Andrew Darke, managing director of property at Assura Group, discusses how the primary care estates could be key to the development of healthcare services over the coming years
In anticipation of the Five Year Forward View, healthcare professionals across the UK are assessing the gap between where we are and where we hope to be, examining the potential models of care delivery that could enable us to bridge the existing gulf.
The need for substantial reform and redevelopment of primary care has been overlooked in previous years due to heightened focus on secondary care services
The financial constraints imposed on the NHS mean that this gap remains a significant one, particularly for healthcare premises development. The freeze on premises funding continues to put pressure on primary and secondary care providers, with social care premises remaining largely unfit to meet the needs of its patients.
The Five Year Forward View requires a calculation of the health and care opportunities available within the financial context. This is particularly vital for the advancement of primary care, as the need for substantial reform and redevelopment has been overlooked in previous years due to heightened focus on secondary care services.
Andrew Darke is managing director of property at Assura Group
Greater attention needs to be paid to optimising existing healthcare estates, which is currently hampered by its fragmentation across many different bodies whose goals are local, and who often have no incentive to use surplus land and buildings to benefit other parts of the community.
In the primary care sector it is estimated that around 4,000-5,000 GP surgeries are unfit for purpose. Similarly, much of the care home sector is of poor quality and faces obsolescence, with over 70% of the stock estimated to be over 20 years old.
As we continue to tackle the issues facing an ageing population, politicians must recognise the need to rebuild our health and social infrastructure around the needs of our communities. All political parties need to respond to the crisis by developing a strategic vision for healthcare estates that will guide local decision-making and help to bridge the many silos within the health and social care sectors.
There has been paralysis of decision-making with regard to upgrading primary care’s infrastructure capacity, with structural reform threatening to prolong this paralysis
There has been paralysis of decision-making with regard to upgrading primary care’s infrastructure capacity, with structural reform threatening to prolong this paralysis. What is now integral to the progress of primary care estates is private sector investment, as it would enable the improvement of health and social care resources at the primary level, easing the strain on secondary care providers.
Private sector investment in healthcare infrastructure is the most-feasible means of confronting the challenges ahead during a particularly stressed period for public finances. With the premises funding freeze showing little sign of lifting, investment from private sector parties could deliver the new generation of healthcare facilities and generate savings for the public sector.
The NHS needs integrated healthcare resources that are high quality and are readily accessible to those that need them. The premises must be developed in line with sustainability and safety guidelines,and be equipped to support the necessary training for primary care staff. With recent BMA reports suggesting that many of these requirements are not being fulfilled to the correct standards at general practices nationwide, the problem becomes more pressing and demands further attention.
With the premises funding freeze showing little sign of lifting, investment from private sector parties could deliver the new generation of healthcare facilities and generating savings for the public sector
Without appropriate facilities for primary and elderly care, in the form of fit-for-purpose medical centres, retirement developments and care homes, it is inconceivable that we will adequately manage the future volume of people cared for in the community. These are what we need to solve the vicious circle where patients inevitably seek care in hospitals that are not designed for their needs.
What the legislators need to keep in mind for the Five Year Forward View is that more-efficient premises make for a less-expensive service. It is my hope that we see some careful, considerate prioritisation of our healthcare premises, and focus not just on the services we provide, but how we deliver it and who we are looking after.