The Select Committee’s inquiry asked for responses on “what is needed from the NHS estate to deliver the Government’s vision of a ‘Neighbourhood Health Service’ — shifting care from hospitals to integrated, preventative services in local communities.”
Adding: “The Committee’s inquiry will examine the physical infrastructure requirements to realise this shift, which includes the establishment of ‘Neighbourhood Health Centres’ in every community. It will explore whether current estate plans, funding and leasing systems, and delivery models are suitable, as well as the risks and opportunities of Public-Private Partnerships. This includes lessons from past models such as PFI.”
Londonwide LMCs’ response
The full response can be read here, key points are:
- It is important to determine what the aims and delivery model are for the neighbourhood health service, until that is done it is not possible to say what additions and changes to the general practice estate will be required. But we can say that if it is to succeed in improving population health and prevention of serious illnesses, it will need to empower GPs working at a local level and avoid centralisation of decision making and moving services out of communities.
- GP practices need estate that is fit for purpose to deliver modern GP access, and large enough to cater for the patient populations and future growth (including hosting allied health professionals and such neighbourhood services as are commissioned/ coordinated in a given locality.
- The space for additional services to be brought into existing GP sites rather than moving GP services away is vital. The further away practices move from local communities the greater the challenges for patients, the more access and travel issues that are experienced, and the more trust and confidence is eroded.
- The longstanding lack of investment in repairs and modernisation of GP premises in London will need to be addressed. There will also need to be changes to the Premises Cost Directions and the rent reimbursement framework for use of premises by providers other than GP practices. Cost efficiencies will need to be realised, with specific attention to service charges, repair and maintenance costs.
- Listen to what practices say they need. Premises have to be affordable. There is little point in building new premises if practices (and others) cannot afford to move into them because of high management or running costs.
- There needs to be public engagement at grass roots level to gain ownership and support change management processes on how, when, why, and where services need to be developed and changed to maximise health gain.