An NHS England (NHSE) response to a freedom of information request suggests that last year only 13% of applications for GP premises development in England were approved.

This lack of investment is worrying in view of the fact it is reported that 40% of GPs say their premises are currently inadequate. GPs will also be extremely concerned that they may be at risk of an adverse finding by the Care Quality Commission (CQC) and it is unclear what steps the CQC will take against practices where funding for improvements is not forthcoming. It must make sense to create an environment where as many patients as possible could be treated in a primary care setting if appropriate. This objective has been supported by the recent GP task force report that recommends that GP trainee numbers are increased with a corresponding reduction in specialist hospital training places. These new trainees will need consulting rooms to practice from and the increased number of patient appointments will have to be accommodated. It will be disappointing for all involved if the standard of the current stock of GP premises acts as a block to this laudable aspiration.

We are looking to forward to the imminent release of an interim guide for NHSE local area teams setting out how premises applications will be dealt with. If there is certainty and a consistent approach to investment in the primary care estate then the developers, funders and most importantly, the GPs will feel confident to submit and progress applications.

We all want to see  a primary care estate that is fit to support the shift to community based care but to achieve this all the component parts must be in place and, after people, premises must be very high on the list.