NHS bosses are examining alternative models as to how primary healthcare is delivered, such as offering some services in settings such as leisure centres or libraries, after revealing they have insufficient funding to extend or build new GP practices.
A meeting of North Yorkshire’s scrutiny of health committee heard while many GP surgeries were at full capacity, with little Government funding and too little funding coming out of developers’ housing estate contributions, healthcare services could be negatively impacted by new housing developments.
The meeting at County Hall in Northallerton came two months after it emerged the NHS had lost out on £273,783 of funding that a housing developer had agreed to pay towards a pioneering health campus in Catterick Garrison after failing to justify why it needed the money.
As councillors expressed frustration over residents’ struggles with getting primary care appointments, NHS managers did not refer to the Catterick issue, but did concede planning was not their core business and developers were “very adept at negotiating”.
They added it was important they utilised “the skills of their partners to get the best deal”.
NHS officials said the organisation had not “always been aligned” with planning teams and the complex ownership of GP surgeries made funding developments difficult.
A Humber and North Yorkshire Integrated Care Board (ICB) NHS manager told councillors developers’ contributions invariably would not cover the cost of a development and Government funding for new health facilities often “came at times broader economic wealth of the country and, dare I say, when there’s funding to support political ambitions”.
She added any capacity the NHS developed was “fast being absorbed”.
The NHS manager said: “The last time we had national funds that we could bid against was 2016… we don’t have anything that replaced that. For the whole of Humber and North Yorkshire ICB we have business as usual capital to support general practice of £3m for build costs and IT. We are bidding in a very constrained pool. We are struggling with how we manage access to money.”
The meeting heard one issue was developers wanted a market rent of around £400 per square metre, the highest rent that the district valuer allowed the NHS to reimburse was £200 per square metre.
She said: “At a national level we are trying to have a sensible conversation about how we bridge that gap.”
Independent councillor Michelle Donohue Moncrieff told the NHS officials residents were reeling from the “lack of delivery of services”.
She said: “You cannot guarantee people’s healthcare will not be worse as a result of housebuilding.”
The NHS manager replied alternative models as to how healthcare is delivered were being examined, such as providing a more holistic, preventative approach and that some services could be sited in leisure centres or libraries.
She said: “We have grown very fond of the model where we have multiple smaller surgeries, but they are becoming quite difficult to staff.”
Councillors said while the best outcomes often came from face-to-face appointments, NHS managers said “the reality is digital options will be used more in future”.