Modernisation of Primary Care Estate

Keith HoughtonAssociate Consultant (NatPaCT)

Premises/Investment

Keith HoughtonAssociate Consultant (NatPaCT)

Premises/Investment

NHS Plan/Targets

• 500 One Stop Primary Care Centres (2004)

• 3,000 Refurbishment's (2004)

• (MADEL) Doctors in Training (2004)

• Disability Discrimination Act

• Diagnostic and Treatment Centres

• Expanding Out Patient Services

Profile

• 10,500 Premises

– 40% Purpose Built

– 80% Undersized

– 5% Co-located with pharmacy

– 50% ex-residential/shops

Current Arrangements

• Importance, quality, access, patient focus

• Investment piecemeal

• GP risk/responsibilities

• Disincentives, leases, inner cities, negative equity

Current Arrangements (Cont)

• Under investment

• Integration - social services/voluntary sector

• Whole systems, local health community plans

Challenges• Developing SSDPs

• Underpinning Estate Strategies

• New ways of working

• Workforce planning

• Whole system impact

• Developing capacity

Changing Patterns of Service Delivery

• Flexible medical workforce

• Wider use of other clinicians

• Integrated teams

• Larger practice cohorts

• Market Competition

Future Opportunities• Integrated care centre

• Community Resource Centre

• Redefining walk-in

• DTC/OPC - community hospitals

• Using Telemedicine/IT

– Digital imaging

– Teleradiology

– Home monitoring/community teams

• Re Engineering

Investment Issues• LIFT - Progress

• Local Partnerships

• Third Party Development

• Traditional - Cost Rent

• Professional Engagement

• Reluctance to change