How investor-funded GP 'super centre' could revolutionise primary care

We speak to the team behind the new Station Medical Centre in Hereford about how the innovative approach to infrastructure delivery could cut millions from the NHS budget and improve primary care services

The new Station Medical Centre will bring a number of GP practices together under one roof and enable more services to be delivered in the community

Last month Prime Minister, Boris Johnson, visited the site of a new GP ‘super centre’ which is due to open its doors later this year.

Station Medical Centre in Hereford is a flagship development, commissioned by the local GP partnership, Hereford Medical Group, and is predicted to become the future of primary care.

Designed by One Creative Environments, and being delivered by contractor, Speller Metcalfe, in partnership with developer Prime; the surgery will bring a number of GP practices together under one roof, with the infrastructure also allowing for the increasing number of virtual consultations.

During his visit, Johnson learnt how specialist private investors and pension funds can deliver affordable healthcare infrastructure in order to meet the evolving needs of patients across the country.

Station Medical Centre is a physical manifestation of what we should be delivering to meet our community’s needs

And Prime chairman, Richard Laing, suggests this approach could be used to deliver around 1,000 similar buildings at a rental cost which would be less than 0.5% of the total NHS budget.

A radical change

Within a matter of days of lockdown being announced in March, the primary care system radically changed its approach to patient communication – but this time it was out of necessity rather than centralised edict.

With the entire population locked in their homes and actively discouraged from visiting A&E, the prospect of telephone, video and online consultations suddenly made perfect sense.

Furthermore, the GP surgery once again assumed its proper position as the gateway to the healthcare system, lifting the burden from local hospitals effectively taken out of the equation for all but emergency and COVID-related conditions.

And, with the brand new Station Medical Centre poised to open, healthcare leaders are excited about how this new flexible facility, which brings together five citywide locations, will play a central role in delivering the service of the future.

With the possibility of fewer face-to-face consultations in the future, but an ever-increasing demand for healthcare across the city; the new space has the flexibility to reshape services to meet modern needs.

“This may mean a greater number of specialised primary care staff located on site, together with the relocation of services from the nearby hospital into the primary care environment,” explains Laing.

“But these changes cannot realistically be sustained from outdated premises.”

A new delivery model

Station Medical Centre has been designed to promote changing models of service delivery.

For example, there is the potential to create a suite that will facilitate virtual consultations, recognising patients’ privacy requirements.

This will be used by GPs, but also provides space for colleagues from across the Herefordshire health system to make use of the consulting rooms for specialist consultations.

“Even more exciting is the opportunity to reshape the services for patients with more complex needs,” explains Dr Andrew Watts from Hereford Medical Group.

“We can do this by combining the efficiency of primary care together with the expertise of secondary care and delivering one seamless service built around patients.

“Only by working at scale in a purpose-built facility do these models become feasible.”

With Government Debt now standing at £2trillion, this presents an opportunity for the Government to score both a much-needed improvement in health infrastructure as well as a significant capital injection into the economy

At a time when the economy needs as much help as it can get, investor-funded primary care also has the advantage of being extremely inexpensive to deliver – as Laing pointed out.

What is more, the long-established contract structure, where the GP partnership takes the lease and obtains cost reimbursement from the NHS, means investment can be delivered quickly and ‘off balance sheet’ to the Treasury.

“With Government Debt now standing at £2trillion, this presents an opportunity for the Government to score both a much-needed improvement in health infrastructure as well as a significant capital injection into the economy,” said Laing.

“Every £1 in primary care rent generates £25 of immediate capital investment, most of which goes directly into the local and national construction economy, with very little impact on Treasury reserves.”

During a recent visit to the site, Prime Minister, Boris Johnson, heard how using the same investor-led approach could deliver around 1,000 new primary care facilities at a rental cost of less than 0.5% of the total NHS budget

Since the LIFT programme was launched in 2000, there has been no new concerted programme of primary care investment across England.

And the few projects that have been delivered have had to wade through a quagmire of centralised process, which has added time and money and all too often simply prevented projects from progressing at all.

“Matt Hancock’s speech on 30 July recognised that during the pandemic the public sector showed how it is capable of making quick decisions and it should therefore re-assess its cumbersome approach to procurement,” said Laing.

“And the case for primary care investment remains high.

“BMA research from 2018 concluded that only 50% of practices felt their premises were fit for their needs and 80% felt they would not be fit for the future.

“The pandemic has no doubt fast forwarded that future and Station Medical Centre is a physical manifestation of what we should be delivering to meet our community’s needs.”

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