The Fuller Stocktake report recognises the fragmentation across the primary care estate, and that to create the right environment for change first there needs to be an understanding of what they have, writes Wendy Farrington-Chadd
The Fuller Stocktake report sets out a new vision for integrating primary care, reaffirming it at the heart of communities, and evolving primary care networks into integrated neighbourhood teams. I was pleased to see the recognition of the estate as a key enabler, along with workforce and data, and crucial to delivery of the new model.
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Community Health Partnerships’ purpose from the outset has been to facilitate the integration of care in local communities using investment and the development of the community based estate as a catalyst. As a Department of Health and Social Care company and partner in the Local Improvement Finace Trust estate, we work in partnership with local health and care systems and know first-hand the positive impact innovative and sustainable spaces have on patient care. We wholeheartedly welcome Dr Fuller’s report, particularly her recommendations to develop system-wide plans to support fit for purpose buildings for neighbourhoods and place teams delivering integrated care and making creative use of space in our portfolio in support.
Understanding the primary care estate
The report recognises the fragmentation across the primary care estate, and that to create the right environment for change first there needs to be an understanding of what they have. This is fundamental. Since 2019, CHP has led the Primary Care Data Gathering Programme on behalf of NHS England and Improvement. This programme has delivered a baseline of consistent data for every NHS reimbursed GP practice across England. The dataset covers estates information including property location, GP contracts, commercial attributes, building information, and occupancy costs.
CHP has utilised this data in creating a PCN Service and Estates Planning Toolkit, developed in collaboration with NHSE/I and the National Association of Primary Care launched in November 2021.
This data and toolkit are displayed in SHAPE, the Strategic Health Asset Planning and Evaluation tool, and can be accessed by integrated care systems and PCNs to inform infrastructure planning.
The programme seeks to align estates plans with delivery of clinical, digital and workforce strategies
Capacity and capability
The report calls for practical support and estates expertise to drive forward with the recommendations in the report. CHP has in the last year introduced regional directors leading system facing regional teams who are actively engaged with ICS colleagues on developing and implementing system wide estates plans. They are using their local knowledge and expertise to maximise the use of spaces.
We are also working with 34 ICSs, circa 700-800 PCNs, using our estates capability to support development of their estates and investment plans. Utilising the PCN Service and Estates Planning toolkit, we are developing PCN estates plans that are relevant to the local context and responsive to wider stakeholder strategies. With this work already happening we are well on the way to understanding the estates requirements at the neighbourhood and place levels and aligning these to the outputs of the Fuller Stocktake report, these can then be fed into ICS infrastructure strategies.
Partnership working
The philosophy of partnership is at the heart of Dr Fuller’s report, something that I would argue permeates the NHS. The success of partnership working boils down to trust and this is earned. Over the last two years we have been working with clinical commissioning groups in selected areas on our Community Integration Programme. The programme seeks to align estates plans with delivery of clinical, digital and workforce strategies. Partnership working is aligned behind a shared vision. Recent evaluation of these programmes show we are trusted partners with a solution focussed mindset.
In North Central London for example through partnership working we have reduced voids by 30 per cent across our buildings over the past 12 months, saving the system over £600,000 and delivered one of the first NHS Community Diagnostic Centres in England. Nationally, we are working in partnership with the National Community Diagnostic Centres Programme to support the NHS in meeting its elective care recovery plan. Making creative use of space is key, there is huge potential to repurpose LIFT buildings to increase diagnostic capacity in the community. Combined with more integrated care at the neighbourhood level, this would be great news for patients.
The Fuller Stocktake report brings to the fore the challenges faced by the primary and community-based estate. It is a real opportunity to work in partnership to turn a major constraint into a true enabler and progress the integration of primary care, especially with the support from all ICS CEO designates.
