Premises reimbursement for practices could be cut if they do not fit with future NHS strategy to “force the pace” of moves to larger care units, say NHS commissioners. It comes after a review that has warned 30% of practices are not large enough.
These proposals came just days before the NHS set out plans to incentivise every practice in England to join ‘local care networks’ which serve 30,000 to 50,000 patients after the NHS had a major review into its estates. It is believed that these local care networks are going to be renamed to ‘primary care networks’.
According to a report by Sir Robert Naylor, with the number of older patients continually on the rise, major investment is needed in primary care estates to build new models of care that can cope with older patients having multiple long-term conditions.
Health Secretary, Jeremy Hunt, has warned that the overall NHS estate could need as much as a £10bn injection of capital funding as well as at least a further £5bn for backlog maintenance costs and a figure similar to that is required to help deliver the Five Year Forward View. The current small programme of capital grants for NHS England to help support primary care premises development “will be inadequate” to hit the Five Year Forward View objectives.
According to the Naylor review, a new Treasury fund, private investment in primary care estates and the sale of NHS property could help deliver the funding that is required.
The report states that around 43% of NHS trust premises are more than 30 years old, which is a key factor in the multi-billion-pound backlog of maintenance costs.
A practice that has a list size under 4,000 patients are “unlikely to be large enough to meet the vision of person-centred care set out in the Five Year Forward View” – practices that do have a list size of less than 4,000 is set at 30% – according to the report.
Scott Sanderson, Healthcare Partner at Hawsons, had this to say: “Jeremy Hunt’s concerns are well founded after a decade of underspending on primary care facilities, the challenge on the horizon for the Government is to ring fence this funding in times where the wider UK economy has its own challenges with a general election and a Brexit deal.”