Primary Care Commissioning Meeting Committees meetings (meetings in Date Tuesday 1 June 2021 Title common) – held in Public Meeting no. 7. Time 9.30 am – 11.30 am

Ms Gillian Adams Venue / Chair Via MS Teams Independent Lay Member (WL CCG) Location

REF AGENDA ITEM ACTION PRESENTER PAPER TIMING Welcome and Introductions Gillian PCCCs/21/32 9.30am Adams Apologies for Absence: LLR CCGs: • Caroline Trevithick East Leicestershire and Rutland CCG: Gillian PCCCs/21/33 • To receive verbal 9.30am Adams West Leicestershire CCG: • Dr Nilesh Sanganee Leicester City CCG: • Dr Sulaxni Nainani Notification of Any Other Business Gillian PCCCs/21/34 To receive verbal 9.35am Adams Gillian PCCCs/21/35 Declarations of Interest on Agenda Topics To receive verbal 9.35am Adams To receive questions from the Public in Gillian PCCCs/21/36 To receive verbal 9.40am relation to items on the agenda only Adams Minutes of the meetings held in common To Gillian PCCCs/21/37 A 9.45am on 6 April 2021 approve Adams

Matters arising and actions for the Gillian PCCCs/21/38 To receive B 9.50am meetings held on 6 April 2021 Adams

ITEMS FOR DECISION, ACTION AND ESCALATION To PCCCs/21/39 Primary Care Estates Strategy Sarah Prema C 9.55am approve National GMS and Contract Changes PCCCs/21/40 To receive Jamie Barrett D 10.30am 2021/22

PCCCs/21/41 GP International Recruitment To receive Tine Juhlert E 10.40am

PCCCs/21/42 Risk Share and CQC inspections 2020/21 To receive Wendy Hope F 10:55am

General Practice Quality - High level PCCCs/21/43 To receive Wendy Hope G 11:10am report FOR INFORMATION ONLY

PCCCs/21/44 GP IM&T update To receive Sharon Rose H 11:20am

Items for escalation / information for the Gillian PCCCs/21/45 I 11.25am Governing Bodies. Adams ` REF AGENDA ITEM ACTION PRESENTER PAPER TIMING ANY OTHER BUSINESS Gillian PCCCs/21/46 Items of any other business. To receive verbal 11.30am Adams The next meeting of the LLR CCGs’ Primary Care Commissioning Committee meetings in common will take place on Tuesday, 3 August 2021, via MSTeams

Paper A LLR CCGs Primary Care Commissioning Committees meetings in common 1 June 2021

Minutes of the LLR CCGs’ Primary Care Commissioning Committees held in common on Tuesday 6 April 2021 at 9.30am Via MS Teams

Present: Leicester, Leicestershire and Rutland CCGs Ms Nicci Briggs Executive Director of Finance, Contracts and Corporate Governance Ms Wendy Hope Head of Quality and Safety (on behalf of Ms Caroline Trevithick) Ms Sarah Prema Executive Director of Strategy and Planning Ms Rachna Vyas Executive Director of Integration and Transformation

East Leicestershire and Rutland CCG: Mr Clive Wood Independent Lay Member Dr Nikhil Mahatma Member Practice Representative

West Leicestershire CCG: Ms Wendy Kerr Independent Lay Member Dr Geoff Hanlon Locality Lead North Charnwood Dr Nil Sanganee Locality Lead North West Leicestershire Dr Ash Kothari Locality Lead

Leicester City CCG: Mr Nick Carter Independent Lay member (Chair of meeting) Dr Avi Prasad Assistant Clinical Chair Dr Tony Bentley Health Need Neighbourhood Chair Dr Raj Than Health Need Neighbourhood Chair

In attendance: Ms Sarah Shuttlewood Assistant Director of Contracts, LLR CCGs Dr Rajiv Wadhwa Local Medical Committee Dr Fahreen Dhanji Local Medical Committee Dr Janet Underwood Healthwatch Rutland Mrs Priya Pandya Contracts Manager Mr Mayur Patel Senior Integration and Transformation Manager (for Item PCCCs/21/27 only) Mrs Daljit Bains Head of Corporate Governance Mrs Claire Middlebrook Corporate Affairs Senior Assistant (Minutes)

Public Gallery There were no members of the public at the meeting.

ITEM LEAD RESPONSIBLE PCCCs/21/19 Welcome and Introductions

Mr Nick Carter welcomed all attendees to the sixth meeting of the Leicester, Leicestershire and Rutland (LLR) Clinical Commissioning Groups’ (CCGs) Primary Care Commissioning Committee (PCCC)

Page 1 of 9 Paper A LLR CCGs Primary Care Commissioning Committees meetings in common 1 June 2021

meetings in common, on behalf of the three PCCC Chairs, reminding members that this meeting was taking place in public and therefore the chat function should not be used and if members wished to make a comment they should use the “raise hand” function.

PCCCs/21/20 Apologies for absence:

LLR CCGs • Ms Caroline Trevithick, Executive Director of Nursing, Quality and Performance

East Leicestershire and Rutland CCG • Ms Fiona Barber, Deputy Chair and Independent Lay member • Dr Girish Purohit, Member Practice Representative • Dr Nick Glover, Member Practice Representative

Leicester City CCG • Mr Jo Johal, Healthwatch, Leicester and Leicestershire • Dr Sulaxni Nainani, South Health Needs Neighbourhood Chair • Dr Gopi Boora, North and West Health Need Neighbourhood Chair

West Leicestershire CCG • Ms Gillian Adams, Independent Lay Member

The meeting was confirmed to be quorate for East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) Leicester City CCG (LC CCG) and West Leicestershire CCG (WL CCG).

PCCCs/21/21 Notification of Any Other Business

Mr Carter confirmed that there were no items of other business.

PCCCs/21/22 Declarations of Interest

GP members present declared an interest in items relating to commissioning of primary care where a potential conflict may arise, noting the register of interest contains the current declarations and this is published on the CCGs websites. It was noted that the Local Medical Committee (LMC) representatives may also be conflicted in such matters and as such this will be noted and actioned accordingly.

Mr Carter noted the following specific declarations:

Paper C – Finance report: • All GP members, with the exception of Dr Tony Bentley, are directly conflicted in respect of the finance report as it covers primary care finance and expenditure, however there are no decisions to be made. • No further action required.

