The state of GP premises often means there is nowhere for additional staff to practise. GP premises are in dire need of modernising – a major 2023 RCGP report found they were ‘inadequate’, concluding that the allied healthcare professional staff had ‘expanded greatly in recent years, without a parallel expansion of clinical space for them to work in’. While the Budget in November 2024 did commit £100m to modernising GP premises, it specified that this would be limited to 200 surgeries.
One GP in Northamptonshire says: ‘We do not have anymore space in our building to recruit additional clinical or administrative staff, and this has led to us running at a far higher number of patients per FTE staff that we would ideally have. In our recent round of recruitment to salaried GP roles, we had many more suitable candidates that we have the space to employ and undertook competitive interviews to select our current employees including ARRS-subsidised recently qualified GP roles.
‘We really need to find an additional or alternative site but options for funding this are limited or unattractive. We already undertake remote working where it is possible to do so safely, and most of our ARRS staff are based in other GP surgery buildings within our PCN. Some clinical rooms are even shared between clinical staff within a session, with a staff member using a room while another has left to undertake a care home round.’
This is a common problem. Dr Grant Ingrams, chief executive of Leicester, Leicestershire and Rutland LMC, says his practice ‘has GPs working from home at times but there are continued problems finding space for people to work from’.
Alex Kimber is a managing partner in Dorset says: ‘I am literally in the process of converting a toilet and cupboard into a telephone consultation room, which isn’t ideal but needs must. Anywhere non-clinical on the ground floor is turning into clinical space. We’ve had to make a waiting room smaller to create another clinical room and are being creative in the way rooms are shared. Meanwhile, my non-clinical team is being shoehorned into smaller spaces upstairs with many more per office than they were designed for.
‘The ARRS staff are great but for our PCN we have to house them in our building as the other practices are smaller and just don’t have the regular space for them.’
Another GP in West London says they ‘could certainly do with additional nurses but are already struggling with space for existing staff, who are having to cope with hot-desking’.
A GP partner in Lancashire says: ‘In 2023, we changed some storerooms into additional clinical rooms and we still don’t have enough space. We have no expansion land as the NHS sold it off years ago. We have nowhere else to go to get more rooms. This impacts who we can hire and what days they can work, as we find clinicians have to room-share or change rooms daily depending on who is in.’