Moving to leased premises is increasingly the solution for GPs in outdated accommodation who are reluctant to shoulder the financial burden of a new owner-occupied surgery.
In the case of two central Bradford practices that relocated to spacious, brand-new premises in September, it was the property developer's decision to alter its original plans for the site that paved the way.
Initially, developer Oakapple Primary Care bought the site with the intention of building key worker studio apartments that would appeal in particular to staff working at the nearby St Luke's Hospital.
Occupied by a derelict public house and redundant filling station, the site was an eyesore and local residents welcomed its development.
Having secured planning permission, Oakapple subsequently discussed the possibility of including a medical centre on the site with Bradford City Teaching PCT (now part of Bradford and Airedale Teaching PCT).
The site's location and the land available met the requirements of the PCT, offering an opportunity to develop a much-needed state-of-the-art medical centre.
The building design was altered so that Little Horton Lane Medical Centre, which houses the two practices, together with a pharmacy and community nursing offices, occupies the ground floor.
The upper floor, accessed via a separate entrance, comprises 27 key worker ‘crash pads' that the developer lets out.
The developer funded the £3.5 million cost of the building.
The two practices that moved into the new medical centre in September are those of Dr Ghulam Gilkar and his son Dr Ishtiaq Gilkar, who have in the region of 4,500 patients, and singlehanded GP Dr Keshaw Mall who has a patient list of about 3,200.
‘It's a very deprived area with a high ethnic minority population, a lot of transient people, including asylum seekers and high incidence of chronic disease,' Dr Ishtiaq Gilkar says.
The larger practice's old premises were in a former police station which the GPs bought and converted into a surgery 10 years ago.
Despite having plenty of space, it did not meet the requirements of modern-day general practice.
With no lift and poor layout, it did not comply with the Disability Discrimination Act and was unsuitable for the elderly and infirm.
Dr Mall's practice, on the other hand, moved into a purpose-built leasehold building shared with other GPs seven years ago.
However, the practice outgrew these modern premises when Dr Mall became a PMS GP and required more staff and consulting rooms.
Before committing themselves to the move, the GPs needed to negotiate acceptable leasing terms with the PCT. Originally the PCT wanted the GPs to take on a 25-year lease but the two practices did not want to commit themselves to such a long lease.
Following discussions, the PCT agreed to take on the lease itself and to sublet to the practices.
Once this stumbling block was removed they visited other medical centres built by the developer and talked to the practices concerned.
The feedback from these practices was positive, so they then turned their attention to the design features required for their practices at Little Horton Lane.
The most important design feature among these was the need for the residents of the flats above to have a separate entrance. The GPs also wanted access to reception without having to go through the waiting area.
The PCT held a public consultation, including forum sessions with patients, to seek approval for the practices' relocation.
Once the plan was approved, Lynn Holland, the business manager for the two Dr Gilkars represented the practice at fortnightly meetings with the developer, the architect and the PCT.
‘We made plenty of visits to the site and went through the various issues and ironed out any problems until we were happy,' says Ms Holland.
Dr Ishtiaq Gilkar says: ‘The move has also helped with recruitment. Two salaried GPs, a nurse practitioner and a healthcare assistant have joined us.'
He remarks that the morale of existing staff also improved: ‘Although the quality of care provided at the previous premises was excellent, the building gave a bad impression.
‘These modern premises truly reflect the high quality of care we provide.'
He would definitely recommend GPs in similar circumstances to move to a leased building.
‘While owning your own building used to be popular, many GPs nowadays do not want to buy into practices,' he says. ‘Nor do they want to take time out of their busy schedules to manage and maintain the building. We have since sold ours and realised the capital.'
Dr Mall is equally pleased. ‘Compared to the cramped conditions I was operating from previously, this new centre certainly gives me the room to grow,' he says.
‘Now that we have moved in there are a couple of changes I would make to the layout but in respect to the scheme as a whole these are minor.'
The premises reimbursement covers the two practices' rent for their accommodation.
On top of this, they pay a service charge to the developer for the general maintenance and upkeep of internal and external common areas.
The developer supplied all fixtures and fitted furniture for the public areas of the medical centre together with the consulting room furniture.
The IT costs were paid by the PCT while the GPs met the costs of the telephone system, soft furnishings and other furniture required.
Dr Ishtiaq Gilkar says: ‘In a deprived inner-city area with many problems, the patients deserve to have modern facilities and it has certainly made them much happier. We are now a 21st-century practice.'
For more details visit: http://www.%20oakappleprimarycare.co.uk/
|How the move came about|
|Autumn 2003||Discussions held between Bradford City Teaching PCT and the developer in Autumn 2003|
|April/May 2004||The PCT approached the two practices about relocating to the site.|
|Spring 2005||The developer secured approval and planning permission|
|March 2005||Patients consulted|
|July 2005||Development work began on site|
|August 2006||Project completed|
|September 2006||Little Horton Lane Medical Centre officially opened|
|Project costs||£ 3.5 million for the whole building|
|Lease rent||£ 137,000 a year paid by the PCT for the two practices' and the community nurses' accomodation.|