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The Changing Needs And Circumstances Of A Practice

Over a lifetime the requirements from a practice will evolve. Every surgery has to serve a purpose and be relevant to others.

There are a host of factors why change is inevitable. From the growing needs of the community to the demands of the wider public, circumstances will always need to be addressed.

The Primary Care Delivery

The recent major shift in the NHS and deliverability of primary care and how care is delivered, with the push for secondary care to release primary care functions, presents a changing wider environment.

Those surgeries that once operated in isolation are now forming partnerships or federations with others to create facilities within one site to share some functions. The NHS desire for amalgamation of practices and activities from say a 10,000 patient practice to a 30,000 norm patient practice is showing the changing circumstances from individual sites to the creation of community hubs.

The building of medical centres on sites can also provide facilities such as step-up, step-down beds with a much lower level of intensity of care than a hospital. This can be linked to a primary care function within a primary care facility. As a requirement grows, different levels of needs can be incorporated, we just need to plan for it.

The creation of a community via purposeful care facilities, not just a care village represents how the needs of society (and surgeries) evolve.

Early Redemption – The Pitfalls And Opportunities

On a more localised level this includes: the circumstances of the practice; early repayment penalties and the strategies in place with GPs, financial advisors and the NHS. These all represent the facets of change that need to be understood.

The changing circumstances of principal practice members may highlight issues such as early redemption fees and negative equity which all have to be brought into the equation.

A number of sources will fund GPs with the provision of funds by a covenant (the understanding and quantifying of an income stream with a sum of money as an investment). However, a doctor may decide to redeem their loan early.

The Dated Surgery

Many surgeries can look out of date remarkably quickly.

Even modern practices can go out of date, notably due to the use of modern architecture.

Change will happen to every surgery, but if there is planning from the outset for a new build, such as making sure there are no internal structural walls, then adjustments can be made to meet the changing requirements of primary care. Every new building has to be flexible. For instance, at the end of a lease (whether 10 or 20 years time), any adjustments from bigger toilets to more rooms need to be addressed with limited complexity.

A huge disservice for new medical centre centres is not planning ahead and the focus to design for future flexibility. It is short sighted to meet a need, today with the focus solely to build a surgery to sell-on or build for a particular fund.

A GPs environment will naturally adjust, planning is key. 19th century Prime Minister, Benjamin Disraeli once said, ‘change is inevitable, change is constant.’

The Charles Higgins Partnership team are well aware that no one can rest on his or her laurels. Every surgery that is created is intended for generations to reflect the needs of the delivery of primary care. On a short-term level, we understand that needs change too. Perhaps it’s time to have that conversation for how your circumstances are evolving?

Call Jon on 01202 744990 or email jon@charleshiggins.co.uk so we can understand where your future fits.

Image at the top of the article courtesy of Flickr



“To end my working days in such a place considering that 31 years ago when I started we worked from two very small rooms. It’s been magnificent.”

Dr Geoff Walder, Retired Senior Partner, Lilliput Surgery, Sandbanks

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© 2013 Charles Higgins