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Paper D – Support for Canon Street surgery: • This report is for approval by the LC CCG PCCC voting members only (Executive and Lay members). • All GP members (including members from ELR CCG and WL CCG), with the exception of Dr Tony Bentley, are directly conflicted as the General Practice Resilience funds are available to all LLR CCGs’ Practices. • It is noted that the LC CCG PCCC GP members are not from the same Practice or Primary Care Networks (PCNs) as the Canon Street Surgery, in addition the GP members cannot vote in relation to the decision. • In order to obtain a GP member perspective on the content of the report it is proposed that the GP members contribute to the discussion enabling the decision makers to gain a GP perspective on the issues highlighted. • As this is a meeting in public, conflicted members can remain in the meeting and are not required to leave the meeting for the decision.

Paper E – Christmas & New Year 202021 LLR Primary Care Cover Arrangements Review • Report for information. • No conflicts identified.

Paper F - General Practice Quality - High level report • Potentially GP members could be conflicted if their Practice is identified within the report, however no specific conflicts have been identified on this occasion.

Dr Avi Prasad welcomed Dr Rajiv Wadhwa as the new strategic Clinical Director lead for Leicester City, following an election that took place.

It was RESOLVED to:

• NOTE the conflicts of interest declared and the actions to be taken.

PCCCs/21/23 To receive questions from the Public in relation to items on the agenda

It was confirmed that no questions had been received from members of the public in advance of the meeting.

PCCCs/21/24 Minutes of the previous meeting held on 2 February 2021 (Paper A)

Minutes of the LLR CCGs PCCCs in Common meeting held on 2 February 2021 were received with the following amendments and comments made;

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• Page 1, it was noted that Ms Yasmin Sidyot was representing Ms Rachna Vyas, not Ms Caroline Trevithick.

• Page 1, it was noted that Ms Fiona Barber Chaired the previous meeting.

• Page 9, Dr Janet Underwood confirmed that the issue highlighted by herself was a Leicester patient, however, noted by Healthwatch Rutland. It was agreed that the minutes should be amended to accurately reflect this.

• Page 15, Dr Nikhil Mahatma noted that he had commented about GPs partners being held to account for advertising campaigns, although this appeared to be missing from the minutes. It was agreed that Mrs Claire Middlebrook would check this outside of the meeting and amend the minutes accordingly.

• Page 15, it was noted that an action was identified in the minutes, however, missed off the action log. Ms Sarah Shuttlewood will provide an update in the next section of the meeting.

It was RESOLVED to:

• APPROVE the minutes of the LLR CCGs PCCC meeting held on 2 February 2021.

PCCCs/21/25 To Receive Matters Arising and actions for the meeting held on 2 February 2021 (Paper B)

The matters arising following the LLR CCGs meetings in common held in February 2021 were received and the following update noted;

PCCCs/21/15 Primary Care – Commercial Advertising Guidance and Principles Ms Shuttlewood confirmed that if the partner at the practice is a GP they are expected to comply regulatory requirements on advertising; however, it was noted that the contract does not make this issue specific. The committee noted that the matter is a grey area and the interpretation of the guidelines will be shared with practices. No further legal advice has been sought on the matter and it was agreed that there is nothing else that could be added.

Mrs Shuttlewood is in the process of drafting a communication to be sent out to practices next week.

Dr Nikhil Mahatma asked for clarity on what would happen if the person who holds the contract is not a GP, as the CCG would have no control over the advertising and this may give an unfair advantage to Alternative Provider Medical Services (APMS) contacts.

Ms Shuttlewood will clarify the situation outside of the meeting.

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PCCC/20/38 General Practice High Level report – it was confirmed that the Risk Share Group Annual Report will be presented to this Committee in June 2021. Action ongoing.

It was RESOLVED to:

• RECEIVE the matters arising and the update provided.

PCCCs/21/26 Finance report (paper C)

Ms Nicci Briggs confirmed that the paper provides an update on the financial situation, prior to the rebate for Covid - 19 costs being received and therefore shows a £4.9m overspend. The rebate is likely to be £2.6m. The majority of Covid – 19 costs are placed against WL CCG, as they have led on the ordering etc. The Finance and Activity Committee will receive a breakdown of the costs per CCG.

Prescribing remains under pressure, with a spike noted in December 2020.

Mr Zuffar Haq questioned if staff who have been working on the vaccination programme have been paid. Ms Briggs confirmed that practices have been paid; however, if the employee has been employed by the bureau or PCN they would need to contact them about their payment. Practices have been paid in advance to ensure that they have not been disadvantaged. Ms Briggs will need to check for any further information outside of the meeting and will ensure any further information is shared with relevant parties.

It was RESOLVED to:

• RECEIVE the update

PCCCs/21/27 Support for Canon Street Surgery (Paper D)

It was noted that this paper is for approval by LC CCG voting members only.

In February 2021 Canon Street Surgery applied to close their list, due to the number of new patient registrations that have taken place (221). The practice is situated in a dense area of Leicester, close to Belgrave Road and is popular practice, due to their recent efforts with holding Covid-19 webinars for patients, provide good patient access and their patients in general feel well supported especially during the pandemic.

The committee were made

Dr Modi, sole practitioner has been shielding since the start of the pandemic and has employed locums to carry out face to face appointments. Due to the increase in patient registrations the practice

Page 5 of 9 Paper A LLR CCGs Primary Care Commissioning Committees meetings in common 1 June 2021 are struggling to cope with the work involved. If the practice had closed their list, this would have had a domino effect on nearby practices in the local area.

The paper is seeking approval of £44k for quarter one to support the practice with new patients check and will be a time limited support.

Ms Vyas explained in this area 40% of patients are not registered with a GP Which means that patients do not benefit from the full range of NHS services. The team are working with the Patient Participation Group (PPG) to try and understand where the patients are coming from.

In July 2020 the area underwent advanced Covid-19 testing and vaccination outreach work took place and therefore this situation is a culmination of a variety of issues. This has had an effect on GPs and nurses in the area with the increase in demand.

A capacity and demand analysis will be carried out to understand the impact of the increased registration. It was reiterated that this support is only for Q1 to avoid impacting on other neighbouring practices. Support is being provided with a weekly check taking place.

