Assura : The data gap in the primary care estate

It is an agreed principle that to solve a problem, one must first understand its scope. The mandatory ERIC (Estates Return Information Collection) data set is collected and published every year, painting a national picture of the NHS' hospital estate and an indication of where improvements are needed. However, in primary care, there is no such picture.

Work is ongoing at national, regional and local level to deliver a primary care estate that is fit for the future of the NHS. However, a better understanding of the current state of affairs through regular, consistent data collection would be invaluable to steer that process. Some CCGs and Sustainability and Transformation Partnership areas have done really fantastic work to assess their estate, but information isn't brought together effectively at national level.

The Naylor review highlighted that private investment was essential to delivering the requisite funding and that the industry is on board. In the appendices, Deloitte noted that more work was needed to improve the primary care estate evidence base and both NHSI's establishment of a primary care estates data group and the announcement of a review of primary care premises are very welcome steps. With the Five Year Forward View relying on having bothspaceand infrastructure to move more services closer to home but without sufficient, consistent data to support where the investment is necessary, it can be fiendishly difficult for Sustainability and Transformation Partnerships to plan their estates for the task in hand. Our recent work with the Nuffield Trust's 'Restate' programme reiterated that challenge, and we look forward to the Trust's report on lessons learned.

The question is how to address it - and reach a sensible, national estimate of the investment needed to keep GP premises fit for purpose for the coming decades. Portals like Patient Access allow ease of administration in GP surgeries when it comes to booking appointments, ordering repeat prescriptions and other administrative tasks. Could these be used to collect basic data on surgery buildings and the improvements they require?

Or is there another way? As it currently stands, the system of notional rent, which is a method of reimbursement for GPs who own their own surgery premises and use it for approved NHS purposes, is the only real, national insight into the cost of running a surgery building. This process is carried out by district valuers every three years to check the notional rent for which GPs should be reimbursed. GPs fund ongoing building maintenance themselves; investment for improvements to existing buildings or new developments has to be bid for and approved by NHS. During that triannual notional rent process, could there be an opportunity to collate basic but consistent information on improvements required? This could go some way to better understand the level of investment needed in existing surgery buildings nationwide - an essential figure to inform policy decisions.

There's no question that our healthcare estate requires significant investment. However, for this to be implemented effectively and for GP surgeries to meet their potential in easing the pressures on the hospital estate, we need to tackle this data dilemma. As William Edward Deming said: 'In God we trust - all others must bring data'.

Jonathan Murphy is our CEO