The Government’s promise of a major upgrade to GP surgeries to enable them to expand and help ease the pressure on hospitals has not materialised, a Pulse investigation reveals.
Health secretary Jeremy Hunt promised a ‘visible improvement in primary care facilities’, but new figures show only 5% of the £1bn fund has been spent by NHS England on improving GP premises, two years after it was first announced.
Figures obtained by Pulse under the Freedom of Information Act show £48m of the ‘Estates and Technology Transformation Fund’ has been spent on premises so far, while £201m has been quietly siphoned off to support other projects, such as seven-day GP access and putting pharmacists in GP practices.
Chancellor George Osborne announced a £1bn ‘primary care infrastructure fund’ would come from fines levied on misbehaving banks in 2014, saying it would lead to a ‘transformation’ of the health service and NHS England chief executive Simon Stevens saying ‘shovel ready’ premises projects would be prioritised.
Around 40% of practices that have applied for funding have been approved, but many were given much less funding than requested and others have been sent back to the drawing board to make their projects deliver the same outcomes for less money.
This is despite four in 10 GPs saying their premises are not adequate for patient care and one in 10 surgeries saying they have hazards that could affect the health of patients and staff.
The NHS’s own plan for its future relies on GP practices expanding, but practices are currently struggling to keep pace with rocketing patient numbers.
A BMA spokesperson for GP premises Dr Peter Holden said the fund has proved to be a ‘trick’: ‘They announce the money, and set an impossibly short application deadline so they don’t end up spending it because practices didn’t meet the deadline.’
Dr Holden should know – his practice applied to the fund. ‘We wanted to add consulting space. We’re hot-desking as it is – I had to go home at lunchtime today to do paperwork because my room is needed by someone else. So we applied a few months ago, and got nothing.’
Dr Robert Koefman, a GP in Bracknell, says that his bid has been kicked into the long grass despite housing developments projected to add 6,500 patients to his 10,500 list in the next five years. He says: ‘We have had no help. We have to hope other practices don’t get funding – because we don’t have the land, which with all this development costs £1m per acre. We’ve looked at funding the work ourselves, but we’re talking about £4.5m and we’re within 10 years of retirement. NHS England even acknowledges it will be a problem, but they won’t help.’
Kathryn Hulme, practice manager of Mayfield Surgery, Stoke-on-Trent, says the practice is considering self-funding after its bid was rejected last year. She said: ‘We have 11,800 patients with seven clinical rooms and 14 clinicians. Our bid has not been deferred, just not agreed as it did not fit NHSE criteria.’
NHS England said that by March, it will have spent £120m of the fund, but it was unable to say how much of this was on premises and technology, and how much had been siphoned off into other projects.
The NHS England spokesperson added: ‘Given it’s taxpayers money being invested, we make no apologies for ensuring that every scheme is well designed and properly vetted before cash is released. We are fully on track to invest an extra £2.4 billion in GP services, which as well as modern surgeries will mean extra doctors, practice nurses, clinical pharmacists and mental health staff across England.’
Full details: Estates and Technology Transformation Fund (ETTF)
Number of applications: 4,059
Number of completed projects: 560
Number of ongoing projects: 316
Number of projects approved but subject to due diligence: 861
Amount spent on premises as of January 2017: £48m
Amount spent on IT infrastructure as of January 2017: Unknown
Amount siphoned off to other projects: £201m (see chart for breakdown)