1. Modernisation of Primary Care Estate Keith Houghton Associate Consultant (NatPaCT) Premises/Investment Keith Houghton Associate Consultant (NatPaCT) Premises/Investment

2. NHS Plan/Targets 500 One Stop Primary Care Centres (2004) 3,000 Refurbishment's (2004) (MADEL) Doctors in Training (2004) Disability Discrimination Act Diagnostic and Treatment Centres Expanding Out Patient Services

3. Profile 10,500 Premises –40% Purpose Built –80% Undersized –5% Co-located with pharmacy –50% ex-residential/shops

4. Current Arrangements Importance, quality, access, patient focus Investment piecemeal GP risk/responsibilities Disincentives, leases, inner cities, negative equity

5. Current Arrangements (Cont) Under investment Integration - social services/voluntary sector Whole systems, local health community plans

6. Challenges Developing SSDPs Underpinning Estate Strategies New ways of working Workforce planning Whole system impact Developing capacity

7. Changing Patterns of Service Delivery Flexible medical workforce Wider use of other clinicians Integrated teams Larger practice cohorts Market Competition

8. Future Opportunities Integrated care centre Community Resource Centre Redefining walk-in DTC/OPC - community hospitals Using Telemedicine/IT –Digital imaging –Teleradiology –Home monitoring/community teams Re Engineering

9. Investment Issues LIFT - Progress Local Partnerships Third Party Development Traditional - Cost Rent Professional Engagement Reluctance to change