At a time when the Government is pushing for health services to be localised, we look at how investment in the primary care estate is vital
The Government is pushing for health services to be moved out of acute hospitals and into local community settings. But this cannot be done without improvements to the primary care estate. Here, we look at one ground-breaking project that is setting a precedent for the future
Increased investment in primary care facilities is vital if the NHS is to cut back on the use of expensive walk-in centres and reduce pressure on hospital A&E services.
While billions has been spent enhancing acute hospital estates, GP centres and clinics have largely been ignored.
As a result, many services are still operating from out-of-date former residential buildings and cramped facilities that are increasingly becoming unfit for purpose.
But how can this problem be addressed without having to spend huge amounts of money, which the health service can ill afford, on major new-build developments?
"One of the key issues in replacing GP surgeries is finding a suitable site in the immediate vicinity,” explains Graham Dupree, head of healthcare property at national law firm, Mills & Reeve.
NHS funding for new developments has tended to favour larger projects which bring together several practices and the lack of suitable sites has led to some imaginative solutions
“NHS funding for new developments has tended to favour larger projects which bring together several practices and the lack of suitable sites has led to some imaginative solutions.
“One option is to renovate existing buildings, but this is relatively rare as it can often be more costly than a new-build project. However, the use of existing landholdings is always a possibility and numerous new primary care facilities have been built on NHS land, where this is in a suitable location. Existing NHS buildings have also been adapted to new uses where this is cost effective.”
One example of this approach is the newly-opened Lion Health Medical Centre at Stourbridge in the West Midlands.
The clinic was originally the historic Foster and Rastrick foundry, which was the birthplace of the famous Stourbridge Lion steam engine. The grade II-listed Georgian building had been empty since 2003.
In 2006 the partners at Worcester Street Surgery felt that a collection of five buildings scattered around Stourbridge and providing healthcare to 26,000 patients was not the way of the future.
The practice realised change was needed in order to provide the care that the NHS, and more importantly, its patients deserved.
Having reviewed the local authority’s Unitary Development Plan, it soon became clear that available space was at a premium.
Our vision is that this unique facility will power a revolution in healthcare locally which can be learnt from, copied, and improved at scale elsewhere
Attention therefore turned to the foundry. While the building did not lend itself to development as a GP surgery, a series of meetings with Abacus Architects and the landowners allowed Lion Health to develop an iconic building and a beacon of future primary health services.
Stephen Mann of Lion Health said: “The creation of this state-of-the-art healthcare facility inside a listed building has given us a constraint that has proven creative, allowing us and our team of staff to develop a building that really flows from a patient perspective, with a sense of space which is tranquil, yet industrial to reflect the heritage of the building, our patients, and the region.”
The architects developed the concept of an internal street at ground-floor level, with consulting rooms sited off a glazed corridor, along with a pharmacy and nursing suite. The ground floor is seen as primarily the’ illness floor’, while the first floor has wellness and health promotion as its theme.
Perpendicular to the old building is a new wing with a contrasting aesthetic, with sheet metal and glazing to both elevations.
“Our vision is that this unique facility will power a revolution in healthcare locally which can be learnt from, copied, and improved at scale elsewhere,” said Mann.
Depree added: “Lion Health Medical Centre is a fantastic example of how old and new can be brought together in a truly-inspiring way.
“It took a lot of faith and vision to see how the old foundry building could be incorporated into a 21st-century healthcare facility, but the result is an overwhelming success.”
But, with public funding dwindling, how can organisations meet the high costs associated with this sort of development?
Dupree advises: “The key to any new GP development is rent reimbursement by NHS England to support either actual rent being paid, or a notional rent if a development is being made from GPs’ own capital.
The key to any new GP development is rent reimbursement by NHS England to support either actual rent being paid, or a notional rent if a development is being made from GPs’ own capital
“There are strict criteria to be met before any such funding is made available, with a rigorous assessment of the business case for the development.
“There is also close control over the extent of facilities provided and the quality of the development.
“When drawing together a large practice or several practices co-locating together with services such as dentistry and a pharmacy, economies of scale can help to underwrite some of the cost of a more-ambitious development."