The following comments and questions were raised;

The CCGs need to look at the overall resilience of GPs, especially for single handed practices and ensure that there is a suitable transition plan in place. A wider piece of work needs to take place on how we support practices with unregistered patients.

It was questioned if three months will be long enough to resolve this issue.

It was noted that this practice is at the heart of the area and we need to ensure that we do not create more health inequalities, as this is an area where there are a lot of unregistered patients and local employers (such as factories) are pushing employees to have the vaccination.

It was noted that Dr Modi has not asked for help from the CCG previously in relation to new patient registrations or high workload; which further explains why support should be provided to the practice.

Mr Carter noted that a long-term plan needs to be in place to support practices with registering currently unregistered patients.

Ms Vyas confirmed that ensuring sustainability is high on the list of priorities, to ensure that testing, vaccination and new registrations can continue. The Primary Care Cell is looking at restoration and recovery; whilst acknowledging growth, thus ensuring a long-term plan is appropriate.

Page 6 of 9 Paper A LLR CCGs Primary Care Commissioning Committees meetings in common 1 June 2021

Mr Carter asked if the new patients are being checked to ascertain if they can access on-line services and also how many extra patients are anticipated. Ms Vyas confirmed that the practice is mostly carrying out new registrations face to face and the patients are of varying ages. Younger patients are more like to use on-line services, with older patients less likely to have access to the internet. The PPG are working with the CCG on this issue.

Dr Prasad stated that he was glad that these conversations were taking place, as they help to address health inequalities. It is important that the framework is in place locally and that we celebrate the support given by the CCG to this practice. In the past the practice is likely to have shut and it should be commended that the CCG is supporting this practice to resolve the issues.

It was questioned if we can use Covid-19 money to support this work. Ms Vyas confirmed that this is not an option as it is a short-term solution only.

Dr Janet Underwood noted that Healthwatch have been looking at digital inclusion; working with the CCGs Communication Team, University Hospitals of Leicester NHS Trust and Leicestershire Partnership NHS Trust on a survey regarding digital enablement, however, have had to pause this, as there is no way to carry out the survey at this time, as you would miss everyone who is not digitally enabled. The problem with access to GPs is not just a City issue as there are also problems in Rutland, due to lack of patient transport as an example. Mr Carter noted a report from Sheffield where it was identified that 23% of people are not online. These patients were identified using practice lists.

It was agreed that access is an issue across the City and County and self-care should be promoted more, as a lot of patients attend their GP for issues that could be resolved by self-care or a Pharmacist etc. If budgets are better aligned this would also help improve access.

Mr Carter highlighted that this paper requires approval by the LC CCG Lay Member and Executives only.

It was RESOLVED to:

• RECEIVE the paper

• APPROVE post-year approval for the support package described for quarter 1 only.

PCCCs/21/28 Christmas & New Year 202021 LLR Primary Care Cover Arrangements Review (Paper E)

Page 7 of 9 Paper A LLR CCGs Primary Care Commissioning Committees meetings in common 1 June 2021

Mrs Priya Pandya confirmed that at the October 2020 LLR PCCC meeting, the opening hours for practices on Christmas and New Yeas’ Eve were agreed, with cover being provided by Derbyshire Health United (DHU). DHU reported low levels of activity on both days, as shown in the attachment to the paper. Ten practices chose to remain open and not close early.

Due to the success of this, it has been decided that a similar approach will be adopted for 2021/22.

It was agreed that this was a common sense approach and the success should be celebrated.

Mr Haq welcomed the paper; however, urged a note of caution regarding the figures as patients often avoid seeing GPs during holiday periods. A review will need to take place following this year’ arrangements, as more patients are now coming into the system, especially cardiac and cancer patients.

Ms Vyas confirmed that the team are expecting a winter surge in 2021, due to long Covid-19, flu and a possible new wave of Covid patients. A wider system review will take place to ensure access is suitable.

Clinical leads welcomed that the direction of travel for this Christmas and New Year was discussed early in April which is positive.

It was RESOLVED to:

• RECEIVE and NOTE the 20/21 review.

PCCCs/21/29 General Practice Quality – High Level report (paper F)

Ms Wendy Hope took the paper as read, noting at 131 LLR practices have been inspected, with three reports published since the last paper presented.

The management team at Thurmaston Health Centre inherited the rating from the December 2020 inspection and have made significant improvement; however, still need more time to ensure systems are embedded. The practice continues to receive support from the CCG.

Bowling Green Street Surgery were inspected in 2019 and since that time have made improvements and were reinspected in December 2020, noting that they have three elements were they ‘require improvement’. The CCG is assured that progress is being made.

Westcotes 1 and 2 were inspected in October 2019 and since that time the leadership team at the practice have changed and improvements noted. The practice is now rated good in 4 out of 5 domains.

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The CCGs Risk Sharing Group continue to monitor 12 LLR practices, providing additional support where required. The team will continue to report progress through PCCC meetings.

It was noted that is it good to see progress being made with all practices and thanks should be expressed to the Nursing, Quality and Performance team and Primary Care Team. Members can see the difference with the support being offered to practices.

It was RESOLVED to:

• RECEIVE the update

PCCCs/21/30 Items for escalation / information for the Governing Bodies

As the Governing Body are already sited on the primary care capacity issues, there are no items for escalation / information for the Governing Bodies.

PCCCs/21/31 Any other business

Mr Carter confirmed that there were no items to discuss.

The meeting concluded at 11.30am.

Date of next meeting

The date of the next LLR Primary Care Commissioning Committee meetings will be held on Tuesday 1 June 2021 at 9:30am, via MS Teams.

Page 9 of 9

Paper B LLR CCGS Primary Care Commissioning Committee Meeting 1 June 2021

LEICESTER, LEICESTERSHIRE AND RUTLAND CLINICAL COMMISSIONING GROUPS PRIMARY CARE COMMISSIONING COMMITTE MEETING Key ACTION NOTES Completed On-Track No progress made

Minute Meeting Item Responsible Action Required To be Progress as at Status No. Officer completed June 2021 by PCCCs 6 October General Caroline Mrs Trevithick to present the December Included in the Risk GREEN /20/38 2020 Practice Trevithick report detailing specific 2020 Share and CQC Quality – High issues in GP Practices at June 2021 inspections 2020/21 level report the next PCCC meeting. report being presented to this committee in June 2021

ACTION COMPLETE PCCCs April 2021 Minutes of 2 Sarah Dr Nikhil Mahatma asked for June 2021 For future APMS GREEN /21/24 February 2021 Shuttlewood clarity on what would contracts the contracts - Advertising happen if the person who team will ensure the issue holds the contract is not a GMS guidance is GP, as the CCG would have included in the contract.

no control over the Ms Shuttlewood emailed advertising and this may Dr Mahatma directly to give an unfair advantage to inform him of this. Alternative Provider Medical Services (APMS) contacts. ACTON COMPLETE

Ms Shuttlewood will clarify the situation outside of the meeting.

