NHS premises restrict patient care and COVID-19 backlog efforts

YouGov survey reveals lack of investment in NHS facilities is scuppering plans to resume services

• Four in 10 healthcare professionals say the premises they work in are constraining services to patients
• One third (34%) say the premises they work in are constraining progress to tackle backlogs of patient care
• A YouGov survey commissioned by national community care premises specialist, Assura, finds the vast majority (84%) of healthcare professionals believe more fit-for-purpose buildings will be important or essential in helping primary care to deliver effective hybrid care to patients

NHS buildings and the need for more-modern spaces are impacting on frontline patient care and efforts to clear the backlog of tests, treatments, and consultations caused by the COVID-19 pandemic, according to healthcare workers quizzed in a survey by YouGov.

Four in 10 – 40% – of healthcare professionals say the premises they work in are constraining the services that can be provided to patients, while a third (34%) say their premises are holding back progress on tackling the backlog of care.

The survey, commissioned by Assura, quizzed more than 1,000 healthcare professionals including doctors, nurses, midwives, ambulance workers, public health staff, and people in NHS facilities and maintenance roles.

And it also found that the vast majority (84%) of those surveyed say fit-for-purpose premises will be important, or essential, in delivering effective hybrid primary care to patients – care delivered through both face-to-face and remote appointments.

Health professionals want to see investment in physical infrastructure now to support both the recovery and evolution of primary care as it seeks to work at scale

In addition, one in five (19%) said they believed premises were hindering recruitment to the service they work in.

It comes as a BMA’s Support Your Surgery campaign calls for more investment into areas such as GP premises across the country, and as new research published in the British Journal of General Practice highlights the impact of GP recruitment challenges in areas of highest healthcare need.

Assura chief executive, Jonathan Murphy, said: “In our survey last year, healthcare workers told us how their premises had often made the never-before-seen challenge of COVID even more difficult to deal with, and what they thought community healthcare premises of the future will need to deliver to help the NHS do its job.

“We’re already putting their ideas into bricks and mortar on the ground, but the clear message this year is that this can’t happen fast enough.

“Health professionals want to see investment in physical infrastructure now to support both the recovery and evolution of primary care as it seeks to work at scale, to play its full part in emerging Integrated Care Systems and – most importantly – to make sure patients are getting the care they need, when they need it, where they need it.”

We’re already putting their ideas into bricks and mortar on the ground, but the clear message this year is that this can’t happen fast enough

Participants in the research were also asked for examples of how they saw the premises they work in constraining efforts to clear the backlog of care. Answers given included:

• Numbers which can be seen at any one time are very restricted due to ongoing social distancing measures and a lack of rooms
• Rooms are too small to adhere to social distancing rules so clinics are very limited resulting in continued long waiting lists
• Not enough space, not enough staff
• Facilities already at 100% capacity pre pandemic. No room/capacity to increase to catch up on backlog
• Insufficient isolation rooms and dated premises
• A need for more waiting room space to enable social distancing
• Old buildings, difficulty in social distancing, ventilation old and does not meet new standards. Lack of single rooms, lack of separate toilet and shower facilities
• Not enough big rooms for consultations. Need time to wipe down after each patient. Stage times of appointments so not too many on waiting rooms at any one time
• Not enough treatment rooms
• Not enough capacity to treat large number of COVID and non-COVID patients
• The estate is one of the oldest in the NHS, crumbling, leaking. Lack of investment over decades slows progress now
• Small waiting room so unable to have too many so face-to-face not as prominent as previous, doing respiratory reviews on phone where possible. This creates a backlog
• Very-elderly buildings without extra assistance for infrastructure or extra space for dividing patients into isolation areas
• Footprint is too small, buildings too small for catchment area
• Old and run-down premises
• Old buildings with small rooms. Newer hospitals with poor ventilation
• We have lost our gym and our dayroom, which now has other services in it and our gym is being used as a staff hub. We cannot have classes with outpatients any more
• The premises are TINY and old. Not able to follow the COVID guidelines set out by the trust to do work safely so still working at a slower pace to keep safe

But there were also some positive impacts, with one respondent telling researchers: “We have a new building with many rooms allowing us to take on more trainee GPs, meaning more patient appointments.”

Companies

• Assura Group