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GP training practices – the £100,000,000 capital programme
29 May 2009
The Department of Health (DOH) has been allocated £100 million
for the year 2009/2010 to advance the upgrading of 600 GP surgeries
to become training practices. The aim of this funding is to target
those areas that have historically had a lower provision of doctors
and to create opportunities for smaller practices to become
training practices.
This funding allocation was announced in the Chancellor’s Autumn
Statement and in the NHS Operating Framework. The Framework clearly
states the DOH’s intention to discuss with Strategic Health
Authorities the best way to distribute the funding to ensure it is
appropriately targeted and effectively deployed throughout the
country.
The funding will also support the extension of GP placements
from 12 months up to 18 months, and the planned expansion of GP
training numbers until the year 2011.
Timing
The DOH warns that the timescales to implement this initiative
are extremely tight. The original timescales envisaged by the DOH
were that identification of relevant practices should be undertaken
by Primary Care Trusts (PCTs) and Deanery GP Directors (who are
responsible for postgraduate medical education and the continuing
professional development of doctors) by the end of April 2009.
Initial capital works budgets were then to be costed and set by the
end of May 2009. A review of the approved list should take place by
the end of May 2009 with budgeted expenditure profiles set towards
the end of June 2009.
Strategic Health Authority Workforce Directors and PCT Chief
Executives are being asked to give urgent priority both in
supporting and implementing this programme.
Allocation
Allocation of funds will initially be made to PCTs. This is on
the understanding that there may be a need for adjustment between
PCTs within Strategic Health Authority (SHA) areas, and also
between SHAs themselves to ensure that all funds are spent within
the allocated year.
The funding is conditional on the practices being accredited or
achieving accreditation as a training practice by the time the
capital works are complete. How this is to be enforced is not known
but as the monies will operate as grant funding, it is assumed that
it will be secured by way of a charge. Efficiencies of scale could
be achieved by aggregating the capital expenditure under a single
works contract, whether by way of a locality or grouping of
practices. This is then the subject of a single procurement and
contract for the works within that locality / practice group.
It is hoped that the financial support being given will allow GP
training posts to increase in capacity from 2,400 in 2008, up to
2,700 in 2009, and then finally up to 3,300 in 2011.
The DOH hopes that the allocation of funding will permit around
seven practices on average to be upgraded in PCTs which are
under-doctored, with an average value of £150,000 being spent per
GP practice. The DOH point out that this £150,000 figure is
intended only to be an indicative sum. On a practice by practice
basis it is possible that certain practices will require
considerably more funding and some may require considerably less.
It is assumed that those practices that participated in the recent
Equitable Access in Primary Medical Care (EAPC) procurement will
not be entitled to access these funds.
Joint working
It is hoped that with a sensible and flexible approach by both
PCTs and SHAs, capital can be allocated appropriately. In
particular, SHAs may be permitted to re-allocate capital where a
PCT does not require it because the practices in its remit do not
fall into the criteria. In addition, situations where GP practices
are unable to be upgraded within the 2009/2010 timescale will be
considered and taken into account.
In terms of organisation and mechanics, it will be expected that
SHA Workforce Directors will take the lead on this programme. They
will, however, require assistance from Deanery GP Directors to
identify practices requiring upgrading of accommodation to allow
for additional GP training places.
PCT Chief Executives will be expected to assist the SHA
Workforce Directors and will be asked to nominate a lead director
to work with the Deanery GP Directors to take the programme
forward.
In essence therefore, there will need to be a very close working
partnership between Deanery GP Directors, PCTs, SHA Finance
Directors, SHA Primary Care and Capital Leads as well as local NHS
Estates.
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