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Revealed: Only 13% of premises applications approved last year

Exclusive Only 13% of GP premises development applications were approved last year, totalling just £14m, a Pulse investigation has revealed, a situation described as an ‘absolute disgrace’ by GP leaders.

Figures from 23 local area teams obtained by Pulse via a Freedom of Information Act request showed only 58 applications were approved in full in 2013/14 while four were approved in part, out of a total of 467 requests.

NHS England spent £14.2m on GP premises development across all of the 25 area teams last year, with much of this applying to finishing previously approved projects rather than newly signed-off investments.

The GPC said that it was an ‘absolute disgrace’ that only 60 out of 8,000 practices across England had been provided with funding for premises improvements, and warned that the £14m represented a ‘drop in the ocean’ of what was needed.

The 23 area teams that provided information in full recorded 467 total requests between them, out of which they turned down almost one-third (30%) and left over half (57%) still pending a decision – while only 13% (62 bids) were approved in full or part.

Two area teams – Bath, Gloucestershire, Swindon and Wiltshire and the North Yorkshire and Humber – did not supply full breakdowns but the former said it had approved some bids in part, granting either 50% or 33% of the amounts requested.

It comes after NHS England had said it was only prioritising a small number of urgent upgrade bids in 2013/14 while determining demand for investment and preparing a national guide for area teams advising which premises applications they should be funding.

Several area teams said requests were pending while they were awaiting these so-called ‘principles of best practice’ to determine which projects should go ahead.

NHS England said the interim guide is due to be published within the next two weeks, while it awaits the outcome of its ‘call to action’ consultation on GP services.

But Birmingham LMC chair Dr Robert Morley said: ‘They have been saying that for the past two years. They do nothing but make excuses and prevaricate and say well we haven’t got the funding or we can’t make a decision, we are still waiting.’

The Birmingham and Black Country area team spent just £536,000 on developing GP premises in in 2013/14, having approved just six out of 83 bids. Five bids were denied and the vast majority, 72 bids, were pending a decision.

Dr Morley added: ‘These figures are stark and they speak volumes. That, as general practice is on its knees, nationally only around 60 practices out of some 8,000 have had some premises funding is an absolute disgrace. Here in Birmingham we have half a million pounds of spending in total and all you’ve got to do is compare that with the millions that have been thrown away on management consultants and the like.’

‘It is just an absolute disgrace and it is just typical of the fact that these people just completely undervalue general practice.’

He added: ‘Nearly all of the requests are pending and then there are requests going back years and years. It means they can’t expand their premises and they can’t take on any additional work as their surgeries are overflowing at the seams. They are not fit for purpose so they are at risk of adverse findings by the CQC.’

In addition to the figures revealed by the FOI request, Pulse has previously reported that area teams are ‘sitting on hundreds’ of applications for premises upgrades since PCT days and the GPC has warned that there is also a hidden demand because practices were told there was no money and so did not put in requests.

A recent GPC survey saw 40% of GPs say their existing premises were inadequate for providing services.

GPC deputy chair Dr Richard Vautrey said: ‘Spending £14m on premises development is just a drop in the ocean and only approving 13% of applications suggests that the vast majority of practices desperate for premises development in order to improve their service to patients are left at best frustrated by the delays and at worst angry at being badly let down.’

‘As our recent survey showed very clearly there is a huge unmet need for premises development and this is a real rate limiting issue for general practice which the Department of Health and NHS England need to take urgent action to solve.’

Asked how much money would be needed to get GP premises up to an acceptable standard, Dr Vautrey said: ‘We are talking about hundreds of millions to sort out the issues around premises.’

GP premises development bids across England* in 2013/14:

  • 467 requests to NHS England area teams excluding Gloucestershire, Swindon and Wiltshire and North Yorkshire and Humber
  • 57% still pending
  • 30% denied
  • 13% approved in full or in part

Source: Pulse FOI request to NHS England area teams

* Bath, Gloucestershire, Swindon and Wiltshire and North Yorkshire and Humber area teams excluded because they submitted incomplete figures