Val Clinton specialises in delivering new build and major generation projects on behalf of the NHS and private sectors. She heads the specialist health unit at EC Harris, providing expertise throughout EC Harris' regional network of UK offices in London, Birmingham, Leeds and Manchester. The team also specialises in valuation and rentals, as well as securing complex planning issues for primary care initiatives involving medical and treatment centres for GPs.
The urgent need to improve primary care premises as identified in the NHS Plan is adding to the day-to-day burdens of the practice manager. The goalposts have subsequently moved since the introduction of the new General Medical Services (GMS) contract for GPs. There are added pressures to increase services and improve the environment for both patients and staff. Practice managers therefore have a crucial role to play in managing change in their organisations, and premises and facilities management will play a key role.
The continuing drive to develop and deliver more services within the primary care setting is in turn having an impact on premises, and is now raising the question amongst many practice managers: "Can our building cope?"
Over to the expert ...
The new contract therefore has significant considerations when it comes to the design and management of new healthcare facilities. As Val Clinton, who heads the specialist health team at EC Harris, explained: "It's not possible to move forward in today's performance- and target-driven NHS without considering the needs of the wider health economy.
"All service developments need to deliver the long-term needs, as identified in the Strategic Service Development Plan, which enables practices to fulfil their practice-based commissioning aspirations."
Val has identified three key questions, or service drivers, when planning ahead:
Highlighting the service drivers will help practice managers to identify what needs to be delivered, in order to respond to the national and local targets that the practice has to meet.
The implementation of service developments as identified under the new GMS contract therefore has a significant impact on the design and management of new healthcare facilities, or indeed how existing premises are used. Val explained: "Responding to the challenges imposed by the NHS on service delivery of nonacute contracts results in a more complex practice organisation. A practice with a greater range of services (and therefore income stream) and a diversity of staff has to be accommodated in the physical environment fit for purpose and capable of responding to future change requirements.
"Practice managers have therefore never had as much responsibility and now need to adopt a more corporate business approach in order to deliver sustainable premises".
The new approach
"This approach would ensure that there are facilities to enhance the patient experience as well as meeting the needs of quality design," continued Val, who has spent the last 20 years specialising in developing primary care premises for GPs and Primary Care Trusts (PCTs).
Having assessed the future service requirements, practice managers then need to focus on thinking about the built environment. This all needs to happen whilst managing the operational day-to-day activities of a busy practice.
All options will have to be considered, including new build, expansion and modernisation of premises. A business case must then be developed to justify any of these options, irrespective of which ownership route is taken, and approval will also be required from the PCT.
Huge pressures are also being put on practice managers to deliver, and in the healthcare sector few projects are straightforward. There are often complex planning issues to be resolved, significant funding matters to be overcome and rigid timescales to be adhered to.
Whilst it is not expected that they will have the necessary skills to move forward on a build project, by securing the right team with the right expertise and levels of support, practice managers can deliver affordable and efficient premises. Having an integrated team is the best asset any practice manager can have. This will ensure that pitfalls can be avoided, and more importantly it also allows the practice manager to fulfil all his or her other duties in running the day-to-day smooth operation of a successful medical centre.