RCGP survey reveals four in 10 GPs working in premises ‘not fit for purpose’

Four in 10 GPs are seeing their patients in practice premises that are ‘unfit for purpose’, according to the latest survey from the Royal College of GPs

Practice teams working in premises they consider ‘not fit for purpose’ say that poor conditions such as an insufficient number of consulting rooms (88%), or rooms of adequate size mean that patients are often kept waiting to be seen by a GP or other healthcare professional and that this is now impacting on the standard of care they can deliver.

They say that limited space is also making it difficult to train new GPs (66%) and restricting the number of trainee GPs that they can take on (75%), further compounding current staffing shortages and leading to even longer waiting times for GP appointments and higher GP workloads.

Some GP staff reported that they were having to hold consultations in rooms less than a third of the size of the required standard set out by the Department of Health and Social Care. Yet almost three quarters of the staff who requested funding to upgrade their premises over the last year were unsuccessful in obtaining it.

Worryingly, almost half (46%) of general practice staff responding to the survey reported that their PC or laptop software was not fit for purpose, with 38% saying their broadband connection was not of an acceptable standard.

Due to these obstacles in digital infrastructure, GPs reported difficulty in exchanging information with other care providers including pharmacy systems (56%), out of hours care (51%) and community teams (51%).

The College has welcomed further pledges in the Access Recovery Plan, including one-off funding for digital telephony and care navigation training. But it has described these as ‘positive steps’ rather than the ‘silver bullet’ that is desperately needed to address the intense workload and workforce pressures GPs and their teams are working under.

It is now calling for urgent action to upgrade outdated IT systems and for all GP practices to have adequate space to treat their patients and train GPs and other practice staff.

It also wants to see further funding for the ‘retro fitting’ of GP surgeries to improve energy efficiency. Investment allocated through Integrated Care Systems (ICS) to primary care estates and IT is just three per cent of the total NHS capital budget per year, according to NHS England data.

Prof Kamila Hawthorne, chair of the Royal College of GPs, commented: “This report reflects the difficult reality that many GPs and our patients are experiencing on a daily basis due to decades of neglect and underfunding for general practice. The demand for our services and number of patients is rising but many practices and the number and size of consulting rooms they have are simply not up to scratch, and not even close to the level we need to ensure that we’re training an adequate number of GPs.

“In addition, we are also being asked to train pharmacy, nursing and physician associate students, as well as many medical students, but there really isn’t enough room for them in many GP practices.

“The recent GP Access recovery plan presented some encouraging initiatives that may improve some of the infrastructure problems we’re facing. However, none of the recent measures announced will be delivered overnight, nor will they address the widespread structural issues affecting many surgeries. Looking forwards, if we are indeed aiming to be working in an integrated manner with other health and care services co-located with us, there needs to be a significant increase in funding for primary care infrastructure, to enable this to happen across the UK.

“It makes for troubling reading to hear just how many practices, and in turn patients, are suffering whether it’s from a lack of sufficient space or an inability to coordinate with other care teams due to outdated IT systems.

“General practice is the front door of the NHS, crucial to the delivery of healthcare nationwide, and yet we’re under-equipped. If we’re to ensure the highest standard of care for patients, addressing these fundamental problems needs to be an immediate priority.”