Wide variation in the way ICBs have responded to supporting GP practices with reinforced autoclaved aerated concrete (RAAC) assessments has been revealed in an investigation by sister title Pulse.
In September, following the controversy around unsafe concrete in schools, NHS England asked ICBs to check that GP practices were not built with RAAC.
The BMA’s GP Committee England has called for ICBs to undertake a ‘funded programme’ for RAAC surveys across the GP estate.
But GPC premises lead Dr Gaurav Gupta told the recent England LMCs conference that it is currently a ‘postcode lottery’ – a statement which is backed up by Pulse’s new data.
Out of the 35 ICBs which responded to Pulse’s freedom of information (FOI) request, 11 have provided some level of funded support – either by commissioning specialist surveyors or a third-party risk review.
But 24 ICBs did not fund any support, with many asking GP practices to carry out their own surveys or simply reissuing the NHS England guidance.
No RAAC has so far been identified in GP practices by ICBs, according to Pulse’s FOI request. However, at the time of response, some ICBs had not yet completed their assurance exercise.
NHS Property Services has to date identified three primary care sites built using the concrete, one of which remained open with temporary supports in place.
At the LMC conference last month, England GP leaders overwhelmingly passed a motion which called for ‘urgent government-funded surveys of all primary care estates’ to identify RAAC, as well as ‘prompt provision’ of state funding to support practices who do identify the material.
Dr Gupta told delegates: ‘GPC and BMA have been vocal about the need for rapid and state-funded solutions to RAAC in general practice and also in the wider NHS estate.’
He also highlighted that the RAAC issue is ‘part of a much bigger picture’ and that GP premises face ‘many critical issues’ which need to be addressed ‘urgently’.
Dr Gupta added: ‘We need to make sure that money is not just ring-fenced for this and then taken away from other developments in the future.’
In Staffordshire and Stoke-on-Trent, the ICB said it had ‘requested information from GP providers to confirm their RAAC status’, putting the onus on GP practices to assure their own properties without funding.
South Staffordshire LMC chair Dr Manu Agrawal told Pulse that they had asked the ICB to provide funding for initial surveys, but also to provide assurance on the process if RAAC is identified, and on who would fund any remedial works.
The LMC also wanted to know ‘whether practices are legally obliged’ to carry out RAAC surveys in the first place.
He said: ‘We haven’t had a clear answer. So they didn’t know whether practices are legally obliged or not. They refused the funding.
‘They didn’t know the process of what would happen if RAAC is identified. And they didn’t know whether they would or would not fund essential remedial works. Effectively we didn’t get a clear answer on anything.’
Dr Agrawal warned that without this support, identifying RAAC could ‘completely destabilise’ a GP practice.
North East London ICB’s position is that GP providers should be managing their own risk.
Their FOI response said: ‘Primary care providers operate from premises where they, or their private landlord, have statutory and legal responsibility for the compliance of the site and therefore in the same way they are responsible for fire, legionella, DDA etc, they should be assessing and managing the risk associated with RAAC.’
Dr James Murphy, the Buckinghamshire GP who proposed the LMC conference motion, said the discovery of RAAC could ‘seriously’ impact GP partners’ business operations.
‘The fact the NHS estate is in such a dilapidated state highlights the impotence of trusts and ICBs to pressure the Government into funding properly-funded solutions,’ he added.
GP leaders have been raising concerns about the general state of the primary care estate for some time, and earlier this year a survey by the RCGP revealed that four in 10 GP practice staff describe their premises as ‘unfit for purpose’.
When the long-term workforce plan pledged to increase GP training places by 50% earlier this year, many GPs expressed concerns about how they would house these new trainees.
Last week, Pulse revealed that only 11 ICBs allocated local funding to GP practices to manage winter pressures.
This article first appeared on our sister title, Pulse.