Make improvements to your practice premises today and see the benefits tomorrow

Whilst some practices are located in brand-new purpose-built developments, many others are in older converted properties, which were not initially designed for medical use. This can mean problems for some premises to achieve compliance with required legislation or standards. Whatever your situation, it is always worth looking at your premises to see if, and what improvements can be made.

Improvements to surgery premises can have a number of benefits:

1. Increased capital value of the property
2. Positive impact on value for notional rent reimbursement
3. Improved ability to demonstrate compliance to CQC
4. Compliance with other legislation, e.g. DDA
5. Enhanced patient experience, which encourages patient retention as well as attraction of new patients.

What improvements can be made to GP surgery premises?

There are four key physical factors which can be improved that can have a positive impact on value, patient experience and the ability to demonstrate compliance to required standards:

1. DDA compliance (Disability Discrimination Act)

Many practice premises, especially older, converted properties are restricted with some of the things that they are able to change, especially those concerning the physical structure of the property such as steps, narrow corridors and split level floors. There are however some issues such as narrow paths, high thresholds, high reception desks, lack of space/privacy areas which can be looked at and modified to improve DDA efficiency.

Simple improvements which can be made to most properties can include the addition of ramps, handrails, level thresholds, dropped counter reception desks , installation of induction loop systems (for people with hearing difficulties), choice of the correct colour schemes for decorations and furnishings to aid people with visual impairments, and clear signage (inc. pictograms and Braille). Works that are more dependent on the physical space available at the premises include widening access routes and providing automatic doors, wide/double doors, dropped counter and wide corridors. All properties however would benefit from high quality installations with any improvements that are made, both from a patient experience factor as well as reduced maintenance costs.

With premises being a key aspect CQC essential standards will be assessing, it is important that practices have considered whether their property is reasonably accessible to all patients to meet the requirements of the Equality Act 2010 and make reasonable adjustments where appropriate.

2. Infection control

Another problem faced in older, converted properties is the ability to address infection control. Newer purpose-built properties are built to the latest standards and will already incorporate items such as proprietary floor coverings with rolled up edgings, hidden pipework, elbow-lever taps and infection control sinks. However, all of these are alterations can be made to existing premises and will create the benefits to the practice mentioned above.

3. Internal maintenance

Regardless of the age and type of your premises a regular programme of planned maintenance (PPM) and decoration is one type of improvement that can be easily implemented. This will not only improve patient experience, but the perception of the property during valuations. For example regular, planned internal redecoration helps keep the building looking clean and fresh. A proactive programme of maintenance will allow for improved budgetary control through greater efficiency and management of the works, and will help reduce the risk of costly, unexpected breakdowns.

CQC essential standards will be assessing whether practices have a maintenance procedure in place, and as such, having a PPM in place is highly recommended.

4. Layout

The layout of practice premises is another issue which can be improved to varying degrees depending on the nature of the property. At the heart of any changes to the layout should be patient experience, and how they are able to move around and use the premises.

While it may not be possible to move walls and change the structural layout, the internal organisation of the building can be reviewed. Referring back to the CQC guidelines, where practices cannot resolve an issue, then they need to manage the problem, therefore even if major work cannot take place, thought should be made as to whether any reorganisation can take place.

For security and privacy reasons, it’s always a good idea to group patient and staff areas separately and there are clear boundaries in place, so that patient access around the premises can be monitored. This may be possible through simple internal reconfiguration or alterations to the use of some rooms within the surgery. Patient confidentiality is also important, for example waiting areas could be reviewed to ensure that people can speak with the staff behind the reception desk privately if needed. Ideas such as locating patient welfare facilities near to the waiting areas will make them more accessible, and addition of services breast-feeding facilities will improve the experience of patients visiting the surgery, combined with encouraging recommended practices.

If practices are fortunate to have spare space or land at their premises, extensions can be considered to create additional space. Not only with this allow the practice to undertake some internal reorganisation of the layout to make the premises more user friendly, but it may also possibly allow practices to offer additional complimentary services such as a pharmacy or chiropractor, podiatrist etc. This is one area that will become increasingly important as the plans in Health and Social Care are rolled out, and there is a shift of some services out of secondary care. Simple things such as increases in natural light to rooms, is also a factor that can greatly improve patient experience and the overall quality of the premises.

Summary

Remember, the smallest changes can make the biggest impact. A lot of the improvements mentioned, can be made by the practice as part of their ongoing maintenance and improvement plans, as opposed to the need for a full scale refurbishments project. If you are considering making any improvements to your premises, it is extremely important that PCT approval and professional advice is sought before undertaking any work.

When planning any works, improving patient experience is the key and with the CQC assessing whether premises are accessible and safe for patients and staff, now is the time to start looking at what you have in place already and making plans for any necessary improvements. The CQC will be looking for evidence of any adjustments practices have made to their premises for the benefit of patients.

On a short-term basis, improvements will help practices demonstrate compliance of standards and improve patient experience, but on a long-term basis, improvements will have a positive impact on the capital value of the property, providing a greater return on investment for the GP partners/landlords.

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