GPs in poor premises are often limited in expansion due to site limitations. The Utilisation of notional rent to the mutual benefit of the PCT & Practice is a distinct possibility, together with a degree of subsidy from private sector tenants. Timescales of projects dictate that many PCGs/PCTs are having to progress rapidly with their agenda on premises and early initiatives are often rewarded whilst funding remains available. Resources are scarce to develop Premises Business Plans and inevitably a Public Private Partnership will help drive things forward faster. LHF has ideas for today and tomorrow and a vision for Modernisation of Primary Care Premises. Initiatives may give rise to opportunities to increase a range of services for patients and help achieve the Health Secretary's goal of patients and primary care staff feeling proud when entering NHS premises. The major aim is to produce cost-effective premises, value for money and increase morale in Primary Care. Available Options Studies need to be undertaken to identify if any additional services need to be provided from the premises at the design stage & whether refurbishment or re-build is the option. LHF can help the PCT plan and budget for providing temporary modular accommodation during any re-construction phase. We can also aid organisations with a mapping exercise of GP services in relation to existing Community premises. Your organisation may need to assess the need around the existing premises and whether a service is viable and necessarily delivered from this site or likely to relocate or require relocation in the future. LHF recommends that the PCTs begin early communication with GPs over their intention regarding premises and potential negotiations over new lease terms based on improved premises and including any new initiatives and modernisations. Each Community or GP Health Centre building needs to be surveyed to assess its suitability for re-modelling/refurbishment/extension. Some will be suitable for refurbishment and extension, but others will certainly need to be demolished and re-built. Even dilapidated premises may be in a prime location and the land may be a considerable asset. How can Lunn Healthcare Facilities help? LHF can provide Management Consultancy and aid in the appointment of a specialist Developer to advise on the condition and development options for each Health Centre & all the current Community sites. This would result in the production of a 'Premises Business Plan' for your organisation. Early approaches need to be made to GPs to ensure the long term viability of notionally rented premises. Resources from Dept. Of Health initiative on 'Modernisation of Premises' need to be explored. All this needs to be matched with the desire the PCT has to own property together with careful consideration of estates management liability. Deprived areas should also have access to quality premises. Encouragement of private sector involvement may also help with rent subsidy. Achieving The Right Balance involves consideration being given to as many community services as possible being delivered from the same premises as GPs currently in the notional rent scheme. This may help maximise efficiency or alternatively, as many GP services as possible being delivered from the same premises as Community Services therefore attracting a combination of notional rent and private investment. We could also explore on behalf of the PCG/ PCT, fully equipping these centres with IT and equipment, furniture, fixtures and fittings, which could potentially be on a leased basis standardising quality across all Trust premises. We would aim to produce a property portfolio for your PCG or PCT with a map of premises, estimate of Maintenance Costs, site appraisals and recommendations based on your intentions for service delivery. We will help develop a priority list e.g. Cat 1 = urgent, Cat 2 = medium-term, Cat 3 = long-term. Primary Care One-stop may be desirable based on your organisation`s health needs assessment within the locality. If good community and GP premises already exist, then expansion potential could be assessed. 'Value for Money' could be measured by a number of factors such as 1. Length of lease 2. Potential yield if Private Developer 3. Landlord / tenant relationship 4. Utilisation capital assets e.g existing land could improve potential for Primary Care in a particular area.