Recommendation 43

HM Government Accepted in Part

Partially accept. The Department partially accepts this recommendation. In 2019, the General Practice Premises Policy Review2 highlighted the challenges faced by GPs and the wider NHS in terms of property ownership and liabilities. Stakeholders including the Royal College of General Practitioners, the Care Quality Commission, and General Practitioners Committee of the British Medical Association, were clear that they did not support a similar approach to Scotland in England. We agree Government should undertake analysis of the GP estate, but should consider all alternative viable models. Government ordinarily makes decisions about capital investment at fiscal events. Currently, capital is allocated to Integrated Care Systems (ICS) on a regional basis using a weighted population approach that considers local populations growing annually, and the responsibility for shaping the right size and fit for purpose NHS estate remains at a local level. Government will continue to consider the need for capital investment across public services. To inform future decisions, a Primary Care Data Gathering programme was completed at the end of 2022–23, which provides relevant data on the age, profile, utilisation, and condition of the primary care estate. This will allow commissioners and general practice providers to better understand their estates needs at neighbourhood level. ICS Estates Infrastructure Strategies are being developed to plan for future estate investment, necessary to ensure value for money for the taxpayer when developing the general practice estate. Integrated Care Boards (ICBs) should take the general practice and primary care estate into account when considering their wider strategy and investment requirements. NHS England and the Department will continue to explore potential solutions to the challenges faced in GP premises through Fuller implementation boards and other ongoing work. As pressure on primary care estate is particularly intense in areas of rapid housing growth, it is important that new development is accompanied by primary care infrastructure, and that this is supported by the planning system. As part of Government’s wider review of the National Planning Policy Framework and planning guidance, we will consider how primary care infrastructure can best be supported through the planning system where new development creates a need for it. Prior to this, we will update planning obligations guidance to ensure that primary care infrastructure is referenced and considered by local planning authorities alongside other infrastructure demands, such as education. We will also update guidance to encourage local planning authorities to engage with ICBs on large sites which may create need for additional primary care capacity.