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Name of meeting: LLR CCGs’ Primary Care Date: 1st June 2021 Paper: Commissioning Committee C meetings in common Public  Confidential

Report title: Update on Primary Care Estate Strategy (PCES)

Presented by: Sarah Prema Executive Director of Strategy and Planning, LLR CCGs Report author: Sarah Prema Executive Director of Strategy and Planning, LLR CCGs Executive lead: Sarah Prema Executive Director of Strategy and Planning, LLR CCGs Receive for information Action required:  Progress update:  only: For assurance: For approval / decision:  Executive summary: 1. A comprehensive review of LLR primary care estates was undertaken to prioritise GP Practices in terms of their potential premises improvement/development needs. This commenced with a collection of data on premises and housing growth at practice and PCN level – this has formed the Baseline Information Document, Appendix One.

2. The Baseline Information was used alongside demographic date to develop a prioritisation criteria based on the following four main categories following agreement of the principles with the CCG Chairs and the joint PCCC: • Demographic, health, and socio economic factors which impact on GMS/ APMS/ PMS services • Housing and Population growth • Suitability of Current Premises • Impact of Service changes (new models of care).

3. The Baseline Information and the Prioritisation Process has identified the following key issues affecting primary care estate across LLR:

• Housing Growth – circa 200,000 new homes in LLR between 2011 to 2050 • Population Growth – in addition to the housing growth • Estate that is too small to manage current patient numbers • Estate that is of poor quality or unsuitable for delivering modern health care • Growth in primary care and PCN workforce • Growth in services delivered locally either at practice or PCN

4. A Task and Finish Group (with GP input) was established to develop and inform the prioritisation process. Score and weighting was established for each criteria and significant scenario stress-testing undertaken to ensure the robustness of the scoring.

5. The Prioritisation Process has identified three areas where practices could potentially need investment into their premises:

i) Practices affected by housing growth

ii) Practices that have insufficient space iii) Practices that have poor quality or unsuitable premises

A list of the highest priority practices for each of these categories is contained in the attached presentation.

6. Proposed next steps are twofold:

i) Establish a Development Plan that will set out the potential solutions (e.g. developer s106 contributions) to each practices estate needs. This will focus on the prioritised practices in the first instance, however retaining a degree of flexibility to consider other practices/opportunities as they arise.

ii) Establish an Investment Plan. There is presently no national capital available for primary care estates thus any developments would need to be funded either through developer contributions or via the practice. To support practice investment we could develop an investment plan that allocates some of our primary care funding to support increases in reimbursable costs as a consequence of individual practice developments.

Appendices: • Appendix 1 – Baseline Information Document • Appendix 2 – Prioritisation Process

Recommendations: The LLR CCGs’ Primary Care Commissioning Committees are asked to:

• NOTE the Baseline Information Document

• APPROVE the Prioritisation Process

• NOTE the next steps to set out a Development Plan and supporting Investment Plan. Report history and Progress and report has regularly been shared with the following parties prior review: • PCES Task and Finish Group • CCG Chairs • Primary Care Cell • LMC • EMT

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG   

2

Implications a) Conflicts of PCCC GP Governing Body Members as relates to Primary Care Estates interest: b) Alignment to N/A Board Assurance Framework c) Resource and Not at this stage financial implications d) Quality and N/A patient safety implications e) Patient and N/A public involvement f) Equality analysis N/A and due regard

3

Primary Care Estate Strategy

LLR CCGs Joint Primary Care Commissioning Committee

1st June 2021

A partnership of: East Leicestershire and Rutland CCG | West Leicestershire CCG | Leicester City CCG Components of the Primary Care Estate Strategy  Baseline Information Document (Appendix One): this sets out the information that we know about the LLR Primary Care Estate.

 Prioritisation (Appendix Two): this describes the prioritisation process that has been undertaken using the information from the Baseline Information Document and additional information to identify a list of priority practices.

 Development Plan: this will be developed using the prioritisation process outcomes and discussions with practice to identify the preferred solution to the estate need identified.

 Investment Plan: this will be developed to identify how prioritised practice developments could be supported. Key Issues Affecting Primary Care Estate The Baseline Information and the Prioritisation Process has identified the following key issues affecting primary care estate across LLR:  Housing Growth – circa 200,000 new homes in LLR between 2011 to 2050  Population Growth – in addition to the housing growth  Estate that is too small to manage current patient numbers  Estate that is of poor quality or unsuitable for delivering modern health care  Growth in primary care and PCN workforce  Growth in services delivered locally either at practice or PCN level Baseline Information Document The document was produced by ECV/Leicester LIFTCo, completed in April 2020 and was supplemented with a housing and population growth update in October 2020. The document and supporting information provide a rich source of information upon which to develop our PCES to the detailed planning stage. Shown below is an outline of some of the key sources employed:  The data collected for the six-facet surveys  Local Plans and other supporting documents featuring Council housing and population planning  The NHS Shape strategic planning and asset tool  ONS/Local Authority demographic projections  Health construction and maintenance cost estimates based on current conditions (2020). Key Outputs from the Baseline Information Document The baseline information document includes the following key outputs:  A socio-economic, demographic, health needs and housing profile for each of the Council areas.  Premises assessments, key issues and risks/implications at HNN/PCN level.  Identification of LLR ‘hotspots’ as a result of housing and population growth.  High-level financial summaries outlining premises risk & backlog costs, anticipated GIA shortfall and planning/build costs, plus potential total costs for the LLR system in terms of primary care premises. Prioritisation

In order to move the Baseline Information Document into something that could be implemented a process of prioritisation was developed and undertaken Prioritisation (2) The prioritisation process was developed in the following way:

