Our leaking roofs and mouldy walls can’t wait – GP practices need funding now

Dr Margaret Ikpoh, College Vice Chair, has written the following op-ed in inews this morning, giving a firsthand account of the state of her practice’s infrastructure and the need for significant investment.

Some of the problems GPs and our teams are facing regularly make the headlines - not enough doctors, growing demand for finite numbers of appointments - but others aren’t as obvious, and one of these is the state of our practices.

The buildings in which we work have a huge impact on the care and access to care we can provide for patients. But many, across the country, are in a woeful condition and getting worse.

Unlike hospitals, many GP practices aren't purpose built. A practice will often be in a converted building - many are in old houses - without the investment needed to address the practical difficulties that can come with this.

At my practice in Yorkshire, this problem is all too evident. One of our main sites was acquired in the 1960s and has a long list of structural issues including frequent leaks, damp walls and build ups of mould. We recently refurbished one of our consultation rooms only to find a huge hidden build-up of mould had formed on one of the walls.

Our consultation rooms are also a concern. Many are small and cramped which makes it challenging to treat patients. It also means we can only see a certain number of patients each day as we have a limited number of private spaces where it's safe to conduct an appointment.

It's deeply frustrating and worrisome - and it's far from the standards our patients rightfully expect from a 21st century health service.

Sadly, our experience is by no means an isolated case. The Royal College of GPs own report found that two in five staff members considered their premises not fit for purpose, with 88% of those citing insufficient numbers of consulting rooms and 75% citing insufficient space to take on additional GP trainees.

The same report revealed accounts from GPs stuck using ‘temporary’ portable cabin extensions for 18 years – even as the walls rot.

Poor infrastructure has a knock-on effect. Without enough consultation rooms of adequate size, the number of GPs, nurses or other staff a practice can hire or train is limited. At a time when patients are already struggling to make appointments, it's another barrier for hardworking GP teams striving to deliver timely, safe and appropriate care.

While funding is available, it has become harder to access in recent years, and it is often not sufficient to address the cost rises we are seeing. My practice’s annual heating and light bill has risen by over £40,000 in the past year, a figure not helped by the low-energy efficiency of our listed premise. The amount we're spending on property repairs and maintenance is in the region of £90,000 per year.

GPs and our teams delivered almost 32.5 million appointments in January – almost 5 million more than in January 2019, yet with 3% fewer fully qualified, full-time equivalent GPs. We're being expected to do more with less and worsening conditions are intensifying the crisis in recruitment which is pushing more practices to a point of closure.

Dedicated funding for renovations has not caught up with rising costs and this inevitably means practices have fewer funds to spend on patient care initiatives or hiring additional staff to be able to see more patients.

The Chancellor’s Spring Budget included overdue investment on NHS technology, but no funding to fix our crumbling buildings. With each passing year the situation Is becoming worse and we need serious action.

One of the key asks in our recent General Election manifesto is for £2 billion worth of funding, not only fix premises but to prepare them for the future. Demand for our services is only going to increase in the coming years and, as it stands, GP infrastructure is not ready to meet the challenge. 

Further information

RCGP press office: 0203 188 7659

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.