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Supersize me: joining together to upgrade practice premises

1 March 2006

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Val Clinton
EC Harris

Val Clinton specialises in delivering new build and major generation projects on behalf of the NHS and private sectors. She heads the specialist health unit at EC Harris, providing expertise throughout EC Harris’ regional network of UK offices in London, Birmingham, Leeds and Manchester. The team also specialises in valuation and rentals, as well as securing complex planning issues for primary care initiatives involving medical and treatment centres for GPs

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The government’s new proposals for improving healthcare in Britain, by providing more services closer to where people live, could cause more problems than they solve, unless additional funding is secured quickly.

The plans for integrated health and social care services in the heart of the community, outlined in January by the health secretary, Patricia Hewitt, are set to impact seriously on both GPs’ time and their premises.

The expansion of so-called “supersurgeries”, providing a wider range of treatments and services, is fine in principle. But in practice it is a nonstarter, unless a cash injection is let loose on the NHS.

As Val Clinton, who heads the primary healthcare team at property consultants EC Harris, explained: “How can GPs provide more services if they don’t have the proper facilities to meet the modern-day agenda? Practices are already struggling to deliver existing services from outdated buildings that were not designed to cope with yesterday’s needs, let alone the ideal in tomorrow’s world.”

The challenges have therefore just got greater. Practices responding to the government’s modernisation agenda, or their own need to grow and develop, must think about their space requirements in a totally different way.

Large growth from modest plans
Just as small acorns grow into large oak trees, it is often the start of a small change that ends up as a major expansion, as in the case of a GP practice in Hall Green in the southern suburbs of Birmingham.

What started out as a plan for a possible extension and refurbishment of the building, discussed in a meeting at the practice nearly five years ago, has eventually led to a multipurpose facility, incorporating five GP practices from the local area.

The project, developed with the help of Val Clinton’s team at EC Harris, now serves 35,000 patients and represents a major contribution of services from the primary care trust.

At a total cost of £4.5m from the taxpayer’s purse, the building had to deliver good value and maximise its 2,600m-squared of space in the most appropriate way. This included the provision of general medical services, other supporting services from the primary care trust and a local pharmacy.

Originally, all five practices had every intention of being independent practices within one large building. However, by the time the project was completed, the practices were working towards becoming one entity.

The success of the scheme reflects the synergy between the five practices and was finished within a three-year period from conception to completion. But like any complex and highly detailed project involving multiple partners, each proposal had to be evaluated at every stage to assess its value for money, as well as its life expectancy, versus the ever-changing NHS agenda for healthcare.

Keeping the bigger picture in mind
Gone are the days of non-cash-limited funding from the primary care trusts; funding is so hard to come by that getting it right first time is essential. Coupled with this was having the foresight and vision to build for future expansion.

Adopting a visionary and holistic approach is necessary for every such project. While the temptation is often to get on with the change, consulting with partners, identifying the minimum cost, disruption and choosing a builder, it is also worth thinking about the bigger picture and the envisaged future services.

As an inner-city project, the requirements for Hall Green were approached in exactly the same way as for a smaller rural practice – ie, the same principles were applied, but on a much larger scale.

This involved extensive dialogue and discussions with the practice managers and GPs to ascertain the capability of the existing building, its flexibility and adaptability. The process is a developing one. Under the guidance of project manager Val Clinton, the proposals for Hall Green evolved into a blueprint, which won the approval of all parties concerned.

Commenting, Val Clinton said: “The creation of this state-of-the-art medical centre in Hall Green demonstrates what can be achieved through developing close relations and having a clear understanding with the primary care trusts in respect of practice needs for the community.

“The result is a building that the whole community of Hall Green are proud to be associated with, and one that has the capability of delivering healthcare services on their doorstep in the future.”

Its celebrated status does not just lie among the GPs, staff, patients and the project team at EC Harris. The medical centre recently gained significant media attention at its official opening last November, and has created a real sense of belonging with the local residents.

Hall Green is therefore fast becoming as famous for its medical services as its greyhound racing, and is now on track for even more success in the future.