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Why Primary Care Estate is critical to NHS ICS'S in tackling the issue of health inequalities.

The NHS is facing huge challenges in the coming years, not least of which is how to reduce health inequalities.

We believe part of the solution will require significant improvement in Primary Care and Community (covering workforce, governance and infrastructure). This investment must be made if we want to see real progress in outcomes for patients. This article explores why NHS Primary Care and Community Estate is so important and raises five important points about why the new NHS Integrated Care Systems must explore the opportunities found in estate strategies.

The NHS in England is moving towards implementing integrated care systems (ICSs), which are designed to provide more coordinated and effective care for patients.

ICSs bring together different health and social care organisations to work collaboratively to improve patient outcomes and reduce avoidable hospital admissions.

The move towards ICSs is part of the NHS Long Term Plan, launched in 2019 and sets out a vision for transforming the health service over the next ten years.

Integrated care is seen as key to achieving this transformation, and ICSs are an important step towards delivering better integration. Theoretically, there are many benefits of implementing ICSs, including improved coordination of care, better management of chronic conditions, and reduced pressure on hospital services.

However, there are also challenges associated with implementing ICSs, such as ensuring that all organisations work collaboratively and ensure that patients receive the right care in the right place at the right time.

Why strong primary care estate strategies are essential.

One of the key components of an effective integrated care system is a strong Primary Care clinical strategy. Primary Care services are often the first point of contact for patients, and they play a vital role in promoting prevention and early intervention.

They also play an important role in coordinating care for patients with complex needs and supporting self-care. Our experience tells us a strong primary care estate strategy is therefore essential to enable the objectives of the clinical strategy to be delivered successfully.

An effective estates strategy should be supported by adequate funding, staffing and resources, and it should be connected to other parts of the system to enable better health care such as improving patients can access the care they need when they need it ( with an emphasis on "access to care").

Good primary care estate is also critical for delivering patient-centred care.

To enable organisations to have a flexible estate that supports multidisciplinary health professionals and provides easy access, standard clinical rooms, interactive waiting spaces that promote good health and SMART systems that address room booking and energy efficiency.

All of these support the delivery of safe, high-quality care and are focused on achieving the best health outcomes for patients.

It also makes it possible to see more patients in the community, which reduces pressure on hospital services. In addition, primary care estates can play an important role in promoting health and wellbeing, for example, by providing space for social prescribing initiatives or community gardens.

A primary care strategy gives transparency to what success could look like, a stocktake of the present position and the steps required for moving forward.

Developing a primary care estates strategy that promotes the co-location of services and working in partnership with local authorities and other partners plays a large role in changing the narrative that primary care services can only be delivered in the confinement of a GP Practice.

The NHS is just one piece of the puzzle, and it's important that communities have visibilities of the the support required from agencies that focus on areas such as housing, education and employment play active part in address health inequalities.

The future of primary care estates is in doubt as the NHS budget cuts put them at risk. But there are ways to overcome these challenges!

  1. Aligning funding streams/tariffs for services which move from secondary care to primary care; therefore, an investment for reconfigurations where required can be attained

  2. Consolidate existing sites that are held on leases / Maximise utilisation ( which benefits revenue implications

  3. Capitalise on the estate that is past its sell-by date, i.e. Disposal or review the opportunities available to the system for excess land, i.e. Capital Receipts

  4. Vertical Integration / Horizontal integration with healthcare providers within the system

  5. Implement a robust long term plan to address Backlog Maintenance.

Now is not the time to abandon primary care estate strategies!

The challenges that the NHS is currently facing do not mean that primary care estate strategies should be abandoned. On the contrary, it is more important than ever to develop and implement such a strategy if the newly formed ICS’s are serious about addressing health inequalities and improving health outcomes. Working collaboratively across sectors can make profound changes to how a modern health system delivers care to its patients in the future.

We will be discussing these issues at a forthcoming event hosted by Sandwell Estates Partnerships in May. To find out more, contact Alston Owens via emai:

Alston Owens, Managing Consultant, gbp consult



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