Shaping the Future of Primary Care in Guildford
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Primary care in Guildford has seen a significant rise in the pressures it faces over the past few years. GP practices locally, particularly Guildowns Group Practice and Woodbridge Hill Surgery, have seen an increase in the following challenges:
- growth in the number of registered patients
- insufficient space to develop services
- inability to develop health and care options for patients
- lack of capacity to develop new workforce models with primary care.
These combined challenges mean that we need to address the pressing requirement for primary care expansion at a local level.
In 2019 we began a programme of work to review and assess how we addressed these challenges for some of our primary care sites. A feasibility study identified a preferred way forward, which was to progress a scheme for two new build developments at Park Barn and the Jarvis Centre. However, further work was needed on all four feasible options before a final decision could be made. However, due to the Covid-19 pandemic, the programme was paused in March 2020.
We are now in position working with health, care and local authority partners to be able to recommence this work and looking to have an outline business case by April 2022.
Aims of the programme
Our aspirations for the future delivery of primary care services at a local level are:
- to work at greater scale to improve access and quality of services for patients
- to provide premises that are fit for purpose and facilitate team working
- to use technology to improve quality.
Previous Options considered in 2019
Before pausing the programme in 2020, NHS Guildford and Waverley CCG had been working with colleagues in two GP practices (Guildowns Group Practice and Woodbridge Hill Surgery) to develop options for the future provision of primary care services in Guildford.
In recommencing the programme, it allows us to revisit and review some elements.
Options were shortlisted in 2019 as follows:
- Option A
Retain all five current GP practice sites for Guildowns and Woodbridge Hill Practices.
Maximise the available space at Wodeland Avenue Surgery.
- Option B
Co-location of both practices on a single site near RSCH or Park Barn, with the exact location to be determined at a later stage.
- Option C
Co-location of both practices on a single site at the Jarvis Centre or nearby suitable location.
- Option D
Co-location of both practices on two sites in west and north Guildford, on sites to be determined but which could include RSCH or Park Barn, and the Jarvis Centre or another suitable location nearby.
- Option E
As option D, but additionally explore the potential to retain the Wodeland Avenue Surgery, with modernisation and/or extension of the building, and the potential for new ownership models.
We value the views of patients and the public on all our plans, including primary care.
From July to September 2019, we carried out a programme of engagement focused around the following themes:
- What GP services do the public value the most?
- What is important in terms of where a GP Practice is located?
- What should be considered when planning GP services for the future?
A number of engagement mechanisms were used including an online and postal survey, face to face workshops, digital engagement via our social media channels, feedback through our postcards and a number of exhibitions throughout Guildford. Two SMS text messages were sent to all registered patients by both practices to publicise this engagement opportunity. Thanks to all those who got involved and shared their views. The analysis of this feedback is available in the engagement report.
In October 2019 we held a key stakeholder forum to talk about the exploratory work that had been carried out since July 2019. The information from this forum is available in the presentation slides.
We will continue to communicate with and engage local residents and patients as the plans progress.
Findings from early engagement
A feasibility study looked at the future needs of the population served by these two practices, including particular health and wellbeing challenges and the significant growth expected in the number of people living in the local area. We also looked at new ways of working to ensure we are planning for the future and able to take advantage of improvements in technology, along with planning for other types of professionals to support the practices and make us less reliant on a scarce and ageing workforce.
The future requirements for space were generated through a demand and capacity model. Architects and cost consultants were then engaged to examine the sites and options for new premises, and the likely costs.
Between July and September 2019 the CCG carried out some initial engagement with patients registered at Guildowns Group Practice and Woodbridge Hill Surgery who were invited to share their views on the future of GP services in the local area, in particular on the potential sites for the development of future premises.
What did patients tell us was important to them in our initial engagement?
- Access to their practice – in particular the availability of public transport to get to their GP practice.
- Parking – the need for sufficient parking, including disabled parking.
- Services in the practice – the need for additional time for more detailed discussions about their health.
- Access to other professionals – such as physiotherapists or a mental health practitioner.
