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Over half of GP practices will not receive promised premises funding, CCGs warn



Exclusive Promised GP premises investment will stretch to less than half of approved practice bids across London, CCGs have warned.

Pulse has previously revealed that NHS England had privately admitted the fund may not stretch to all approved bids, but this is the first indication of how significant the shortfall might be

The GPC warned that this pattern is replicated in other parts of the country, with demand for premises improvements outstripping the funding available.

The Government’s promised £1bn down payment on general practice – the Estates and Technology Transformation Fund – was supposed to deliver a ‘permanent improvement in GP services’, but London CCGs have revealed that the majority of 284 approved projects are ‘on hold – awaiting confirmation to progress’.

And from this London shortlist, ranked in order of priority, commissioners are now saying projects ranked 142 and below are ‘unlikely to progress during the lifetime of the [ETTF] programme’.

The list, unveiled in board minutes covering NHS Barking and Dagenham CCG, NHS Redbridge CCG and NHS Havering CCG, says that just 62 projects are progressing with ETTF funding currently. Another 12, it says, have been recommended to receive funding through a separate funding pot. The rest remain on hold in a ‘pipeline’.

The minutes said: ‘Whilst it is anticipated that more schemes will be supported to progress, it is unlikely that London’s current ETTF allocation will enable schemes that have been ranked in the bottom two quartiles of the pipeline to progress during the lifetime of the programme.

‘With this in mind, commissioners are actively endeavouring to identify other funding sources, such as the London Improvement Grant fund, to take forward suitable schemes.’

The same update warns that the London region was forecasting a roughly 40% overspend on its allocation of the fund last year, £7.6m over its budget of £17.3m at month ten – though this estimate is said to be ‘volatile’.

Londonwide LMCs chief executive Dr Michelle Drage said any funding that reaches practices ‘should be seen as a positive’ but the fact that many more were missing out was a sign of ‘continuing chronic under investment’.

She told Pulse: ‘For decades the capital’s GPs have been starved of the premises and IT investment needed to meet the challenges of a growing population with increasingly complex health needs.

‘Properly funding the annual schemes for refurbishments and upgrades would make a far greater difference to practices and patients than the short window provided to bid for the one-off pot of money provided by the ETTF.’

And the GPC told Pulse this was not just a problem in London.

GPC deputy chair Dr Richard Vautrey, a GP in Leeds, said that ‘it’s a similar story across Yorkshire and the northern region… but even those who have received promises of funding are experiencing delays’.

He added that practices are ‘bursting at the seams’ and inadequate buildings are limiting their abilitiy cope with rising patient populations, take advantage of support from other professions, and offer new services in the community.

Dr Vautrey said: ‘While the promised investment in the ETTF was welcome, it’s being delivered too slowly and with too much bureaucracy linked to it.

‘The fact that is now also inadequate to meet the real need means any incoming Government must look again at how they can invest not just the capital to enable practice developments, but just as importantly how the running costs can be factored into annual budgets.’

NHS England did not provide a comment but confirmed that the scheme was heavily oversubscribed and while it was not possible to invest in every application other funding pots were being considered for infrastructure obejctives in London.

What is the £1bn transformation fund?

The £250m-a-year fund was a commitment made by then chancellor George Osborne, which would address immediate capacity and access issues, and lay the foundations for delivering care in the community.

Speaking in 2015, when GP practices were first invited to bid for funding, NHS England chief executive Simon Stevens said ‘kick-starting an upgrade in primary care infrastructure is mission critical’.

But the scheme was taken back to square one in its first year with practices needing to align their plans with local estates strategies.

And Pulse has since shown that just fraction, £48m of the £500million that was meant to be committed at this stage, has reached practices.

The need for practice premises to be fit for the 21st century was strengthened even more last year when Jeremy Hunt said he wanted general practice to become a ‘one-stop shop’ taking on outpatient care for chronic conditions.