Will government plans to change planning rules damage primary care services?

Last month Prime Minister Theresa May turned her attention back to the UK’s housing market, with a promise to ‘rewrite the rule book in terms of planning’ to force councils to hit housebuilding targets. However, Adam Thompson from healthcare property specialist Primary Care Surveyors warns that unless primary care provision is factored into the house building equation, the UK will see a decline in primary health provision in the next 10 years.

The Prime Minister is expected to outline changes to the National Planning Policy Framework to release more land for development, in addition to removing planning powers from those councils that miss their goals, passing power to independent inspectors.

“The danger,” warns Adam Thompson, “is that with such an ambitious plan to increase the number of homes built each year from 217,000 in 2017, to 300,000 this year to cope with the growing UK population, green belt land has been earmarked for some of this development, which includes little or no primary care infrastructure.”

It is fast becoming clear that unless attention is paid to the required social infrastructure to support such developments, a shortage of medical facilities is looming which may become critical unless action is taken now and appropriate plans made. House builders pay councils millions of pounds through Section 106 contributions and the Community Infrastructure Levy to build social facilities which should include GP practices. It is important, if the current government plans go ahead, that Section 106 contributions are channelled in this direction.

“Many current medical premises are woefully inadequate, outdated and not fit for purpose, requiring substantial investment and improvement. GP practices can only grow and improve, in order to better serve the increasing population and its increasingly complex needs, if their premises are modern and adaptable.

“The solution may be to build new super medical centres that can incorporate multiple services, such as GP practices, dental clinics, pharmacies, district nurses, social care and other community services. However, this will require significant investment and collaboration with existing GP practices in order to form local super-clinics. Failure to do so will only put undue pressure on local hospitals and A&E departments,” Adam cautions.

Sajid Javid, the Housing Secretary, has previously stated that he would like to build five new garden towns, or ‘garden villages’, between Oxford and Cambridge, taking advantage of the ‘varsity line’ rail links set to be built between the two university towns. Already thousands of new homes have been earmarked in the areas around Bicester, Bedford, Milton Keynes and the district of Aylesbury Vale.

Adam Thompson concludes: “The lack of primary care infrastructure will be even more pronounced in rural areas. The number of homes being planned on green belt land in England is to increase to more than 300,000. With the Government poised to weaken protections to meet ambitious building targets, there will, without doubt, be a lack of primary medical clinics and GP surgeries, requiring substantial investment into medical facilities for those areas alone.”

With house occupancy averaging at 2.3¹ residents per dwelling, this rural expansion would potentially accommodate over 690,000 inhabitants. With the UK ratio of patients to GPs varying across the country, but averaging at 2,000 patients registered to a single GP, this increase in population within the green belt alone would make a case for over 345 new GPs to administer to that number of patients.

From research conducted in 2015 by HSCIC (Health & Social Care Information Centre) the average population per GP practice in the UK was 6,884 patients. For this green belt expansion, this would make a case for over 100 new primary care medical centres, without taking into consideration existing local capacity, if that capacity were able to support the new population boom.

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