 Task and Finish Group established to develop the prioritisation process  Key information from the Baseline Document was used together with demographic data to establish a set of criteria  A score and weighting was established for each criteria; see Appendix Two for detail  Each practice was scored against each criteria  Scenario testing was undertaken to ensure the robustness of the scoring and weighting as result adjustments were made to the weighting  The process identified three areas where practices could potentially need investment into their premises  Practices affected by housing growth  Practices that have insufficient space  Practices that have poor quality or unsuitable premises

 The next three slides show the ‘Top 20’ ranked GP practices in each of the three categories outlines above. NHS Housing and Notes (where the Practice appears in CCG Contract Practice Name PCN Area Population more than one of the thre priority Code Growth categories) Forest House Medical ELR C82066 North Blaby 165 Top 20 Centre South Leicestershire ELR C82001 Medical Group (The Cross Counties 165 Old School Surgery) Empingham Medical ELR C82044 Rutland 155 Practices – Centre The Practice - City C82624 City Care Alliance 150 Beaumont Leys Beaumont Lodge C82094 Also in the top 20 for unsuitability of City Medical Practice (The Millenium 150 premises excluding GIA Housing Surgery) North West WL C82014 Castle Medical Group Leicestershire 145 (Hub 1)

C82623 Heatherbrook Surgery Also in the top 20 for unsuitability of Growth City Aegis Healthcare 140 (Dr F Rizvi & Partner) premises including GIA Market Market Harborough ELR C82009 Harborough & 140 Medical Centre The table shows the top 20 Bosworth Latham House Syston, Vale and ELR C82038 135 Medical Practice Melton North West highest scoring GP practices Castle Donnington WL C82007 Leicestershire 120 Surgery (Hub 3) Student Medical Appears as a top 20 in all three from the prioritisation process. WL C82111 Carillon 115 Centre categories The final two columns show the WL C82064 Forest House Surgery Beacon 115 Woodbrook Medical WL C82070 Carillon 115 Centre Also in the top 20 for unsuitability of score and where practices WL C82035 Park View Surgery Carillon 115 premises excluding GIA C82030 Downing Drive City Salutem 115 appear in more than one of the Surgery Bridge Street Medical WL C82026 Carillon 115 Practice Pinfold Medical three top 20 categories. WL C82011 Carillion 115 Practice St Elizabeth’s Medical City C82676 Salutem 115 Please note that there are more Centre (Dr J A Wood) Greengate Medical Also in the top 20 for unsuitability of WL C82003 Watermead 115 than 20 practices included in Centre premises including GIA City Y00137 Dr Roshan Aegis Healthcare 115

Also in the top 20 for unsuitability of WL C82628 Groby Surgery Bosworth 115 the list as more than 20 premises including GIA Silverdale Medical WL C82627 Watermead 115 Centre Also in the top 20 for unsuitability of achieved the threshold score. WL C82656 Field Street Surgery Beacon 115 premises excluding GIA Thurmaston Health WL C82678 Watermead 115 Centre WL C82091 Birstall Medical Centre Watermead 115

Also in the top 20 for unsuitability of ELR C82022 Billesdon Surgery Cross Counties 115 premises excluding GIA ELR C82056 Glenfield Surgery North Blaby 115 (Un)Suitability NHS Notes (where the Practice of Current CCG Contract Practice Name PCN Area appears in more than one of the Premises Inc. Code thre priority categories) GIA Score Student Medical Appears as a top 20 in all three WL C82111 Carillon 165 Centre categories Also in the top 20 for unsuitability of Top 20 ELR C82021 The Central Surgery Oadby & Wigston 158 premises excluding GIA C82651 Dr KS Morjaria & Belgrave & Also in the top 20 for unsuitability of City 155 Partner Spinney Hill premises excluding GIA Also in the top 20 for unsuitability of Practices – WL C82034 Quorn Medical Centre Soar Valley 151 premises excluding GIA C82614 Also in the top 20 for unsuitability of City Spirit Asquith Surgery City Care Alliance 151 premises excluding GIA Forest House Medical Insufficient ELR C82066 North Blaby 146 Centre Highgate Medical WL C82644 Soar Valley 144 Centre

Space C82623 Heatherbrook Surgery Also in the top 20 for housing and City Aegis Healthcare 143 (Dr F Rizvi & Partner) population growth

Hazelmere Medical South Blaby & ELR C82098 143 Centre Lutterworth North West Also in the top 20 for unsuitability of WL C82017 Measham Medical Unit Leicestershire 142 premises excluding GIA This category is based on (Hub 1) Spinney Hill Medical C82024 Belgrave & City Centre (Dr Pancholi & 140 a combination of the Spinney Hill Partners) proportion of m2 space WL Y00252 Cottage Surgery Soar Valley 140 The Limes Medical ELR C82055 North Blaby 138 per registered patient and Centre Also in the top 20 for unsuitability of City C82116 Highfields Surgery Leicester Central 137 the findings of the six premises excluding GIA North West The Whitwick Road WL C82045 Leicestershire 135 Surgery facet surveys including (Hub 3) Also in the top 20 for housing and WL C82628 Groby Surgery Bosworth 132 population growth the utilisation assessment. C82046 Saffron Health Leicester City City 132 South C82662 Leicester City City Walnut Street Surgery 130 South Greengate Medical Also in the top 20 for housing and WL C82003 Watermead 130 Centre population growth WL C82082 The Centre Surgery Hinckley Central 130 C82086 Leicester Health City Fosse Medical Centre 130 Focus C82084 Dr B Modi Belgrave & City 130 Spinney Hill (Un)Suitability NHS Notes (where the Practice appears of Current CCG Contract Practice Name PCN Area in more than one of the thre priority Premises Exc. Code categories) GIA Score Also in the top 20 for unsuitability of Top 20 City C82116 Highfields Surgery Leicester Central 92 premises including GIA Student Medical Appears as a top 20 in all three WL C82111 Carillon 90 Centre categories Forest House Practices – ELR C82066 North Blaby 86 Medical Centre Beaumont Lodge Also in the top 20 for housing and City C82094 Medical Practice Millenium 84 population growth Poor Quality or (The Surgery) The Central Also in the top 20 for unsuitability of ELR C82021 Oadby & Wigston 83 Surgery premises including GIA North West Measham Medical Also in the top 20 for unsuitability of Unsuitable WL C82017 Leicestershire 82 Unit premises including GIA (Hub 1) Also in the top 20 for unsuitability of WL C82035 Park View Surgery Carillon 80 Premises premises including GIA Dr KS Morjaria & Belgrave & Also in the top 20 for unsuitability of City C82651 80 Partner Spinney Hill premises including GIA Also in the top 20 for housing and This category is based on ELR C82022 Billesdon Surgery Cross Counties 79 population growth Barwell & the findings of the six facet WL C82061 Hollycroft Medical Fosseway 78 Centre (Barwell) surveys. Evington Medical Likely to be removed as an ETTF City C82088 Centre (Halsbury The Fox's 78 scheme was completed post six facet Please note that there are street) survey. Checking branch status Al-Waqas Medical City C82099 Centre (Dr KA The Fox's 78 more than 20 practices Choudhry) Dr S Shafi C82653 included in the list as more City (Westcotes GP Millenium 78 Surgery- 2) than 20 achieved the City C82114 Dr UK Roy City Care Alliance 77

