Premises - Frequently Asked Questions
What parking will be available on the proposed Udney Park site?
The surgery will have parking 12 spaces on-site, plus a loading / ambulance bay. We have an informal agreement with Quantum that would see us able to use additional parking on / under the proposed residential development opposite the surgery. This is a significant improvement of the existing 4 x 1-hour parking bays.
Will this make it easier to see a doctor?
Yes. We are in a position currently where we would like to employ more doctors' time, but have no physical rooms in which to put them. Additionally, we have four doctors who are qualified to train medical students, junior doctors, and trainee GPs at the practice, but are limited in how many trainees we can have, again by available room space. As such, although we are subject to the national problems recruiting staff due to dismal morale, less than half of doctors progressing to specialty training, and so on, we expect the move to enable us to have more doctors in the surgery.
How will this help booking appointments?
As with doctor numbers, we can't employ more administrative and reception staff without somewhere to put them, so as well as increasing available appointments, we will look at having more people available to answer the phones when we have desks to put them at.
Are Park Road Surgery benefiting financially from the proposed Udney Park development?
No: the agreement we have with Quantum would see the partners involved buy land from them at healthcare values, and then pay ourselves for the construction of a new surgery. This means that if we do move to a new building there - or anywhere else - it will be funded by a commercial mortgage. Our annual running costs in a larger building will be significantly higher than they are in the current building, meaning that the partnership will lose money year-on-year moving to a larger building: the suggestion that we would profit from a move is the opposite of the truth.
Who will own the land and the building?
The building and the land would be owned by a limited company, separate to the GP partnership but owned by those NHS partners who wish to be involved in the ownership of the building. There are several reasons for this:
(1) it insulates the NHS practice from the risks of the development period - if anything goes wrong this does not affect the core business of the practice, and partners' individual liability is limited to the assets of the company rather than e.g. their homes.
(2) exposure to interest rate rises after completion again is held separately to the NHS partnersip
(3) In future, incoming partners will not be put off by being obliged to take out a mortgage of ~£1m to join the practice.
Any new building will therefore be held separately to the partnership with "drop-down" lease to it, and with the articles of the limited company allowing NHS partners to buy-in to the premises if they wish to (rather than their being obliged to). The only parties involved in the company are three of the five NHS partners.
In effect this is the same as if a healthcare developer bought a site and leased it back to the surgery; the difference is that the partners retain control of the building and don't have to battle to retain it in 25 years when the lease comes up for renewal.
Are you buying the land at a discount?
It depends on what you regard as a discount.
Looking at the value of land for residential use, you could argue that it is "discounted" - this was the problem we faced in negotiations with the Council over the North Lane site, where their assessment of value was based on residential use of the site. There is more information on this gap below under the heading How are NHS GP surgery buildings funded. However, we are paying a fair healthcare value for the site - this is based off a standard surveyor's development appraisal which looks at rental income over a period of time and offsets this "gross development value" against the cost of building the surgery.
Why do you require such a large building?
The space requirement for the surgery is set by NHS England, who base it on a practice's current list size + 10% to allow for growth. For us, this gives a requirement of 1,020 m2, and we need that size of building to secure NHS funding approval for the increased rent, or to have good reasons for going for a smaller building.
How are NHS GP surgery buildings funded?
NHS GPs receive 'rent reimbursement' at a rate set by the District Valuer, and any premises move needs to be covered by that rent reimbursement. One of the problems NHS GPs face is that NHS rent is about 20% less than commercial rent levels - this is why for instance we were unable to lease the building at 1 Park Road which was recently on the market. This means our options when looking to move are limited financially by government policy on GP rent levels, over which we have no control.
Why did you use patients' contact details to ask for support for a planning application?
We hold contact information for a variety of reasons, and this includes communicating with patients about medical treatment but also, among others, public health campaigns, research projects, opening hours, and premises moves, so we regard it as appropriate to ask for our patients' support for a planning application which would result in new premises for the surgery. The key concepts are outlined by the Information Commissioner's Office, although these will change in May when new legislation comes into force.
Why was the e-mail you sent so one-sided? Why didn't you outline the downsides of the proposals?
During the survey we ran last year we linked to the FUPPF website from here, so we have presented the downsides of the proposals in the past. The recent e-mail was intended to ask our patients to support the proposals in that they would benefit local health provision, and we felt that directing patients to the details of the planning application was sufficient to allow them to draw their own conclusions.