The place for primary care

The built environment of your practice has a huge impact on patients, says Claire Rick from Assura. Here, she looks at the work they are doing to support the Patients’ Association in understanding how patients’ feel about practice buildings. By tackling access issues, she believes patients – and staff – can enjoy a better primary care experience

When your patients walk through the door of your practice, their surroundings aren’t the first thing on their minds. Patients often want to get in and see the GP or nurse, maybe collect a prescription, and get out as quickly as possible. Their experience of the medical centre building itself is just peripheral, isn’t it?

A look at the findings of new Patients’ Association research (Making best use of GP premises) suggests there’s rather more to it. In a survey of members and focus groups around the country, people talked to the charity about the many different ways in which their practice building impacts upon their experience – and even on how they feel about the services you deliver inside.

Space, colour and even smell, were highlighted for their role in creating our sense of a building; for some patients with conditions like dementia, autism and allergies, the Patients’ Association’s work illustrates the many ways in which the physical environment can both help and hinder their experiences of primary care. And it’s not just patients; staff can be affected by the environment too.

Compromised access

What certainly won’t have come as a surprise to many practice managers around the country are the challenges identified around patient access. The current general practice estate is comprised of a variety of buildings and the legacy of these older and converted buildings is clear.

Some comments in the research included:

  • No lift and the corridors are narrow.
  • Doctors having to come downstairs to see patients.
  • Difficulties in moving around the buildings in wheelchairs.
  • Difficulties in being able to get into the building easily or get to the reception desk due to lack of space to turn and manoeuvre.

The report states that the Health and Safety at Work Act 1974 requires access routes to be suitable for all foreseeable users, and the Disability Discrimination Act 2005 (DDA) requires establishments to give disabled people important rights of access to everyday services. The ageing infrastructure of some buildings can make this particularly difficult for practices.

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It’s an area that needs urgent attention, the report says, considering it to be one of the most pressing problems facing the NHS.

Staff satisfaction

We shouldn’t forget that practice buildings aren’t just for patients; they also need to function for the people who work within them. The space and facilities have to be right to deliver the services you provide to your communities. It’s also important that our working environments are well cared for, because they can affect how we feel about our professional lives and our employers. A well-maintained building demonstrates an employer who cares – making us feel valued and supported.

We shouldn’t forget that practice buildings aren’t just for patients; they also need to function for the people who work within them.

The NHS Long Term Plan’s focus on primary care will bring physical infrastructure into sharp focus; technology will, undoubtedly, change the premises primary care needs in the future, but the need for a physical place for care will never be completely replaced. In fact, as general practice grows, the proposed broader, bigger teams of professionals will need more space. Inevitably, this will lead some practices to question whether the facilities they have today are right for the services they need to deliver tomorrow.

For patients, primary care buildings themselves have an important role to play in supporting good mental and physical health. There really is no ‘one size fits all’ – GP surgery buildings must reflect the communities that they serve. But there are common patterns of good access and positive, patient-friendly design – and in improving premises that’s where our focus must lie.

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