Field Street Also in the top 20 for housing and WL C82656 Beacon 76 threshold score. Surgery population growth Quorn Medical Also in the top 20 for unsuitability of WL C82034 Soar Valley 76 Centre premises including GIA Clarendon Park City C82122 Aegis Healthcare 76 Surgery Narborough Road City C82119 The Fox's 76 Surgery Spirit Asquith Also in the top 20 for unsuitability of City C82614 City Care Alliance 76 Surgery premises including GIA East Leicester City C82063 Aegis Healthcare 76 Medical Practice Development Plan

The next stage in the process is to take the prioritisation process and establish a Development Plan. This will set out the potential solutions to each practices estate needs, focused on the prioritised practices in the first instance. However we must be flexible to consider opportunities as they arise.

The plan will also consider the level of input needed to investigate and develop service and/or estate solutions from individual service or practice level up to PCN and Place level. This will include the impact on both CCG and primary care resources as we recognise that this is a significant programme of work. What are the potential solutions

Area Potential Solutions Housing Growth Developer Contributions

Poor Quality or Unsuitable Premises Practice Development:  Self funded  Third Party Development  Use of underutilised premises  Combining estate across PCN  Place based solutions with partners

Insufficient size for patient numbers Practice Development:  Self funded  Third Party Development  Use of underutilised premises  Combining estate across PCN  Place based solutions with partners Develop Investment Plan

There is currently no national capital available for primary care therefore any developments would need to be funded either through developer contributions or via the practice. To support practice investment we could develop an investment plan that allocates some of our primary care funding to support increases in reimbursable costs as a consequence of individual practice developments.

(note where developer contributions have been used to fund an estate solution the rent is normally abated for a number of years – so the additionality in the short term is just increased rates; water) Level of information now available on primary care estate The level of data we now have in relation to the primary care estate, supplemented further by the NHS Shape planning tool, supports us to develop detailed plans at individual practice, locality, PCN, Place and up to system level. Following approval for the approach to and outcome of the prioritisation process, together with support to move to the production of a development and financial plan, we will then focus on detailed planning in specific subject and geographic areas. For example this could include:  A feasibility study to calculate the cost/opportunities of improving our poorer quality practices through improvement grants (or similar depending on potential funding sources).  Improved use of the PCN or wider public estate as an alternative to investment in GP premises were other more appropriate options are available.  A focus on geographic ‘hotspots’ highlighted through the baseline information document and underlined by the prioritisation process. An example of an initial focus on the Shepshed and Loughborough areas is included on the next slide. It shows GP practices identified in the ‘Top 20’ across the three categories, together with planned housing growth in the area. Example of work to develop local planning Next Steps

 Complete a high level review on all practices as to whether there is a solution already available – i.e. do we have developer contributions; will we be applying for developer contributions; is their a legacy ETTF scheme being finalised; has the practice already resolved their estate issue  In depth work with the top 20 prioritised practices on each of the lists, there are some duplications, to work with to identify a workable solution if one is not already in place  The above two actions will then produce the Development Plan.  Develop a primary care premises investment plan to support prioritised developments for approval by a future Joint Primary Care Commissioning Committee.  Develop a communications and engagement plan to support the programme/next steps and outline support offer to GP practices. Recommendations

The Leicester, Leicestershire and Rutland Clinical Commissioning Groups Primary Care Commissioning Committee members are asked to:

NOTE the Baseline Information Document

APPROVE the Prioritisation Process

NOTE the next steps to set out a Development Plan and supporting Investment Plan.

Intentionally Left Blank

© Community Ventures Management Ltd. This document is provided to and for the sole use of our client Leicester LIFT Company and covers their particular instructions and requirements. It must not be made available or copied or otherwise quoted or referred to in whole or in part in any way, including orally, to any other party without our express written permission and we accept no liability for any use by any other party.

FOREWORD

Coming from Tim Sacks with the CCGs aims and approach for readers of the PCES.

