Four out of 10 GPs feel their premises are not adequate for patient care, a BMA survey reveals this week.
Almost 4,500 GP practices in England and Scotland responded to the survey describing how they are struggling to provide essential services in buildings that are cramped and outdated.
Six out of 10 GPs in England are forced to share consulting rooms or ‘hot-desk’ around their surgeries at a time when consultations have risen to 340 million a year and the government is moving more care into the community, the survey finds. In Scotland, just over half of GPs fact this problem.
The survey is part of the BMA’s Your GP cares campaign, which this week saw the association host a summit with policy makers about how to tackle issues such as declining and inadequate premises.
BMA GPs committee chair Chaand Nagpaul said: ‘GP practice buildings in large parts of England are in such a poor state that they are beginning to seriously undermine patient care.
‘Far too many practices have seen no real investment in their buildings in the past 10 years, leaving them in cramped, unsuitable conditions that are hindering the ability of some to even offer basic general practice services.’
He added: ‘We need the government to urgently work with GPs to address this problem with long-term, sustained investment that is focused on making all GP facilities fit for current and future challenges.’
The survey also reveals seven out of 10 GPs in England and six out of 10 in Scotland feel their facilities are too small to deliver extra or additional services to patients and just over half of GPs in both nations have had no investment or refurbishment in the past 10 years.
Just over four in 10 in England and six in 10 in Scotland say they believe ‘hot-desking’ or sharing consulting rooms is restricting the number of appointments their practices can provide. GPs are concerned it damages the overall delivery of services.
Bursting at the seams
BMA Scottish GPs committee chair Alan McDevitt said general practice was ‘bursting at the seams’.
He said: ‘The capital budget is being squeezed and new ways of getting funding for GP premises are now urgently required. A number of health centres have been rebuilt in recent years, but the vast majority of GPs and their staff are struggling by in buildings that are not fit for purpose.
‘In order to achieve the government’s intention to shift care out of hospitals and into local communities, they need to build the capacity to enable general practice to provide this care.
‘NHS boards need to take stock of the state of GP premises in their areas. We need to look at how we can maximise the space we have in the short term, but in the longer term we need a programme of investment that enables GPs to provide 21st century healthcare in 21st century buildings.’
Join the queue — more patients, less room
London GP John Bentley (pictured above and below) is sometimes forced to wait outside his consulting room with queues of patients due to his cramped and unsuitable premises.
Two of the three consulting rooms at the practice in Golders Green are upstairs but the stairs make it inaccessible to patients with mobility issues, who have to be seen downstairs in Dr Bentley’s room.
‘If a patient is unable to navigate the stairs, they have to wait downstairs and then I have to come out of my consulting room and wait in the corridor, as a busy doctor with a full list, so one of my colleagues can see the patient … It’s hot-desking to an absurd degree.’
The three GP partner practice has been based in a three-bedroom terraced house since before the inception of the NHS and its list size is now over 7,000, rising significantly in recent years following population growth and the closure of a nearby practice.
Damp, cramped and unsuitable
Cumbria GP Kaye Ward has lots of ideas of how to develop her practice and deliver the government’s pledge to provide more community-based care.
However, she and her GP practice partner Jane Rimington are prevented from doing so because of their damp, cramped and unsuitable premises. Funding obstacles also mean they are unable to take up the opportunity of a new surgery.
Their surgery, Hawkshead Medical Practice in the Lake District, is housed in a converted forge where the doors are not wide enough for wheelchairs, the window and door frames are rotten and there is damp in many rooms. The examination room adjoins the consultation room so whenever the GPs, who job share, are running a surgery the practice nurse can only work in the office.
‘The building is not fit for purpose and there’s no way we can deliver future plans in taking care out of hospital into primary care because this building is just not suitable for that,’ Dr Ward said.
The GPs have been presented with a solution to their premises problem by a local resident who has offered to build a purpose-built surgery with two flats above it. Planning permission has been granted for the surgery but the GPs are unable to take it up because of NHS England concerns about potential rent rises.
Dr Ward also wants to set up a temporary visitor service for the 350 holidaymakers who visit the practice each year. The practice has a permanent list size of 1,150 patients, each year.
She explained: ‘Some days we have four temporary residents registered and our patients queuing trying to get into the surgery too. We would like to have a dedicated temporary visitor service so we could take their details and get them to come back at a specific time.
‘We want to be flexible. We understand we can’t stay the same and want to offer more services but it’s just not possible at the moment.’
See the results of the survey
Find out more about Your GP cares
Watch the BMA's video about GP premises
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