Doctors warn that General Practices are bursting at the seams
Three quarters of GP practices responding to a BMA survey say their premises are not suitable for anticipated future needs. The survey results, published today describe how family doctors are prevented from expanding their patient services by lack of space, coping instead with a daily round of “hot desking”, room juggling and even using the coffee room for immunisations.
In contrast to government announcements proclaiming record investment in primary care premises, the BMA’s GPs Committee (GPC), which commissioned the premises survey, says general practice is being prevented from reaching its potential by the way the – insufficient – funds are channelled.
Dr Hamish Meldrum, chairman of the GPC, comments: “Despite all the fine talk by ministers of money for new buildings, the fact remains that general practice is bursting at the seams. The GPC survey results paint a picture of surgeries where every conceivable space has been converted for clinical use, with consulting rooms in former storage areas and doctors doing their paperwork in the kitchen.”
Just under six in ten of the 251 UK practices who took part in the survey said their premises were not suitable for their present needs. And 182 of them (three quarters) felt their surgeries were not suitable for their expected future needs. Two thirds of the practices said their clinical staff “hot desked”. One GP wrote: “We all hot desk…on Friday we used the staff common room for flu vaccinations.” Another said: ”No clinician has their own room. I have had to move desks up to 5 times in a two-hour period.”
Dr Meldrum commented: “With such a high proportion of GP practices saying their surgeries are not suitable for their future needs there is little hope of implementing the English Department of Health’s plans to move care from hospitals closer to patients’ homes unless a significant amount of resources are set aside for practice premises development.”
If practices could extend or improve their premises, family doctors would like to provide extra patient services as well as taking on additional GPs, nurses and other health professionals to provide more appointments. “Minor surgery, physiotherapy, dermatology, counselling, taking blood for tests, and treating minor injuries were just some of the extra things practices would like to offer their patients if they had the room” said Dr Meldrum.
Evidence that family doctors have been trying to modernise their buildings is shown by the fact that over four in ten practices in the survey had found some funding for improvements in the past five years. The money came from a variety of sources including loans and mortgages, practice savings, private finance initiatives, grants and cost rent schemes that cover the interest on loans.
Many practices in the survey had had planning applications refused or were in listed buildings in a conservation area, making successful planning applications unlikely. “Others had already extended as far as was possible or had no room to expand on their current site”, said Dr Meldrum.
One practice reported: “There are days when there are not enough rooms to allow all the doctors to consult. The extra doctor sits in the kitchen/typing room and works through mail. Another said: “We were hoping to move many years ago and have asked for Primary Care Trust help with funding for the last 8 years at least.”
Lack of space is hampering practices from training the next generation of GPs: Only 46% of practices felt they had enough room to provide training for GP registrars. Worryingly, over a third of the practices responding were unable to make the necessary adjustments to their premises to ensure compliance with the Disability Discrimination Act. A quarter of respondents felt their practice premises posed some risk to the health and safety of their staff and or patients. Cramped conditions also meant that confidentiality was an issue.
Dr Meldrum said: “If the government is serious in its intentions to transfer healthcare out of hospitals and into the community it has to recognise that we need somewhere to treat these patients. General practice premises are very clearly overstretched. The money for premises has been too little, too late, and with too many strings attached. What is needed is a longer-term commitment to regular revenue funding so that GPs can seriously plan for the 21st century.
One-off PFI or capital assistance schemes might provide a short-term political fix but GPs want to plan for the future. That means recognising the need and providing for the cost of being able to give patients the primary health care they need in the environment they deserve.”
http://www.bma.org.uk/pressrel.nsf/wlu/SGOY-6PQHSY?OpenDocument&vw=wfmms
In contrast to government announcements proclaiming record investment in primary care premises, the BMA’s GPs Committee (GPC), which commissioned the premises survey, says general practice is being prevented from reaching its potential by the way the – insufficient – funds are channelled.
Dr Hamish Meldrum, chairman of the GPC, comments: “Despite all the fine talk by ministers of money for new buildings, the fact remains that general practice is bursting at the seams. The GPC survey results paint a picture of surgeries where every conceivable space has been converted for clinical use, with consulting rooms in former storage areas and doctors doing their paperwork in the kitchen.”
Just under six in ten of the 251 UK practices who took part in the survey said their premises were not suitable for their present needs. And 182 of them (three quarters) felt their surgeries were not suitable for their expected future needs. Two thirds of the practices said their clinical staff “hot desked”. One GP wrote: “We all hot desk…on Friday we used the staff common room for flu vaccinations.” Another said: ”No clinician has their own room. I have had to move desks up to 5 times in a two-hour period.”
Dr Meldrum commented: “With such a high proportion of GP practices saying their surgeries are not suitable for their future needs there is little hope of implementing the English Department of Health’s plans to move care from hospitals closer to patients’ homes unless a significant amount of resources are set aside for practice premises development.”
If practices could extend or improve their premises, family doctors would like to provide extra patient services as well as taking on additional GPs, nurses and other health professionals to provide more appointments. “Minor surgery, physiotherapy, dermatology, counselling, taking blood for tests, and treating minor injuries were just some of the extra things practices would like to offer their patients if they had the room” said Dr Meldrum.
Evidence that family doctors have been trying to modernise their buildings is shown by the fact that over four in ten practices in the survey had found some funding for improvements in the past five years. The money came from a variety of sources including loans and mortgages, practice savings, private finance initiatives, grants and cost rent schemes that cover the interest on loans.
Many practices in the survey had had planning applications refused or were in listed buildings in a conservation area, making successful planning applications unlikely. “Others had already extended as far as was possible or had no room to expand on their current site”, said Dr Meldrum.
One practice reported: “There are days when there are not enough rooms to allow all the doctors to consult. The extra doctor sits in the kitchen/typing room and works through mail. Another said: “We were hoping to move many years ago and have asked for Primary Care Trust help with funding for the last 8 years at least.”
Lack of space is hampering practices from training the next generation of GPs: Only 46% of practices felt they had enough room to provide training for GP registrars. Worryingly, over a third of the practices responding were unable to make the necessary adjustments to their premises to ensure compliance with the Disability Discrimination Act. A quarter of respondents felt their practice premises posed some risk to the health and safety of their staff and or patients. Cramped conditions also meant that confidentiality was an issue.
Dr Meldrum said: “If the government is serious in its intentions to transfer healthcare out of hospitals and into the community it has to recognise that we need somewhere to treat these patients. General practice premises are very clearly overstretched. The money for premises has been too little, too late, and with too many strings attached. What is needed is a longer-term commitment to regular revenue funding so that GPs can seriously plan for the 21st century.
One-off PFI or capital assistance schemes might provide a short-term political fix but GPs want to plan for the future. That means recognising the need and providing for the cost of being able to give patients the primary health care they need in the environment they deserve.”
http://www.bma.org.uk/pressrel.nsf/wlu/SGOY-6PQHSY?OpenDocument&vw=wfmms
posted by Dr Search- Principal Consultant at the Search Clinic at
9:53 AM
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