COMMENT: The challenge of technology in the primary care estate

14-Dec-2012

Andrew Darke of Assura Group explores how clinical commissioning groups will need to improve the primary health estate in order to take advantage of next-generation technology

As the Government announces that the first 34 GP-led clinical commissioning groups will take over the responsibility for the NHS budget, ANDREW DARKE, managing director of property at Assura Group explores the role technology will play in the future of the primary care estate

Andrew Darke is managing director of property at Assura Group

Andrew Darke is managing director of property at Assura Group

Healthcare provision in the UK is undergoing some of the most significant changes since the NHS was established, aimed at improving the service offered to patients while removing inefficiencies.

Most would agree that the changes are necessary to deliver an effective universal care system and drive down unsustainable budgets; yet government plans to implement the changes thus far have received a barrage of criticism.

The introduction of the new clinical commissioning groups (CCGs) is one of the most significant changes, giving groups of GPs responsibility for commissioning or buying health and social care services in their local area. It essentially gives GPs the power to ‘design’ local health service provision.

As the role of the GP changes, so does that of the average local medical practice. GPs are required to deliver more services to more people by extending both the provision and commissioning of care. But, faced with an abundance of inadequate primary care buildings, the task could not have arrived at a more challenging time.

Not only do many properties need updating or even rebuilding completely, but the medical profession is also tasked with including up-to-date technology within their services. The right use of technology has the potential to revolutionise the patient experience and expand the GP offering. However, the health sector has not always been a keen early adopter of new systems.

As much as many people would like to convince themselves to the contrary, the health sector needs to embrace the technology explosion – all premises need to be prepared to accommodate IT in order to continue to deliver quality services to patients and keep up with developing services.

As much as many people would like to convince themselves to the contrary, the health sector needs to embrace the technology explosion – all premises need to be prepared to accommodate IT in order to continue to deliver quality services to patients and keep up with developing services

IT needs to be incorporated in order to embrace new methods of dealing with patient confidentiality, booking systems, referrals, follow-ups etc. There are already many options on offer in terms of technology aimed at assisting the healthcare sector. For instance, many companies now offer the ability to store vital information at a server off-site, easily accessible from a variety of buildings, and protected by strict security measures. This is particularly helpful for CCGs that operate over a number of premises, meaning that data can be transferred across a wide area.

In order to utilise various new IT services available, the new CCGs are understandably keen to improve their capacity for technology and are far ahead of their secondary care counterparts in this thinking. However, procuring IT services in the new commissioning environment is rather difficult.

In these straitened times, the NHS has very little capital available to assist GPs with the process, and Property Services (or PropCo) has already stated that it is wary of getting involved with the implementation of new technology. As a result, it may be necessary for trusts and GPs to look to private sector landlords to work with them to help meet the new requirements.

We are still not sure what the next 20 years of technological development will bring, so it’s important to design and build in such a manner that gives the building flexibility to accommodate developments in the future

Keeping up to speed with technological advances is only really possible within modern GP premises. These properties are built with some simple but essential features designed to ensure that its purpose can be expanded as demand changes. Stud petition walling is designed to accommodate a mass of cables and ensure a simple retrofit if necessary, alongside suspended ceilings to support lighting grids and provide further space for cabling. The buildings are also designed to factor in technological requirements such as server rooms and cooling systems.

In the case of older premises, they often converted residential buildings, and even relatively ‘modern’ properties dating back to the 1970s were designed without the smallest inkling of what kind of technology would become available. In the 21st Century, we are still not sure what the next 20 years of technological development will bring, so it’s important to design and build in such a manner that gives the building flexibility to accommodate developments in the future.

Bringing older surgeries up to the required standard has been shown to be an expensive and time-consuming exercise and we have already seen the costs associated with CQC compliance cited as a reason for the potential closure of a small number of surgeries across the country.

GPs are required to deliver more services to more people by extending both the provision and commissioning of care. But, faced with an abundance of inadequate primary care buildings, the task could not have arrived at a more challenging time

The modern and more ambitious technological delivery of care to patients is likely to result in the extension of primary care teams, who will be able to offer new expertise, plus diagnostics and improved social care. Facilities have to be improved too – delivering small, isolated services from inadequate converted premises must no longer be acceptable. Technology has the potential to make healthcare delivery offering simpler and more efficient. However, major financial investment is needed to get the healthcare sector up to speed.

The investment will have to come from the private sector unless central government acknowledges the challenges and chooses to equip the NHS with the skills and funds needed to really assist its primary care professionals.

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