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40% of GP practices not fit for purpose, finds survey

by Julie Griffiths
31 May 2023

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Four in 10 practice staff describe their premises as ‘unfit for purpose’, an RCGP survey has revealed.

Among those who said this, nearly a third (32%) said their premises have poor disabled access, and 25% said the building had water leakage, mould, or mildew. And 88% said there was an insufficient number of consulting rooms.

Yet almost three-quarters of the staff who requested funding to upgrade their premises over the last year were unsuccessful in obtaining it, the survey also found.

The findings were detailed in an RCGP report Fit for the Future Reshaping general practice infrastructure in England, which said that ‘the current state of physical and digital infrastructure within general practice in England makes it difficult for practices to deliver the basic level of care’.

It called on the Government to provide the resources for every ICS to work with general practice to develop and implement a primary care infrastructure plan (see box).

The survey of 2,649 practice staff members, including 297 practice managers and 1,234 GP partners, took place between December 2022 and January 2023.

Respondents said that limited space is making it difficult to train new GPs (66%) and restricting the number of trainee GPs that they can take on (75%). 

The survey also highlighted technical problems with almost half (46%) of general practice staff reporting that their PC or laptop software was not fit for purpose. And 38% said their broadband connection was inadequate.

Due to these obstacles in digital infrastructure, GPs reported difficulty in exchanging information with other care providers, including pharmacy systems (56%), out-of-hours care (51%) and community teams (51%).

RCGP chair Prof Kamila Hawthorne said the survey highlights ‘the difficult reality that many GPs and our patients are experiencing on a daily basis due to decades of neglect and underfunding for general practice’.

Earlier this month, the Government’s GP Access Recovery Plan included a promise of £240m funding for digital telephony and care navigation training.

But Prof Hawthorne said: ‘None of the recent measures announced will be delivered overnight, nor will they address the widespread structural issues affecting many surgeries.’

The RCGP said a significant increase in funding for primary care infrastructure is needed if general practice is to work in an integrated way with other health services and the Government should make more funding available to ICSs to achieve this.

According to the NHS England Capital Guidance 2022 to 2025, investment allocated through ICSs to primary care estates and IT represents just 3% of the total NHS capital budget for 2022/23.

Last year, the NHS Confederation called for more funding for GP premises. It said the lack of fit-for-purpose premises is risking patient safety and worsening waiting times, as primary care teams are unable to work efficiently.

RCGP recommendations

The RCGP report called on the Government to give the resources to every ICS for a primary care infrastructure plan, which should include: 

  1. Investment in upgrading general practice premises to ensure sufficient space and good conditions for patient consultations, expanded practice teams, and the development of more ‘community hubs’.
  2. Expand training capacity in general practice for trainee GPs and other healthcare professionals.
  3. Invest in IT systems and organisational support to implement improvements in how practices operate and connect with other parts of the healthcare system.
  4. Provide a permissive framework and the appropriate resources for practices to improve energy efficiency.