Half of premises unsuitable for GP practice needs, finds survey

Half of GPs and practice managers do not think their premises are suitable for current needs, with GP leaders warning it is ‘directly undermining’ the Government’s 10-year health plan.

The BMA GP premises survey of almost 2,000 GPs and practice managers found 50% of respondents did not feel their premises met their needs; and 83% were not confident they would meet future needs.

This is despite the Government announcing a £102m capital fund for upgrades for 1,000 GP practices in 2025/26. The fund had initially been earmarked for 200 sites.

The survey – the first since 2018 – also found almost three quarters (74%) of respondents did not have space to provide training for new GPs; and 83% said since joining a PCN they did not have enough space for additional staff on site. 

One survey respondent reported having a staff kitchen which could fit only one person standing, at a practice with 50 staff in total. Another said their practice’s 35 staff had to share one toilet. 

Dr Gaurav Gupta, BMA GP Committee England premises policy lead, said the survey revealed ‘a system at breaking point’ and argued the issue was ‘directly undermining’ the NHS 10-year health plan. 

He said: ‘Patients deserve to be seen in safe, modern surgeries that allow GPs and their teams to focus on what matters most, but instead they are being cared for in buildings that are simply not fit for purpose and were never designed to meet modern health needs. 

‘Many surgeries cannot house additional GPs and other staff, meaning patients face longer waits and fewer services close to home – directly undermining the Government’s 10-year plan, which places neighbourhood health services at its core. 

‘This is not just about bricks and mortar, this is ultimately about patient care. We urgently need substantial investment to modernise GP surgeries, clear action to free up space by removing paper records, and resolution of service charge disputes that have gone on for years.’ 

Earlier this month, health secretary Wes Streeting told a BMA special representative meeting the Government was ‘exploring private finance options’ for capital investment into neighbourhood health centres. 

Mr Streeting told BMA council chair Dr Tom Dolphin during a Q&A session: ‘We’re treading extremely carefully in this area, as you might imagine.

‘No one wants us to repeat the costly mistakes of the private finance initiative, but we have seen in other areas of the mutual investment model that the Welsh Labour Government has used, without controversy, successful examples of LIFT (Local Improvement Finance Trust) schemes.

‘I’m interested in that kind of approach that’s been proven to work without the downsides and negatives, so we’re exploring that with Treasury as well.’

The survey also found over a third (35%) of respondents who were tenants of NHS Property Services (NHSPS) buildings and a quarter (26%) of Community Health Partnerships (CHP) tenants had considered handing back their contract due to service charges disputes. 

65% of NHSPS tenants and 74% of CHP tenants told the survey they had received inaccurate invoices.  

Last month, the union demanded Government intervention over ‘unaffordable’ GP service charges from the two providers which had forced some practices to hand back their contracts. 

A spokesperson for NHSPS told Pulse: ‘We acknowledge the publication of the BMA’s Premises Survey results and welcome the findings, which we are currently analysing in more detail.  

‘We are pleased to see some improvements in our performance areas since the last survey. However, we are aware that there is always more to do and remain committed to supporting our primary care colleagues facing financial challenges. 

‘This is illustrated in our improved billing and charging processes, which we have been refining since 2021, following the introduction of our standard occupancy documentation programme.  

‘This initiative, alongside our Annual Billing Schedule check-ins, enable practices to review and understand their charges in detail and we encourage any practice with concerns to contact us so we can review their circumstances and provide support and clarification.’

A CHP spokesperson said: ‘We welcome feedback from our tenants and have an active programme to maintain and improve tenant satisfaction, including our service on financial queries.

‘We recognise the financial challenges and constraints across the healthcare sector and are committed to providing transparency on charges. We issue all tenants with annual budget information, including a breakdown of tenancy charges and explanatory materials.

‘The annual budget statement shows all costs reasonably incurred in operating the building. Where GP tenants have questions and queries about their bills, we encourage them to contact us so that we can respond quickly.

‘Tenants of LIFT buildings are charged in line with national policy. The charges are calculated on a cost recovery basis in line with the terms of the lease or the percentage of space occupied. This means that service charges reflect the actual costs of providing services such as cleaning, utilities, and maintenance.’

Meanwhile, a spokesperson for DHSC said: ‘This government inherited a crumbling hospital and primary care estate. Our decisions at the Budget meant we have been able to invest £100 million this year into GP estates across England to carry out vital upgrades – providing a better service for patients.

‘Primary care services will be the cornerstone of neighbourhood health services under our 10 Year Health Plan.

‘That’s why we are fixing the front door to our NHS, shifting more care from hospital to the community by recruiting over 2,000 more GPs, cutting red tape and investing more than £1 billion into the GP contract this year to boost staffing.’