3 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

FOREWORD

4 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

CONTENTS 1. EXECUTIVE SUMMARY 8.8.2 Key Issues from Appraisal and Mapping 8.8.3 Risks & Implications for LS HNN 2. INTRODUCTION 8.9 Leicester North & West Health needs Neighbourhood (LN&W HNN) 8.9.1 Premises Assessment 3. NATIONAL POLICY CONTEXT 8.9.2 Key Issues from Appraisal and Mapping 8.9.3 Risks & Implications for LN&W HNN 4. LEICESTER, LEICESTERSHIRE & RUTLAND OVERVIEW 8.10 Leicester North & East Health needs Neighbourhood (LN&E HNN) 8.10.1 Premises Assessment 5. LLR STRATEGIC CONTEXT 8.10.2 Key Issues from Appraisal and Mapping 5.1 System Overview 8.10.3 Risks & Implications for LN&E HNN 5.2 PC/PCN Strategy 9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 6. HOUSING & POPULATION GROWTH PLANS 9.1. North West Leicestershire District Council Area 6.1. Housing Development in Leicester City Council Area 9.1.1. Socio-economic Profile 6.2. Housing Development in Leicestershire County Council Area 9.1.2. Demographic Profile 6.3. Housing Development in Rutland County Council Area 9.1.3. Health Needs 6.4. Overall Impact of proposed Housing Development across LLR 9.1.4. Housing 9.1.5. Map of Practices & Housing Developments 7. METHODOLOGY & PROCESS FOR THE REVIEW 9.2. NWL Hub 1 Review of Estate 7.1. General Approach 9.2.1. Premises Assessment 7.2. Six Facet Building Surveys 9.2.2. Key Issues from Appraisal and Mapping 7.3. Survey Considerations 9.2.3. Risks & Implications for NWL Hub 1 7.4. Premises Sizing Considerations 9.3. NWL Hub Review of Estate 7.5. Housing Considerations 9.3.1. Premises Assessment 7.6. Population Impact of Housing Development 9.3.2. Key Issues from Appraisal and Mapping 7.7. ‘Hotspots’ 9.3.3. Risks & Implications for NWL Hub 2 9.4. NWL Hub 3 Review of Estate 8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 9.4.1. Premises Assessment 8.1 Socio-economic Profile 9.4.2. Key Issues from Appraisal and Mapping 8.2 Demographic Profile 9.4.3. Risks & Implications for NWL Hub 3 8.3 Health Needs 9.5. Hinckley & Bosworth Borough Area 8.4 Housing 9.5.1. Socio-economic Profile 8.5 Specific Considerations for Leicester City Analysis 9.5.2. Demographic Profile 8.6 Map of Practices 9.5.3. Health Needs 8.7 Leicester Central Health needs Neighbourhood (LC HNN) 9.5.4. Housing 8.7.1 Premises Assessment 9.5.5. Map of Practices & Housing Developments 8.7.2 Key Issues from Appraisal and Mapping 9.6. Hinckley Central PCN Review of Estate 8.7.3 Risks & Implications for LC HNN 9.6.1. Premises Assessment 8.8 Leicester South Health needs Neighbourhood (LS HNN) 9.6.2. Key Issues from Appraisal and Mapping 8.8.1 Premises Assessment 9.6.3. Risks & Implications for Hinckley Central PCN

5 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

CONTENTS 9.7. Bosworth PCN Review of Estate 9.16. South Blaby & Lutterworth PCN Review of Estate 9.7.1. Premises Assessment 9.16.1. Premises Assessment 9.7.2. Key Issues from Appraisal and Mapping 9.16.2. Key Issues from Appraisal and Mapping 9.7.3. Risks & Implications for Bosworth PCN 9.16.3. Risks & Implications for South Blaby & Lutterworth PCN 9.8. Fosseway PCN Review of Estate 9.17. Oadby & Wigston Borough Council Area 9.8.1. Premises Assessment 9.17.1. Socio-economic Profile 9.8.2. Key Issues from Appraisal and Mapping 9.17.2. Demographic Profile 9.8.3. Risks & Implications for Fosseway PCN 9.17.3. Health Needs 9.9. Charnwood Borough Council Area 9.17.4. Housing 9.9.1. Socio-economic Profile 9.17.5. Map of Practices & Housing Developments 9.9.2. Demographic Profile 9.18. Oadby & Wigston PCN Review of Estate 9.9.3. Health Needs 9.18.1. Premises Assessment 9.9.4. Housing 9.18.2. Key Issues from Appraisal and Mapping 9.9.5. Map of Practices & Housing Developments 9.18.3. Risks & Implications for Oadby & Wigston PCN 9.10. Soar Valley PCN Review of Estate 9.19. Melton Borough Council Area 9.10.1. Premises Assessment 9.19.1. Socio-economic Profile 9.10.2. Key Issues from Appraisal and Mapping 9.19.2. Demographic Profile 9.10.3. Risks & Implications for Soar Valley PCN 9.19.3. Health Needs 9.11. Watermead PCN Review of Estate 9.19.4. Housing 9.11.1. Premises Assessment 9.19.5. Map of Practices & Housing Developments 9.11.2. Key Issues from Appraisal and Mapping 9.20. Syston, Vale & Melton PCN Review of Estate 9.11.3. Risks & Implications for Watermead PCN 9.20.1. Premises Assessment 9.12. Carillon PCN Review of Estate 9.20.2. Key Issues from Appraisal and Mapping 9.12.1. Premises Assessment 9.20.3. Risks & Implications for Syston, Vale & Melton PCN 9.12.2. Key Issues from Appraisal and Mapping 9.21. Harborough District Council Area 9.12.3. Risks & Implications for Carillon PCN 9.21.1. Socio-economic Profile 9.13. Beacon PCN Review of Estate 9.21.2. Demographic Profile 9.13.1. Premises Assessment 9.21.3. Health Needs 9.13.2. Key Issues from Appraisal and Mapping 9.21.4. Housing 9.13.3. Risks & Implications for Beacon PCN 9.21.5. Map of Practices & Housing Developments 9.14. Blaby District Council Area 9.22. Market Harborough & Bosworth PCN Review of Estate 9.14.1. Socio-economic Profile 9.22.1. Premises Assessment 9.14.2. Demographic Profile 9.22.2. Key Issues from Appraisal and Mapping 9.14.3. Health Needs 9.22.3. Risks & Implications for Market Harborough & Bosworth PCN 9.14.4. Housing 9.23. Cross Counties PCN Review of Estate 9.14.5. Map of Practices & Housing Developments 9.23.1. Premises Assessment 9.15. North Blaby PCN Review of Estate 9.23.2. Key Issues from Appraisal and Mapping 9.15.1. Premises Assessment 9.23.3. Risks & Implications for Cross Counties PCN 9.15.2. Key Issues from Appraisal and Mapping 9.15.3. Risks & Implications for North Blaby PCN

6 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

CONTENTS 10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.1. Socio-economic Profile 10.2. Demographic Profile 10.3. Health Needs 10.4. Housing 10.5. Map of Practices & Housing Developments 10.6. Rutland Healthcare PCN Review of Estate 10.6.1. Premises Assessment 10.6.2. Key Issues from Appraisal and Mapping 10.6.3. Risks & Implications for Rutland Healthcare PCN

11. LLR HOTSPOTS

12. FINANCIAL SUMMARY 12.1. Risk Cost & Backlog R&M Costs i.e. current and backlog investment costs 12.2. Anticipated GIA shortfall & future build costs 12.3. Anticipated Planning Work Costs 12.4. Total Costs for LLR

