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Experts warn of increasingly tough times for GP premises funding

Redundancies and cost-cutting by NHS managers are hitting GPs' ability to secure funding to upgrade their premises, experts have warned.

GP premises experts have told Pulse that the drive for PCTs to balance the books before they are abolished in 2013 means some are ‘thinking twice' about funding GP premises.
The raft of redundancies among PCT backoffice staff has also left premises claims in limbo as some NHS managers handling the process have lost their jobs or moved on, they claimed.
Last month, Pulse reported on an Audit Commission report revealing that PCTs spent £221m on redundancies in 2010/11. A quarter of cost savings made by PCTs involved culls on staffing levels that saw over 3,500 PCT managers and 35,000 non-management staff axed.

Paul Conlan, managing surveyor at premises consultant GP Surveyors, said: ‘The upheaval around the PCT structures is causing some uncertainty around premises claims.'

'It is not carte blanche - there are still PCTs funding upgrades - but in PCTs where lots of jobs have changed sometimes claims from GPs aren't reaching the right people. The budget pressures on PCTs also mean some are thinking twice about investing in surgery premises as they won't be around to see the benefits of the investment.'

‘In some cases doctors are going ahead to get work done without PCT approval. That has always happened but in the past PCTs often approved the funding retrospectively. With PCTs far more budgetary aware at the moment, they are less likely to pay for premises claims where practices have not gone through the proper process.'

Dr Peter Holden, a GPC negotiator and a GP in Matlock, Derbyshire, said ‘there is no question' that PCTs are reluctant to spend on premises and warned that premises were too often seen as a 'soft option' for PCTs looking to cut costs.

Dr Holden said: ‘There is no question that PCTs are reluctant to invest in GP premises.'

'There has been no significant sustained premises spend for the thick end of 15 years. Trophy schemes like Darzi centres have given ministers soundbites, they can say they have put £108 million into premises to build these things.'

'But the point is you need a sustained commitment to premises funding – one-off splurges are no good. What the governments of both colours need to recognise is that if you want more care done in the community via general practice then GPs need somewhere from which to do it.'

Dr Holden repeated his call for the Government to invest £250m in GP premises – the sum he claims was ‘raided' from premises development monies to fund the MPIG in 2004. He said concerns arising from a 2006 survey by the GPC that showed six in 10 GPs felt that their premises were unsuitable for their present needs, had not been addressed.