'Super centres' set to replace outdated GP practices, conference hears

Speakers reveal need for integrated primary care facilities as it is revealed two thirds of buildings are below standard

Modern, state-of-the-art GP surgeries are vital to underpin the future of the entire NHS, a conference has heard.

Converted houses and old listed buildings will no longer provide a suitable environment for the delivery of first-class primary care services, according to speakers at the Latest Developments in Primary Healthcare Property conference in London last week.

Instead, the UK needs to invest in a new network of ‘super surgeries’ that will bring together single-handed GP practices and offer a much greater range of health and diagnostic services.

Conference chairman and managing director of The Healthcare Property Company, Paul Stacey, said: “This event is about reinforcing the fundamental importance of having updated, compliant premises for expanded community-based primary medical services.

We are having to spend a lot of money on improving buildings and at some point it becomes unviable to do that and impacts on the delivery of patient services

“Moving forward we need the ability to transfer some services currently provided in hospitals into GP surgeries and community settings. Fit-for-purpose premises are vital for this.”

The call for improvements to primary care facilities comes as data from the Royal College of GPs reveals that 543 surgeries are at risk of closure this year due to GPs retiring. A British Medical Association survey further shows that 40% of GPs admit their practices are not adequate for patient care, and 70% say their buildings are too small. Half of practices say they have not invested in improving or refurbishing their facilities in the past 10 years, and 60% say a poor environment means they cannot provide training.

“GPs have the wrong infrastructure for the new models of care being demanded,” said Adam Thompson, director of Primary Care Surveyors.

“We need to see a shift towards larger integrated practices. House conversions need to be replaced by larger, more modern surgeries. Maybe the overall floorspace within primary care may stay the same, but I expect it will be dispersed among fewer centres.”

Figures provided by leading estate agent, Savills, show two thirds of existing primary care facilities are GP-owned and 20% are owned by investors. Two thirds of these are sub standard and less than 50% are purpose built. A quarter are still occupied by single GP practices, and 40% will need replacing within the next five years.

Typical issues facing buildings include small consulting rooms, a lack of privacy, inefficient heating and lighting, outdated fixtures and fittings, non-compliance with the Disability Discrimination Act, and escalating maintenance costs.

“There is an awful lot of pent-up demand for new buildings,” said Savills’ director of healthcare, Andrew Surgenor.

Looking forward the focus is now on quality and personalisation of care and giving more power to clinicians and patients. It will mean the traditional model of single GP surgeries being replaced with multi services available under one roof in GP super centres

“We are having to spend a lot of money on improving buildings and at some point it becomes unviable to do that and impacts on the delivery of patient services.

“Looking forward the focus is now on quality and personalisation of care and giving more power to clinicians and patients. It will mean the traditional model of single GP surgeries being replaced with multi services available under one roof in GP super centres.

“We will be bringing together wide and complimentary care services in one-stop shops, including diagnostics and scanning, outpatient clinics, minor surgery, dentistry, physiotherapy, childcare and counselling services. We will also see consolidation of small GP practices currently in outdated accommodation.”

The conference heard there is hope for the sector, with the GP property market seen as a good investment opportunity for private companies, with niche corporates such as Assura, PHP and MedicX already active.

“The primary care market is seen as a safe haven,” said Surgenor. “Investors are attracted by the government-backed, long-term rental streams available. IPD returns are good, tenant default is rare, and there are long leases available, usually without breaks.”

Banks are also increasingly willing to lend to GPs and private sector investors. Steve Pratt, healthcare banking consultant at Lloyds Banking Group, told the conference: “Single-handed GP practices are a dying breed and there will be more mergers.

“Banks love GP surgeries and as such we have very, very good offers available.”

Lloyds currently offers 100% loans for GP surgery developments at some of the lowest interest rates ever.

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