A GP practice in Cheshire has been battling to get new premises for more than a decade despite having staff injured and signed off sick because of the state of the buildings they are working in.
The Knutsford Medical Partnership is based over four sites in old Victorian buildings with steep stairs, access problems and such a lack of space that face to face appointments regularly have to be replaced by phone clinics.
One staff member broke an ankle after falling down the steep stairs – an issue that led to the CQC asking questions about risk assessment. Another fell and cut their head, as first revealed by the Knutsford Guardian.
A damp problem in one of the buildings that has now been fixed led to one member of staff having to be signed off after it caused a flare up of a respiratory condition. In another building there are issues with roof leaks and buckets to catch drips, said GP partner Dr David Hans.
Plans for a new purpose-built health centre have been under discussion for more than 12 years, he explained but it’s always been ‘two steps forward and five steps back’.
Three practices in Knutsford had merged into one just before Covid with the aim they would all be housed under one roof before long, he said.
They have not been able to invest or access much in the way of grants to help improve or fix problems with the buildings because it has always been assumed they would not be in those unsuitable premises for long, he added.
Yet despite a site being identified for private development of a medical centre – a location that already has a community hospital with some space used by the practice – Cheshire East Council and East Cheshire NHS Trust have so far not agreed to sell the land.
Patients at the practice are among those who have written to the chief executives ahead of a meeting earlier this month to stress that an urgent decision to sell the site is needed.
‘At various times we have been told we’re a priority and then there’s another NHS reorganisation and we have to go through the whole process of estates review again,’ said Dr Hans.
‘The idea is to build a new health centre on land that is already being either not used or used for health purposes. But trying to get agreement between the council between the trust between the ICB has proved quite difficult even though everyone seems to agree it is a sensible thing to do.’
A huge number of hours has been wasted on meetings trying to resolve the issue as well as constantly juggling space for the GPs and increasing numbers of ARRS staff, he says.
They have a high number of elderly patients and access to rooms up steep stairs is a real problem. GPs often have to help patients back down again to make sure they’re safe.
‘You’re in the middle of the surgery and someone’s booked in [who can’t get up the stairs] and you have to try and swap a room with someone downstairs and then the patient has a longer wait. It’s not satisfying as a doctor, it’s not satisfying as a patient.’
A planned housing development also means the 23,000-patient practice is about to increase by another 2,500 patients.
In a report published last week to mark the NHS 75th birthday, the NHS Assembly noted that almost a fifth of the primary care estate was built before the NHS was founded.
The RCGP noted this month that almost a half of GP premises were ‘unfit for purpose’ with a quarter having water leakage mould or mildew.
‘I understand the challenges and the financial constraints but equally it’s difficult to accept that when you sat in the buildings that we are struggling in.’
A spokesperson for Cheshire East Council said the council had retained the land at the proposed site for a number of years whilst the NHS has developed its plans and sought capital funding, which had not happened.
‘The council has a statutory responsibility to achieve appropriate value for money for council taxpayers when disposing of any assets and the capital cost of any scheme brought forward by the NHS will need to include the cost of purchasing the site from the council.
‘The council will continue to work closely with the NHS as it develops its plans for the site and identifies the funding required to deliver a viable project.’
NHS Cheshire and Merseyside’s place director for Cheshire East, Mark Wilkinson, said: ‘No decision has been made on proposals to establish a new central primary care facility in Knutsford.
‘We are exploring options with partners, by reviewing existing buildings in the town and considering how they could be adapted to suit the long term healthcare requirements of the people of Knutsford.’