Half of practice managers and GPs in England think their surgery premises are currently unfit for purpose while more than 80% believe they won’t be suitable to meet growing patient demand, a BMA survey has found.
The survey of 1,914 practice managers and GPs revealed widespread concern about the state of surgeries, with 74% of respondents also saying their premises do not have enough space to provide training for new GPs.
Despite inadequate infrastructure, since 2022, 42% of applications for funds to make improvements to premises have been rejected. The vast majority (88%) of these grant applications were for less than £150,000, the survey also found.
Just under three quarters of respondents (71%) said their main site is more than 26 years old, while 14% said that the last significant modification or extension to their premises took place 26 years ago or more
Practices are not just experiencing issues with poor buildings, the management of premises and relationship with landlords is also problematic. For example, a quarter of respondents reported having been invoiced with inaccurate service charges and less than half of these described the charges as ‘resolved’.
Results varied according to whether a practice’s landlord was NHS Property Services (NHSPS) or Community Health Partnerships (CHP), both companies owned by the Department of Health and Social Care (DHSC).
For example, findings showed:
- Over 65% of respondents in NHSPS buildings and over 74% in CHP buildings said they have received incorrect invoices.
- 54% of NHSPS tenants and 35% of CHP tenants said that service charge disputes were affecting the sustainability of their practices.
- 35% of NHSPS tenants and 26% of CHP tenants have considered handing back their GP contract due to service charge disputes.
BMA GP Committee England (GPCE) premises policy lead Dr Gaurav Gupta said the survey showed a system at ‘breaking point’.
He said: ‘Staff have told us about working out of converted containers, in cramped rooms, and kitchens that can barely fit one person, which makes it hard to provide the safe, confidential, and dignified care that patients deserve. Many surgeries cannot house additional GPs and other staff, meaning patients face longer waits and fewer services close to home – directly undermining the Government’s 10-year plan, which places neighbourhood health services at its core.
‘Training new GPs is almost impossible when practices have no space for them, threatening the future supply of family doctors,’ he added.
‘At the same time, practices are being drained by unfair and inaccurate service charges, forced to spend precious time disputing bills rather than focusing on patient care’.
The BMA has made three recommendations on the back of the findings:
- There should be urgent investment made to upgrade GP infrastructure, which should address non-clinical spaces as well as clinical rooms, such as meeting rooms, kitchen areas, and staff welfare areas.
- NHS England should fund the immediate removal of paper notes from GP premises to free up space, and reimburse practices that have already invested in digitisation or off-site storage.
- There should be swift resolution of long-standing service charge disputes, which ‘continue to destabilise practices and divert attention from patient care’. Alternative ownership models for DHSC-owned premises should also be developed ‘that promote transparency and fairness in property management’.