- Access to appointments – currently there can be a delay of up to three weeks to see a GP for a non-urgent appointment.
Ensuring emergency appointments are available.
- Technology – a balance between traditional methods and the use of new technology for example continuing with face to face and telephone appointments but also offering online appointments.
What did patients think about the options?
People generally welcomed the opportunity to improve primary care premises locally, but had some concerns about some of the options.
People said that reconfiguration of the sites from five sites to one wouldn’t be right for the local area and would not provide the local access to primary care that people need and value.
There is concern about the potential loss of the Wodeland Avenue Surgery and how this area would be served if this happened.
Some people asked about the time it would take for these proposals to come to fruition and whether sites would still be available when the business case development had been completed.
There was feedback about other potential sites and ensuring that all appropriate sites have been considered.
The five options highlighted have been considered as part of a wider feasibility study looking at potential sites for new premises and the likely costs. Each option has differing impacts on the community, workforce, the CCG and the delivery of care. These are proposals at this stage and no final decisions have been made.
Feasibility Study 2019
The feasibility study focused on options for Guildowns Group Practice (which currently operates from four sites at Wodeland Avenue, The Oaks Surgery, University Medical Centre and Stoughton Road Surgery) and Woodbridge Hill Surgery.
A number of factors are increasingly affecting the ability of GP practices in Guildford to meet the needs of their patients:
- Population growth in Guildford.
- Guildford Borough Council has been developing its own Local Plan, which indicates significant numbers of new homes are likely to be built in the catchment area of these two practices over the next 10-15 years.
- More people are living longer often with multiple long-term health conditions that require monitoring and treatment.
- The buildings that some of our GP practices operate from do not have enough space to provide the range of additional services required for future, modern primary care.
- Some parts of the existing buildings are not accessible for all patients.
- Limited capacity to develop the growing primary care workforce.
These combined challenges mean that we need to address the pressing requirement for primary care expansion at a local level. If we do not deal with these issues, the future sustainability of these practices will be at risk.
The study concluded that four of the five options were feasible, but that no change was not a feasible option. The feasible options were:
- One site at Park Barn
- One site at the Jarvis Centre
- Two sites, at Park Barn and the Jarvis Centre
- Three sites, at Park Barn, the Jarvis Centre and retaining the existing Wodeland Avenue Surgery
The feasibility study identified a preferred way forward, which is to progress a scheme for two new build developments at Park Barn and the Jarvis Centre. However, further work will be needed on all four feasible options before a final decision can be made.
The next stage is called the Outline Business Case and this will include further modelling of demand and capacity, closer examination of the potential sites, a full financial appraisal, and public consultation if any significant changes are proposed.
The next stage will also look at other services that might be co-located in any new buildings, including adult community services, children’s services and mental health services.
We have now established a robust governance process to support the recommencement of the programme.
We will continue to keep stakeholders and the public informed as the project develops.
In summary, the work carried out so far has been to inform the options for the CCG, together with Guildowns Group Practice and Woodbridge Hill Surgery, to develop primary care premises that are fit for the future.
We welcome all the input and views that have been expressed.
This was the first stage of the work. The options are not proposals at this stage and no final decisions have been made.
The five options, the feasibility study and the engagement report were considered by the Primary Care Commissioning Committee (PCCC) in November 2019. The committee agreed that the programme could move to the next stage, which is to examine all the options in more detail through an Outline Business Case and to work out how any new premises will be funded and delivered. If any significant changes are proposed as part of the next phase of this work, there will be a public consultation before the proposals are finalised.
Information capture and site analysis
March to April 2019
Stakeholder and patient engagement (feasibility study)
May to September 2019
Feasibility Study completed
CCG recommendation to proceed to next stage
Funding and option appraisal
October to December 2019
Programme paused due to Covid-19 pandemic
Outline business case
Full business case
Opens to public
If you would like to be kept informed about this work or if you have any questions please contact us via:
- Telephone: 0300 561 1555
- Text: 07917 087 560