‘One in four’ GP practice premises in ‘poor’ or ‘very poor’ state

One in four GP practice premises is in a ‘poor’ or ‘very poor’ state, new BMA research has suggested.

Substantial capital investment is needed in GP practices and other healthcare premises, according to a BMA report which found crumbling, outdated and poorly laid out buildings in need of repair and modernisation.

In addition, any nationally mandated increase in primary care staffing within GP practices must come with additional funding for premises expansions and improvements, it concluded.

Funding should be made available to GP practices and to make necessary accessibility improvements where possible or – where not – to ensure new premises are fully accessible as standard, the report on Estates Infrastructure said.

One in four respondents to a BMA survey included in the report who worked in primary care said the building in which they work is in a poor or very poor state.

GP practices do not have enough support to expand or make improvements yet lack of space hinders doctors training and access to care for patients, it found.

Concerns were also raised in the survey about the layout of premises not allowing for appropriate ventilation and infection prevention control.

‘Shortage of space is a major challenge in general practice’, it said. ‘Making it harder for GPs to see patients quickly and even preventing some practices from expanding their patient list.’

The BMA also raised concerns that the overall estates repair bill in the NHS is now greater than the whole capital budget.

While hard to calculate the maintenance backlog in primary care due to the mixed model of ownership, many practices struggle to make major repairs due to a lack of available funding, the BMA said.

Greater capital investment is also needed to make healthcare buildings more energy efficient and meet NHS sustainability targets, the report said.

This should involve all UK healthcare systems exploring the provision of interest free sustainability loads to GP practices. Such an approach had been tried in Scotland but the loans had proven difficult to access.

A second report published at the same time criticised the NHS’ digital infrastructure with out-of-date, slow and incompatible IT systems and hardware ‘costing valuable staff time and putting patient safety at risk’.

Dr Latifa Patel, BMA representative body chair, said: ‘It is a national scandal that a continued failure to invest properly in the bricks and mortar of our hospitals and GP practices, is threatening safe patient care.

‘The scenes described by our members in this report are not what we would expect to see in a 21st century health service in one of the world’s richest countries.’

She added: ‘Alongside physical buildings, digital infrastructure is way behind where it should be for a modern health service that can meet the needs of patients and staff.

‘Doctors face daily battles with outdated systems that do not talk to one another, unreliable connections and crashing computers – that is if they can find a computer at all.

‘The Government lauds its commitments about digital transformation and data, but without fixing outdated infrastructure, and getting the very basics right, these ambitions cannot be realised.’

Dr Gaurav Gupta, BMA England GP committee contracts and strategy policy lead, said: ‘We know that a significant proportion of GP practice buildings simply aren’t fit for purpose, underlined by the findings of this survey.

‘Practices are now caring for more patients than ever, and employing a wider range of professionals that require their own space and facilities. Yet often there just isn’t enough space to meet this rising demand or to house the growing practice team.

‘As GPs in this report highlight, this means unsuitable spaces are being converted from their original use, and things like break and meeting rooms are becoming a thing of the past.

‘Cramped conditions and outdated buildings have also made infection control more difficult, which was a real concern for GPs and their colleagues during the height of the pandemic and will continue to be an issue as we head into this winter.

‘It’s vital that practices, whether the buildings are owned or leased, are supported and able to access funding to easily update, expand and maintain premises so that they can meet the growing needs of patients and practice teams, and deliver a safe and sustainable service for their local communities.’

A Department of Health and Social Care spokesperson said: ‘This government is investing record sums to upgrade and modernise NHS buildings so staff have the facilities needed to provide world-class care for patients, including £4 billion this year and £12 billion over the next three years.

‘We are also investing an initial £3.7 billion as part of the biggest hospital building programme in a generation, alongside delivering over 70 major hospital upgrades across England.’