Published: 24/10/2002, Volume II2, No. 5828 Page 8 9

GP practices should be 'put on notice' by primary care trusts that they should not expect to receive reimbursement for substandard premises. The warning came from NHS Estates' Keith Houghton at the NHS Alliance conference in Harrogate.

Mr Houghton is working with the national primary and care trust development Programme on efforts to improve the quality of the primary care estate.

He said that, as part of their strategic service delivery plan, PCTs would have to develop an estates strategy by the end of the financial year. This would detail how premises would play their part in improving service capacity and quality, as well as meeting national and local priorities. He also pointed out that PCTs have vicarious responsibility for the health and safety of staff, such as community nurses, working in GP surgeries and health centres.

Mr Houghton said that although PCTs had the power to withhold reimbursement for notional rent and rates on substandard GP premises, very few did so. This was despite the fact that, according to Mr Houghton, most PCTs had practices whose premises did not meet access criteria and/or were inappropriate for the services being delivered.

The urgent need to improve the quality of the primary care estate meant that PCTs had to consider the option of withholding funding more seriously if the necessary changes were not forthcoming.

PCTs should carry out inspections of all GP practices to identify problems, he added.

However, Mr Houghton said that PCTs should also be working with GP practices to help them find ways - through the local improvement finance trust programme, for example - to improve premises.

He added that this winter's allocations of funds to PCTs would provide 'a massive opportunity' for investment which the organisations should grasp.

Despite this, the Department of Health might have to 'say no' to some hospital expansion plans.

Later in the conference, South Yorkshire strategic health authority chief executive Mike Farrar explained that if the new GP contract was introduced, PCTs would hold some of the money intended for investment in premises centrally. Mr Farrar claimed these funds would allow PCTs to invest strategically across their patch and to attract inward investment.