NHS England to pilot six super hubs including GPs and other health services

NHS England has set out to create super health and wellbeing hubs – dubbed Cavell Centres – with six sites under consideration nationwide.

The aim of the Cavell Centre pilot programme is to bring all health and social care services together in one building, which would see the co-location of GP practices and other health services such as pharmacies, dental clinics and mental health support.

There is already a Cavell Centre at Edith Cavell Hospital in Peterborough, Cambridgeshire, that comprises seven inpatient units, which provide mental health care and specialist learning disability services, but no GP services.

However, NHS England is considering new sites that would include GP services in Sleaford, Lincolnshire; Staines, Surrey; Hucknall, Nottinghamshire; Plymouth, Devon; Derby, Derbyshire; and Shrewsbury, Shropshire.

The hubs – named after Edith Cavell, a British nurse during World War I – also aim to change the way in which primary care estates are managed by the NHS, focusing on a model that is owned and controlled by the wider health and care system rather than individual GP partners.

The plans for the sites are still in development and subject to both ICB and NHSE approval, with the most developed currently in Devon and Shropshire.

However, a parliamentary debate in October revealed that funding issues have threatened the programme’s development in Devon.

The proposed £60-million centre at Colin Campbell Court in Plymouth’s West End may no longer be built after it emerged that £41 million of NHS funding was not going to arrive, despite demolition work already being underway at the site.

At a Westminster Hall debate on 25 October, Labour MP for Plymouth, Sutton and Devonport Luke Pollard asked health minister Robert Jenrick to restore the funding or find it from somewhere else as he claims that Plymouth’s GP emergency is ‘acute’.

He said: ‘Plymouth’s primary care crisis is acute… One third of Plymouth’s population is currently covered by GP practices with emergency standing contracts, but as more GP surgeries close in our communities and practices hand back their contracts, we need an alternative long-term and large-scale intervention. That is what the super health hub, the Cavell Centre project, delivers in buckets.’

He added: ‘At least three GP surgeries in substandard accommodation, currently with large lists of patients – North Road West medical centre, Adelaide surgery and Armada surgery – would relocate to larger premises where they could see more patients.

‘There would be space for 24/7 out-of-hours GP surgeries and pharmacy and X-ray facilities, enabling earlier diagnosis and better management of conditions, such as weight management, smoking, cessation, district and practice nursing facilities, physiotherapy and occupational therapy space, mental health services, drug and alcohol treatment, and nutrition.’

In response, Mr Jenrick said that NHS funding had never been approved but £250 million had been given to the Devon ICB over three years, which could fund the Plymouth Cavell Centre.

He said: ‘For the scheme to progress, the NHS Devon ICB would need to prioritise its construction via this operational capital budget or other locally sourced funding solutions… As things stand, there is no additional national funding to deploy for projects like this.’

However, the minister said he would visit Plymouth and arrange a meeting between the local ICB chair, stakeholders and NHSE to look for an ‘innovative or creative’ solution.

A report by NHS Devon said: ‘As part of the programme, NHS Devon, alongside local partners, were encouraged to develop the business case at pace while national colleagues sought to identify the c£40 million needed, potentially from underspends elsewhere in the national budget.

‘NHS Devon received £83 million for this financial year to allocate for capital works, IT infrastructure and medical equipment across Devon, Plymouth and Torbay.

‘This money is fully committed for critical and high priority projects, with works in train, and NHS Devon is therefore currently unable to cover the shortfall in national funding.’

Meanwhile, the proposed centre in Shrewsbury – which would absorb six GP practices and serve 40,000 patients – has prompted concerns from both councillors and residents over transport and traffic congestion issues. The sentiments were echoed by a group of retired GPs in an open letter this summer.

In response to these concerns, the programme – supported by Shropshire Council – agreed to identify alternative site options in the area, with 14 remaining as possible options.

The council also said it will support the scoping of transport options once a site has been identified. However, it added it cannot fund any dedicated transport services.

A report by Shropshire, Telford & Wrekin (STW) ICS, who is leading the Shrewsbury pilot, said: ‘The centres form part of a national estates programme and are designed around a core primary care offering.

‘They will promote the co-location of community services, outpatients, diagnostics and other NHS health services helping to support the wider determinants of health.’

It also added that the ICS-owned centres will offer care for ‘between 25-150k population’.

A sites options appraisal is expected to take place in January 2023.