Half of all GP surgery buildings 'unfit' for purpose

British Medical Association calls for urgent capital investment after report reveals shocking state of UK's primary care facilities

The majority of GP premises need urgent upgrades to meet current and future demands on services, according to a BMA survey

The British Medical Association (BMA) has called for urgent capital investment in primary care facilities after a worrying survey revealed that half of all buildings are unfit for purpose.

Around 50% of doctors and clinic managers do not think their surgeries are suitable for present needs, according to the BMA poll.

And 78% of the 1,011 respondents said their practices would not be able to handle expected future demands, such as population growth and an increase in the prevalence of long-term conditions.

In light of the findings, the BMA is urging the Government to invest in GP premises and ‘bring facilities up to 21st-century standards’.

Without more space and upgraded facilities, patients will continue to face long waits for appointments, BMA GP committee chairman, Dr Richard Vautrey, warns.

The capital budget is being squeezed and new ways of getting funding for GP premises are now urgently required

He said: “GPs have been telling us for years that their practice buildings are not up to scratch and now we have evidence showing just how serious the situation is.

“Despite their best efforts, GPs and their teams are ultimately limited by space and cannot meet the growing needs of their patients without an urgent increase in capacity.”

His comments come shortly before NHS England is expected to publish a review into GP practice premises.

It will set out the scale of the problem and, it is hoped, will be supported by additional funding.

Dr Vautrey said: “More broadly, the Government must use next month's Spending Review to urgently invest in practice premises, as well as wider NHS infrastructure, to bring facilities up to 21st-century standards and ensure that GPs and their colleagues throughout the health service can guarantee the best care now and in the future.”

The problem is prevalent across all countries in the UK, with Ireland leading the way with plans to invest £30m over the next few years.

BMA GP negotiator, Peter Holden, said ‘relatively-modest’ sums were needed to meet expectations, but called for a rethink of the way premises were funded currently.

BMA Scottish GPs committee chairman, Alan McDevitt, agreed, adding: “The capital budget is being squeezed and new ways of getting funding for GP premises are now urgently required.

“A number of health centres have been rebuilt in recent years, but the vast majority of GPs and their staff are struggling by in buildings that are not fit for purpose.

“In order to achieve the Government’s intention to shift care out of hospitals and into local communities, they need to build the capacity to enable general practice to provide this care.

GPs have been telling us for years that their practice buildings are not up to scratch and now we have evidence showing just how serious the situation is

“NHS boards need to take stock of the state of GP premises in their areas and we need to look at how we can maximise the space we have in the short term, but in the longer term we need a programme of investment that enables GPs to provide 21st-century healthcare in 21st-century buildings.”

Speaking to BBH about the impact of this pressure on facilities, London GP, John Bentley, said he is sometimes forced to wait outside his consulting room with queues of patients due to his cramped and unsuitable premises.

The three GP partner practice in Golders Green has been based in a three-bedroom terraced house since before the inception of the NHS and its list size is now over 7,000, rising significantly in recent years following population growth and the closure of a nearby practice.

Two of the three consulting rooms are upstairs, but the stairs make it inaccessible to patients with mobility issues who have to be seen downstairs in Dr Bentley’s room.

“If a patient is unable to navigate the stairs, they have to wait downstairs and then I have to come out of my consulting room and wait in the corridor so one of my colleagues can see the patient,” he said.

“It’s hot-desking to an absurd degree.”

And while Cumbria GP, Kaye Ward, of Hawkshead Medical Practice has lots of ideas of how to develop her offering, she and practice partner, Jane Rimington, are prevented from doing so because of the damp, cramped and unsuitable premises.

Funding obstacles also mean they are unable to take up the opportunity of a new surgery.

NHS boards need to take stock of the state of GP premises in their areas and we need to look at how we can maximise the space we have in the short term

The surgery is housed in a converted forge where the doors are not wide enough for wheelchairs, the window and door frames are rotten, and there is damp in many rooms.

And the examination room adjoins the consultation room, so whenever the GPs, who job share, are running a surgery the practice nurse can only work in the office.

“The building is not fit for purpose and there’s no way we can deliver future plans in taking care out of hospital into primary care because this building is just not suitable for that,’ Dr Ward said.

The GPs have been presented with a solution to their problem by a local resident who has offered to build a purpose-built surgery with two flats above it. Planning permission has been granted, but the GPs are unable to take it up because of NHS England concerns about potential rent rises.

“We want to be flexible. We understand we can’t stay the same and want to offer more services but it’s just not possible at the moment,” she said.

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