so make sure to account for these costs. And don’t underestimate the amount of work. For the application itself, you have to pay close attention to the strategic direction of the NHS, so I would recommend linking it to the Five-Year Forward View.
Dr Surinder Chaggar is a GP in Coventry and integrated care lead for NHS Coventry and Rugby CCG