Neighbourhood health centres to be approved by summer amidst unaffordable estate upgrade requests

The Government will approve the first proposals for neighbourhood health centres by the summer, however it has received a lot of ICB proposals for estates upgrades that it ‘can’t afford’.

Director of capital at the Department of Health and Social Care and NHS England Oliver Clarke told the NHS Confed Expo conference in Manchester that the Government expects to provide ‘initial approval on certain schemes by the summer’.

NHSE had given regions working with ICBs a 28 May deadline to give a ‘clear articulation’ of the potential neighbourhood health estate in their areas.

The Government plans for 250 neighbourhood health centres to be created in England, which NHS England advised should be ‘anchored around general practice’.

ICBs were asked to agree the geography (‘a neighbourhood’) around which services should be delivered, and plan for neighbourhood health centres to serve a population footprint – around 50,000 people, the scale of a PCN – with ‘general practice at the core’.

The guidance also laid out four ‘archetypes’ (see box), which outline the differences between those centres to be created from the existing NHS or local authority estate, and those to be newly built. 

NHS England asked commissioners to identify the model or combination of models ‘best suited’ to each neighbourhood. 

Mr Clarke said: ‘We asked ICBs and regions to come to us with their proposals for neighbourhood health centres. We have those pipeline proposals now.

‘We have a lot of proposals, so we will be doing some assessment, and we’ll need to do some prioritisation. Certainly, there are more proposals for upgrades and a collective value that we can’t afford, so that’s one of the things we’ll need to work through. We are doing that now.

‘We expect to get into a position of providing initial approval on certain schemes by the summer.’

He also said that proposals ‘may need to be refined after submission particularly for new builds’ and where further detail is needed on ‘scope, site, utilisation or affordability’.

Mr Clarke was questioned by the conference’s audience on what the Government is trying to achieve through these proposals.

The Doctors’ Associaiton UK GP spokesperson Dr Steve Taylor said: ‘What are we trying to invent here? Is it outpatients in the community or is it actually community care? I think there is a sort of mixed up approach that we’ve got going on here, and I’m slightly concerned that we are missing something in terms of what we already have, and how do we integrate that better.’

Mr Clarke said: ‘We’ve sort of set out these archetypes that allow for different models of neighbourhood health care.

‘I think the critical thing that we are trying to achieve, and I think you said it, is about the integration of the services around the patient, and I don’t think we have that routinely right and in the right way that patients understand now, and so I think that is the big shift we’re trying to achieve.’

GP leaders have previously warned the Government could be excluding GPs and primary care from leading on neighbourhoods through premises schemes.

GP practices and local authorities were not included in a recent scheme to transfer NHS Property Services-owned premises to hospital trusts, and the BMA said the transfer scheme suggested the Government had a preference for secondary care to lead neighbourhoods.