Local councils want more power over primary care estate

The councils want to update the capital’s “ageing GP and primary care premises” and are calling for “a key role in driving the improvements alongside their NHS partners,” London Councils said in a statement today.

It said more than half of GP surgeries need some refurbishment, “while 13 per cent were poor, very poor or terrible and should be rebuilt” and “a third of practices were found to be inaccessible for people in wheelchairs”.

It wants “a more collaborative approach” to developing the primary estate and has set out three requirements:

• Devolving and simplifying NHS capital funding “so that boroughs can participate in decision-making and help accelerate improvements to local primary care premises”;
• “Comprehensive, up-to-date maps” of primary care sites and surgeries so boroughs can “make better use of their planning powers to support new primary care infrastructure”; and
• Health and wellbeing boards to have more of a role in primary care estate issues, “with health partners working with boards as a matter of routine”.

London Councils said local government “must be key partners for primary care planning” because of their “democratic accountability and place-making responsibilities”. Increasing their role “could help speed up the delivery of new buildings, ensure efficiency and improve outcomes for Londoners”.

This intervention comes as three of London’s sustainability and transformation partnerships prepare to merge their clinical commissioning groups in April — from bodies that shared footprints with their corresponding London boroughs to single CCGs spanning multiple boroughs.

Some in local government are worried this will reduce the extent to which they can hold their NHS partners to account for health services in their boroughs.

The announcement was described as “enormously helpful” by Sir Sam Everington, a GP in east London who chairs the Tower Hamlets CCG as well as London’s Clinical Commissioning Council, made up of the city’s 32 CCG chairs.

He said better joint working could help address variation in how councils work with primary care on their patches. “Tower Hamlets has been absolutely fantastic with their section 106 funding,” he said.

This could mean building GP surgeries into schools, building them with space for a pharmacy on site or a dentist surgery, or making them “part of the local community centre”.

“And I suppose the final point is that there has been a lot of emphasis nationally on hospitals and so this actually is a reminder to everybody about the importance of primary care,” he added.

Sir David Sloman, the regional director for the NHS in London, said: “Working with our partners is key to delivering on our vision to make London the healthiest global city, and we are looking forward to working together to provide the best care for Londoners.”

Update: this article was updated at 09.49 on 24 January to include a comment from Sir David Sloman.