Half of GP practice buildings not fit for purpose, BMA survey reveals

Maybe you’re unhappy about your practice space, layout and scope for offering the high quality service you come to work every day to deliver. Well, you’re not alone; a new study shows that half of of your colleagues feel your pain…

This is an edited version of an article first published in the BMA. 

Only half of GP practice buildings in England are fit for purpose, with surgeries too small to meet the demands of growing populations, a major survey on practice premises from the British Medical Association (BMA) has found.

The survey of more than 1,000 practices in England asked doctors and practice managers about their experiences with property ownership and management. One of the main findings was that eight-out-of-ten GPs said their premises were not fit to meet anticipated future needs.

The findings present a snapshot of the GP premises’ landscape, as well as the issues faced by family doctors, staff and their patients. Key findings include:

1. Only half of practices said their premises were suitable for present needs.
2. Around eight-in-ten said their practices were not suitable for future needs or anticipated population growth.
3. GP premises are, on average, 35-years-old, having been first built or converted in 1984.
4. Eight-in-10 practices are in purpose-built premises.
5. The last significant modification or extension to premises took place in the mid-2000s (2005), on average, pre-dating many of the increases in patient demand and population growth witnessed over the last decade.
6. When asked what would make premises more suitable for present needs, most practices noted that more space is needed, including by extending the premises, adding more consulting rooms to manage a growing patient list, improving access including for disabled patients and expanded and improved patient waiting and reception areas.
7. Of those respondents who said they had applied to NHS England for improvement grants, the majority reported waiting in the region of three-to-six months to receive information on the status of their application. However, some reported waiting more than two years, with the process ongoing.
8. Eight-in 10 practices leasing from an NHS organisation said they had been invoiced with charges that were inaccurate in the last 12 months, with only 5% reporting these issues had been resolved.

No simple solutions

In light of the survey’s findings, the BMA is now urging the government to use next month’s spending review to invest in GP premises. The BMA is also calling for health bosses to remove the bureaucratic barriers that can often prevent practices carrying out the improvements that they need.

“GPs have been telling us for years that their practice buildings are not up to scratch, and now we have evidence showing just how serious the situation is,” . “Despite their best efforts, GPs and their teams are, ultimately, limited by space, and cannot meet the growing needs of their patients without an urgent increase in capacity. What is most worrying is how few practices feel their buildings are prepared for the future, with just two-in-10 saying they are fit to meet anticipated future demand.

“Without more space, and the ability to add rooms and facilities easily, patients will continue to face long waits for appointments, as GPs and their wider practice staff can only work with what they have. 

“The BMA recently came to a significant agreement with NHS England, as part of contract negotiations, to expand the primary care workforce – with groups of practices employing pharmacists, physiotherapists and other professionals – but for patients to benefit from this expanded team, they too will require space to work.

“Our research shows that the solution to this problem is not as simple as partners adding rooms or extending their surgeries to meet demand, with approval processes arduous and NHS grant applications not always running smoothly. GPs who lease their buildings from the NHS face their own set of problems, with rocketing and unwarranted service charges and management fees often not met with adequate maintenance. 

“At a time when GPs are facing extreme financial pressures, these unilateral price rises could push practices to the brink.”

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