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GP practices blocked from bidding for premises fund by cash-strapped CCG

Exclusive Practices looking to expand or improve their premises have been excluded from NHS England’s much-touted £1bn 'transformation fund' because cash-strapped CCGs cannot afford the subsequent rent increases.

NHS Leeds North CCG told practices that because of its poor financial position it would not support bids for funding where it would lead to increased rents, because it could not afford the cost of increased reimbursements.

But a GP leader said this was another example of ‘short term’ thinking that NHS England has applied to the fund first announced by chancellor George Osborne in 2014. The GPC has previously highlighted concerns that the fund was being underspent, with one in five approved projecets at risk of collapse.

NHS Leeds North CCG board papers said: 'Due to financial constraints in 16/17 practices were made aware that within any bids submitted, if there is development of new or expansion of existing General Medical Services (GMS) space, the CCG will not be in a position to provide practices with reimbursement associated with rent for this additional space.'

NHS England requires CCGs to support all costs associated with a successful bid to the fund and NHS Leeds North CCG told Pulse that they would therefore not be putting forward those where rent reimbursements would increase.

It said it would review this position for next year’s bids but that it had been important to be clear with practices when they were drawing up plans.

A spokesperson said: 'The CCG is supporting practices to submit bids to access monies through the fund, but cannot currently afford to incur any related additional, recurrent, revenue consequences.

'NHS Leeds North CCG supports practices’ entitlement to rent reimbursement. However, in 16/17 the CCG is unable to support bids to Estates and Technology fund which will result in an increase in revenue costs to the CCG as a result of increased rent reimbursement.'

But Leeds LMC assistant medical secretary Dr Richard Vautrey, also deputy chair of the GPC, told Pulse the LMC was 'challenging the CCG on this point’.

He said: 'It undermines the viability of practices, does not recognise the pressures of population growth or any plans for community development long-term with such a short term approach.’

He added: 'This is likely to be one of the reasons why the fund is not being spent - and why it needs to be rebadged so often - because the recurrent funds for practice premises have not been properly factored in to this investment.’

NHS England was approached for comment on the CCG’s position but had not responded at time of publication.

The £1bn premises fund

The fund launched by NHS England in 2014 has already been rebranded twice in its first two years was intended to ’modernise’ general practice, and prioritised bids that would improve care for the elderly and extended access.

More than 1,000 practices were given the green light for funding from the first year’s £190m slice of the fund, with 32 bids worth between £1 and £5m given the approval in principle in March 2015.

But the original scheme required projects to be completed, and funding spent, in year one and Pulse revealed how millions in pledged funding had been withdrawn from practices by November.

This was shortly followed by an announcement from NHS England that management of the scheme had been handed to CCGs, and practice bids would now have to be redrawn in line with local estates plans.

It has most recently been rebranded the Estates and Technology Transformation Fund, after having been re-hashed again in the General Practice Forward View published this April.

Readers' comments (8)

  • This is short sighted folly.Having retired from being a GP and CCG Exec member,I travel the country for the CQC,and the contrast between the Practices in modern purpose-built premises and those in unfit-for- purpose Victorian terraces is stark.
    21st century medicine needs 21st century facilities.If, NHSE, you are not going to fund this, then get off our backs and accept that the consequence is substandard medicine.

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  • I agree somewhat with Anon 10:25am that this may appear to be short sighted but it will depend on what the schemes in questions are. If a scheme found a solution for 3 or more practices into one building and that scheme included agreements from the practices to run the practices at scale as one service rather then having 3 separate reception desks, admin, consulting space it might stand more of a chance of getting support. Also there's nothing to stop practices taking space at risk without reimbursement if they are confident they can make additional services work or have other tenants in mind such as dentist, pharmacist, AHPs etc. that might cover some of the build costs?

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  • General Practice Forward View. More like no room no view.

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  • Anonymous | NHS Manager13 Jun 2016 11:17am - NO NO NO! The contract provides reimbursement, so no we can't do this. And the ROI on GMS is shrinking as it is, so we can't take this risk, and we can't be sure we can afford it for any long period.

    The whole issue here is that the country is broke, and we're kidding ourselves we can still afford services like the NHS. Time for co-payment.

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  • Then comes the big bad wolf called CQC WHO WILL blows YOU AND YOUR PREMISES to pieces.

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  • When we stop trying to be property developers with two mortgages, and concentrate on healing the sick/signing GANFYDs, we can let NHSE sort out reimbursement and take ourselves out of the equation.Any JD, fresh from a hard day's placard waving and mild industrial unrest would be mad to entertain buying in to premises.

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  • NHS is corrupt. Premises funding goes to those with connections. If an average Practice wanted to make improvements it would struggle to prove there is a need. In one case, when a matter of essential funding being refused by NHSE was brought to the CCG at a GP Meeting, the CCG Chief waived away the issue commenting 'So you probably did not need it'. No discussion was allowed.
    Funding has been given to bigger Practices mainly where this particular CCG Chief works. Corruption needs to go first and then let's sit down and discuss forward, backward or downward 5 year plans.

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  • Vinci Ho

    The simple question , ' if the government really means it , why goes around in circles with rebranding after rebranding of this fund and called it another name in the GP forward view?'
    Liar , liar , pants on fire . For those who are Stevens' sympathisers and supporters , would you not want to wake up to confront all these Pinnochio(s) (true faces well exposed by this EU referendum bloodshed)? I guess not......

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