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Some 600 GP premises improvement projects delayed, minister admits

Hundreds of GP premises upgrades are on hold because they depend on the conclusion to negotiations over new reimbursement terms and conditions, a minister has admitted.

Health minster Philip Dunne said that ‘up to 627’ projects earmarked for support from NHS England’s £1bn premises fund were unable to progress until new Premises Cost Directions, which set out costs practices will be reimbursed for, had been agreed.

This comes despite NHS England previously claiming GP premises upgrades would not be hampered by the delayed negotiations, which have now dragged on for more than two years.

It also comes as a Pulse investigation into the rollout of the ETTF earlier this year revealed that only £48 million had been spent on GP premises.

GP leaders said there were fundamental improvements needed to make GP premises fit for purpose and condemned the ‘impasse’ preventing long-awaited funding being released from NHS England’s Estates and Technology Transformation Fund (ETTF).

The Premises Cost Directions, which were last updated by the Department of Health in April 2013, set out what practice business and building-related costs can be reimbursed by NHS England and under what circumstances.

Responding to a written question from Labour MP and shadow cabinet minister Richard Burden, Mr Dunne said that the cost directions are ‘currently being negotiated’ betwen the DH, NHS England and the BMA’s GP Committee, adding that an end could finally be in sight.

He said: ‘It is anticipated that the new directions will be agreed shortly.’

But, responding to Mr Burden’s question about what impact the delay was having on the ETTF, Mr Dunne said that although ‘no fully approved schemes’ were being held up, a ‘large number’ of projects were in fact affected by the delay in finalising the premises cost direction changes.

He said: ‘[T]here are a large number of improvements to existing premises and new builds which are dependent on the revisions we have been negotiating (up to 627 schemes).’

The news comes as last year’s GP Forward View pledged that planned changes to the Premises Cost Directions, including lifting the 66% contribution cap on premises developments, would allow it to fund GP bids through the ETTF at 100%.

NHS England, which lists around 600 ETTF projects as provisonally approved on its website, declined to comment on Mr Dunne’s statement despite last year pledging that ‘no project will be disadvantaged by the delay in the changes to the Premises Costs Directions’.

GPC chair Dr Richard Vautrey said: ‘Having good quality practice premises is fundamental to the successful delivery of general practice and its a scandal that so many practices are still struggling to cope in inadequate building that would be better suited the 19th century, let alone the the 21st.

‘Despite promises made about significant funding to support vital premises development very few practices have actually seen anything delivered and those involved in the process have been caught up in a bureaucratic quagmire.

‘It’s imperative that urgent steps are taken to resolve this impasse and deliver essential funding to practices.’