Case Study - Estate Planning

An estate plan for a growing community

Futureproofing GP practices for local patient and service growth

With a rapid growth in the region’s population, West Essex CCG needed a robust estates plan for each of its localities to support the integration of core teams and other providers into GP premises. West Essex called on McLaren Perry’s expertise to assist.

The challenge

The new estates plan not only had to ensure flexibility, seamless integration and futureproofing, but also had to include insights and learning from a comprehensive strategic review of the current approach.

Optimising the use of existing sites was critical, particularly in the context of evolving service models of care, creating a number of specific challenges:

  • Reducing the occupation of unsuitable buildings – many GPs own the buildings where their surgeries are based.  A significant number are not fit for delivering modern primary care
  • Minimising empty space and associated costs – NHS reimburses practices for rent and rates, but the formula means it sometimes does not cover the full cost. Where premises are owned by an external person/company, service charges are often poorly managed or controlled
  • Maximising disposal opportunities – Primary Care sector investors have increased value expectations of surgery premises (alternative use values often less than existing use) making relocation difficult
  • Ensuring capacity to take account of forecast population growth in the area – large new housing developments in Essex have created a practice capacity issue. Ideally, new surgeries are required, but NHS budget pressures mean new extensions/new builds can take years with strict regulation of size and standards.
The process

Working closely with the local teams and professionals, McLaren Perry researched the region’s core drivers of cost and efficiency.  Gaining an understanding of current and future models of care allowed MP to:

  • Develop a robust baseline of existing health and care sites within the localities, including assessment of current service delivery scope
  • Hold focussed discussions with stakeholders to understand their needs – GPs, community services, mental health, social care and voluntary sector
  • Work with local authorities to understand area growth and their appetite for change
  • Create detailed premises development reports including cost, facility and timescale options
The outcomes

A number of themes were uncovered that would shape the future estates strategy.  Within xxx months of the start of the project, McLaren Perry, West Essex CCG and the GP Practices had reached consensus critical to the success of a long-term strategy. This included:

  • GP practices on future collaboration
  • New models of care between the stakeholders
  • Use of technology
  • A framework for estates development for each five-year segment of the emerging Local Plan
Ongoing

These broad agreements created momentum which led to a significant number of positive changes. Some were immediate, whilst others are ongoing including:

  • Improved communication, teamwork, personalised care, joint clinics, joint role
  • Greater collaborative support between GP practices
  • Development of enhanced patient self-care through digital/remote care and advice
  • Reduction in the need for face-to-face appointments
  • Optimisation of community assets including voluntary sector activities
  • Integration of services at a neighbourhood level
  • Development of scalable services for some key aspects of primary care
  • Planning and transfer of high volume, low tech hospital-based activities to ‘hub’ sites, including outpatients, advice and some diagnostics
  • Resolution of property issues relating to partner retirement at one practice
  • Minimising use of a high-cost hospital site
  • Enabling closer links with prevention services
  • Providing capacity to accommodate housing-led growth and existing capacity deficit

McLaren Perry is now working with individual practices to develop business cases for development, land acquisition and planning for new surgeries and branches, as well as strategic project management of new build projects.

 

What our client says

“Facing significant housing and population growth locally, combined with legacy estate challenges, we needed an independent and objective assessment of some of our current estate and a pragmatic approach to our future direction.

By working with local stakeholders and helping to develop our local premises strategy, McLaren Perry are supporting us in improving our estate for the future delivery of primary care services.”

Geoff Roberts – Assistant Director, Estates & IT Development, NHS West Essex CCG