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BMA and RCGP call for ‘urgent’ investment in GP premises

by Lily Canter, Costanza Pearce
8 August 2019

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Primary care leaders have urged the Prime Minister to invest in GP surgeries to prevent patient care from being ‘put at risk’ and to reduce waiting times.

Responding to Boris Johnson’s announcement that the Government will bankroll 20 hospital and CCG upgrades to the tune of £1.8bn, the British Medical Association (BMA) has called on the new PM to invest a further £3.5bn to modernise community care.

A letter signed by chairs of the BMA, Family Doctor Association, National Association of Primary Care, Royal College of General Practitioners (RCGP) and The Patients Association has asked for ‘an urgent commitment’ to support investment in general practice and community care premises such as community nursing and mental health services for children and adults.

The letter said: ‘GP premises have been underfunded over a number of years leading to a decline in provision available and a situation where safe, timely patient care is being put at risk.’

Not fit for purpose

Lack of infrastructure investment, delays by NHS England in providing premises cost directions – the policy framework which sets out how costs incurred by GP practices are reimbursed and how funding is delivered – and policies diverting health capital funds to revenue budgets have created a situation where many premises are not fit for purpose, according to the signatories.

A BMA survey showed that only half of practices considered their premises to be fit for present needs, falling to just over two in 10 practices when asked if they thought their premises were fit for the future.

NHS England’s premises review also found that there had been some deterioration in premises due to ‘confusion’ around who is responsible for maintenance.

Lack of capacity

The letter to the PM also pointed out the planned expansion of 20,000 additional support staff in GP practices is reliant on having enough space in premises to accommodate extra employees.

The letter said: ‘Primary care estates must therefore be prioritised in the upcoming spending review. Such an approach will be crucial in improving patient care and contributing towards reducing GP waiting times.’

In order to bring the UK in line with other countries capital funding of £9.5bn is required in 2019/20 according to letter authors Dr Richard Vautrey, Dr Peter Swinyard, Dr Minesh Patel, Rachel Power and Helen Stokes-Lampard.

This would be a £3.5bn increase on top of the current capital budget in 2018/19, rising to £4.1bn by 2023/24.

The letter added: ‘Alongside this, an end to regular transfers from capital to revenue budgets is needed so that NHS trusts can invest and plan for the future. Worryingly, 78% of income from capital sales diverted to revenue spend last year alone’. 

‘Government needs to urgently rethink approach’

It comes as independent think tank Reform warns that primary care will need ‘urgent’ investment if secondary care waiting times are to be reduced.

New NHS performance data published today by NHS England shows that waiting lists for hospital treatments increased by 20% between June and July and A&E attendance reached a record high last month.

Claudia Martinez, health policy lead of the think tank Reform, said: ‘Nobody should be surprised that patients are flocking to A&E when they see no alternative. A third of patients can’t book a same day appointment with their GP, while around 90% aren’t aware of any out-of-hours services.

‘The solution is a primary care system that keeps people out of A&E. Illness isn’t constrained to working hours, so GPs need to provide care when patients need it – which requires investment.’

She added: ‘It’s ridiculous that only 6% of the £1.8bn promised to the NHS this week is earmarked for primary care. The Government needs to urgently rethink its approach.’