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Is it likely that GP consortia will be responsible for the PCT Estate and, if so, how should we as consortia prepare for this?

Is it likely that GP consortia will be responsible for the PCT Estate and, if so, how should we as consortia prepare for this?



Unfortunately, the impact of the planned changes arising from the Health Bill on future ownership and/or responsibility for the primary care property estate is currently unknown and subject to much conjecture.

In light of the coalition’s general direction of travel towards decentralisation, the promotion of the localism agenda and the aims set out in the White Paper, it is indeed highly likely in our view that GP consortia will have significant management responsibility for the primary care estate, even if ownership and certain financial and controls on overall allocation of resources were to remain vested centrally, such as with the NHS Commissioning Board.

This outcome would also be consistent with what is happening to the future ownership and management of parts of the PCT-owned estate under the Transforming Community Services initiative.

However, irrespective of how the boundary is set in relation to ownership, management and allocation and control of primary estate resources, it is clear that GP consortia will need to strategically think about the whole estate (PCT and other GP/Third Party) and make sure they have sufficient expertise and resource at day one to ensure the estate supports and helps drive their plans.

As a matter of priority we would recommend that all GP consortia should be undertaking (with appropriate expert support) a strategic review of the existing estate within their consortia’s boundary, its fitness for purpose and the opportunities and constraints that currently exist to affect future changes in service delivery.

This review, if done comprehensively, would also assist in highlighting matters such as: opportunities to better and more intensively utilise the existing estate and opportunities to rationalise and reconfigure the estate to enable the effective implementation of innovative service redesign.

While all PCTs have previously produced a Commissioner Investment and Asset Management Strategy (CIAMS), there has been a suggestion that some are of variable quality, being centrally produced often with incomplete data and without innovation. At the very least these strategies will need to be reviewed and updated to reflect new emerging commissioning strategies and plans.

As indicated in the McKinsey Report, Achieving World Class Productivity in NHS 2009/10: Detailing the Size of the Opportunity, significant savings can be delivered, even allowing for new investment and estate improvement costs.

We have already witnessed this in practice with new primary care estate facilities being procured fully or partially funded through ongoing cost savings. As with GP commissioning, the key will be to ensure it’s done locally and with involvement of experts.


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