NHS PROPERTY
The future for primary care premises F
Ingrid Saffin, head of healthcare at law firm Mundays LLP, considers the future for NHS property after the reforms.
or many primary care providers, the land- lord of their surgery is their local PCT.
When PCTs cease to exist in April 2013 – a little over a year’s time – where will that leave the primary care providers?
Details are emerging from the Department of Health about what will happen to premises currently owned or leased by PCTs. NHS trusts, foundation trusts and community foundation trusts will have the opportunity to acquire PCT-owned “service critical clinical infrastructure”; that is, hospitals and other premises integral to the provision of services by those trusts.
The trusts will not be able to acquire the PCTs’ interests in operational primary care properties, including GP surgeries, dental surgeries,
pharmacies and ophthalmic
surgeries. LIFT schemes, Private Finance Initiative/Public Private Partnership properties and third party developments are also excluded from this process.
Those properties not transferring to trusts will be transferred to NHS Property Services Limited, a new company which will be owned by the Department of Health.
Amongst the stated objectives of NHS Property Services are: 1. to deliver value for money; 2. to cut administrative costs by consolidating the management of the properties; and 3. to deliver cost effective property solutions for community health services.
A clear theme here is value for money and the drive for greater efficiency. The Department of Health says that savings will be used to invest in other frontline services. Fitness for purpose and protecting the availability of premises for the provision of services are also key considerations for the Department of Health.
PCTs are being encouraged in advance of transferring their properties to put in place proper documentation for occupiers of those properties. Where properties are being transferred to trusts, it is not anticipated that there will be model documents for occupational arrangements.
If this principle is adopted for NHS Property Services’ properties then where arrangements with occupational primary care providers are currently undocumented, NHS Property Services will be free to agree documentation that is tailored to the circumstances specific
to any terms that are agreed and to the given premises. Where NHS Property Services does not own the freehold itself, its freedom will be limited by the confines of its contractual position with its own landlord, being the primary care provider’s superior landlord at those premises.
It is anticipated that maintenance and management staff currently employed by PCTs will transfer across to trusts that are taking over PCT premises. It is not clear yet if the same will apply to NHS Property Services properties.
As to the wider management of these premises, the umbrella group the LIFT Council has been reported as saying that LIFT companies see a role for themselves in relation to management of the NHS estate and are hoping to become involved in strategic planning for the creation of efficiencies.
Primary care providers who own their own premises will not be directly affected by the transfer of PCT primary care premises to NHS Property Services. Similarly, primary care providers whose landlord is not a PCT will only be affected if a PCT is a superior landlord of their premises (that is, a landlord to the primary care providers’ own landlord or “higher up the tree”). For primary care providers in this category or whose direct landlord is a PCT, the primary care provider should make sure that they understand the terms on which they hold their premises and that those terms are clear and unambiguous.
There are a number of statutory obligations that are placed on occupiers of premises and with which the documentation for the lease
of the primary care clinic, surgery or other premises should deal. In so far as primary care providers may not have complied with such obligations yet, CQC inspections may prompt compliance.
An example is compliance with disability discrimination legislation to ensure that disabled patients have proper access to patient services at a GPs’ surgery. Another example is carrying out an asbestos survey and dealing with the safe removal and/ or ongoing management of asbestos at the surgery. Is the PCT responsible for the cost of this or are the GPs? Will this remain the case when NHS Property Services takes over?
The state of repair of the premises and, if it is part of larger premises, the premises of which it forms part is another key issue. Which repair is the responsibility of the primary care provider? To what standard of repair must the primary care provider keep the premises, particularly if the premises were in poor repair when they took up occupation? If the PCT provides services of repair, maintenance or common areas, is it clear the basis on which they collect a contribution from the primary care provider for those the repairs?
Healthcare occupiers and PCTs should be taking steps now to clarify the position between themselves but this will take time. And April 2013 is approaching fast.
Ingrid Saffin FOR MORE INFORMATION
E:
ingrid.saffin@
mundays.co.uk W:
www.mundays.co.uk/healthcare
national health executive Mar/Apr 12 | 45
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