Exclusive: GP negotiators have begun talks with ministers about the most fundamental review of GP premises funding since the introduction of the nGMS contract, amid concerns that without urgent action surgeries will be ill equipped for the new world of general practice.
The Department of Health is planning a major overhaul of GP premises regulations from 2013 as part of the transition from PCTs, with last week’s passing of the health bill confirming their duties would move to other bodies including a private company.
But the GPC is warning unless the DH uses the opportunity to reverse the current slump in premises investment, practices will be unable to meet the demands set by the NHS reforms and will face a ‘mass declaration of non-compliance’ with Care Quality Commission standards.
Pulse understands talks are focusing on providing GPs with resources for refurbishing their existing premises, valuations and rent reimbursement. They come as up to £2bn of PCT estates are set to be transferred to a new company wholly owned by the DH, NHS Property Services Ltd. One of the company’s main functions will be to act as a landlord to providers including GP practices, supporting itself largely through rental income – and sparking fears of hefty rent increases.
GPC negotiators met DH officials earlier this month to press their case for a revamp of funding arrangements, Pulse has learned. The GPC is drawing up a list of demands to support practices in developing surgeries, and also want to make it easier for younger GPs to buy into premises.
The talks are being held against a backdrop of slumping investment in GP surgeries, with a Pulse investigation finding LIFT funding in 2010 had dropped by a quarter compared with the previous year, and that the LIFT Council was preparing to cut support for new builds.
Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex, said premises had risen to the top of the GPC’s agenda in the wake of the health bill passing into law: ‘In the context of the NHS reforms and moving care into the community, GP premises is the elephant in the room. GPs could be prevented from developing the range of services they’ll need by the current, inflexible system. The Government needs to invest more and make it easier for GPs to invest. We believe the investment will pay for itself in better, more efficient care. The current relative disinvestment in GP premises is not sustainable.’
Fellow GPC negotiator Dr Peter Holden said the Government remained reluctant to provide GPs with resources to refurbish existing buildings: ‘The Government is still wedded to the polyclinic model of general practice. What this Government, like others before it, has failed to understand is that we don’t need ribbon-cutting, photo-opportunity developments, but a large number of £200,000 to £300,000 extensions to existing practices.’
Dr Holden also said CQC premises requirements from April 2013 made the talks particularly urgent, and warned failure to act could lead to GPs refusing to co-operate with CQC registration.
A DH spokesperson said: ‘A review of the GMS Premises Costs Directions is under way as the NHS Commissioning Board will take on PCTs’ responsibilities for primary medical care, including reimbursement of GP premises costs. Changes will therefore be required for April 2013.’