13. IMPLEMENTATION PLANNING FRAMEWORK 13.1. Estates Capability & Capacity 13.2. Approach to Implementation

14. RECOMMENDATIONS & NEXT STEPS

15. BIBLIOGRAPHY

APPENDIX – Six Facet Classifications & Worked Example

7 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

1. EXECUTIVE SUMMARY Across the Leicester, Leicestershire and Rutland area there are • Construction of a profile for each of the Local Authority and General Practice premises ranging from rural branch surgeries, to second tier authority areas, together with supporting information large single or multiple practices in fully maintained buildings. One that can also be used to plan at Primary Care Network (PCN), hundred and thirty-three (133) GP practices occupy one hundred and Health Needs Neighbourhood (HNN), and individual GP practice seventy-nine Primary Care estate buildings, providing services for circa level 1,155,128 registered patients. • Identification of estate risks and implications (based on data analysis), ‘hotspots, and outline delivery costs This document represents the first stage of development of the • Working in collaboration across the Sustainability and Leicester, Leicestershire and Rutland Primary Care Estate Strategy Transformation Partnership (STP) through the Local Estates (PCES) commissioned by the Leicester City, West Leicestershire Forum to deliver a One Public Estate (OPE) approach across and East Leicestershire and Rutland CCGs. The strategy is built Leicester, Leicestershire and Rutland. upon: Following the Executive Summary and Introduction Section 3 • Completion of six facet surveys (6FS) for Primary Care Estate considers the national policy context. Sections 4 and 5 offer an surveys which assess them against Schedule 1 Minimum overview of Leicester, Leicestershire and Rutland (LLR) areas, Statutory and Contractual Standards for Practice Premises outlining the local picture including a health needs and economic (NHS [General Medical Services] - Premises Costs Directions profile of the Local Authority (LA) areas and local partners, together 2013) with the strategic context in which each area’s Primary Care strategy • Bringing together, reviewing and improving GP premises data and plans are located. and existing (legacy) premises plans across the three CCGs • An assessment of the impact of local and national drivers for CCGs have drawn up Commissioning Plans to address the health change on the current and future estate needs of their current populations which take into account the

9 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

1. EXECUTIVE SUMMARY available forecasts for future demographics in terms of both the estate and to encourage PCNs, HNNs and wider STP partners to number and age profile of the population and proposed local housing work together more effectively to maximise the efficient use of the development plans, in order to address significant local challenges in existing estate. terms of health outcomes and high levels of inequality, as well as an increasing and ageing population, which together will bring Section 7 explores the national policy approach to housing increasing dependence on health and social care services. development which requires local planning systems to support communities through providing the delivery of new the supply of The CCG are continuing to develop a model for primary care in line housing required, (including affordable and specialised housing), that with the NHS England Five Year Forward View (5YFV) and the Long- is able to meet present and future needs of the population. In Term Plan (LTP) in order to develop primary care models aligned particular, the section, particularly for an ageing LLR population, with the local Sustainability and Transformation Partnership Plans outlining how LLR Authorities are working together to identify to the (STPs). Objectively Assessed Need for Housing (OANH) for Leicester, Leicestershire and Rutland. The housing issues and priorities for The formation of new groupings of General Practices into PCNs has each area are highlighted, with the recognition that there will be prompted a change in approach to estate planning and utilisation that variance across LAs in terms of housing completions and each underpin new models of care and include consideration of the wider Authority’s ability to meet the housing requirements of their areas, NHS estate in that area. The estates profiles generated in this and whether there may be potential scope for future housing supply Strategy were considered against these emerging commissioning to be absorbed across neighbouring LA borders. intentions to identify any impact and issues for the current asset base and inform potential estate priorities for the area. An important part An outline of the methodology used to undertake the review of the of the CCG’s strategy is the development of systems to identify and primary care estate, including the completion of surveys and analysis improve utilisation and reduce void space across the primary care

10 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

1. EXECUTIVE SUMMARY of the planned housing development data to inform the PCES NHS minimum standard requirement of Condition B, which should be development, is provided at Section 7. managed through routine contract monitoring processes.

The review and assessment of the existing primary care estate In addition to condition surveys, estimates of current space provision across LLR is detailed in Sections 8, 9 and 10 which identifies the for each practice (with reference to NHS England Space Maxima main risks, implications and issues across for each area and the Schedule (Premises Expert Advisory Panel)) have been made to suggested actions to be undertaken. Analysis indicates that the assess current clinical space provision within a building and to existing estate is in generally in good or satisfactory condition, with therefore identify any potential shortfalls which may impact on the some of this is influenced by an active history of decision making and ability to effectively respond to local population increases from investment, in particular a significant LIFT programme that was planned housing developments. adopted in Leicester City. This has enabled improvements in the existing primary care estate in addition to extensions and new build Based on proposed housing development and existing primary care premises for individual GP practices or within service centres where analysis, a number of ‘Hotspots’ have been identified where there is multiple services have been co located. However overall, the quality significant housing or estate impact of major significance across is mixed whereby there exists a small number of premises that are multiple primary care premises, or where that impact needs to be currently in poor condition across all three LLR Local planning considered across more than one PCN/HNN, which would require Authorities areas. partnership and joint working to address these challenges. The Hotspots information offers a basis for action planning to inform an All buildings within the existing estate require ongoing and effective Implementation Plan and is detailed in Section 11. estate management and investment, particularly in terms of statutory compliance with Fire, Health and Safety and Access, the Disability A high-level financial summary is included in Section 12. This Discrimination Act (DDA), and backlog maintenance to achieve the identifies a total risk cost of the existing properties across all CCGs,

11 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

1. EXECUTIVE SUMMARY subject to additional costs identified in the 6FSs undertaken in 2019 programme-based approach to managing implementation. This will (for fees, project management etc) which is estimated at £7,195,609 require translating strategic priorities into clear actions, setting clearly over a five-year period. Many of these costs will be ‘business as defined measures of success and timescales against which progress usual’ and therefore are the responsibility of owners/tenants rather of implementation can be monitored, particularly over the long term. than the CCGs. The improvements identified, particularly to respond to an increased local population as a result of planned housing The final section summarises the recommended next steps following developments, identifies that there is a potential space shortfall of completion of the PCES and its adoption by the relevant CCG/LLR 23,209m² across LLR. Estates Group. Next steps will then need to be agreed and undertaken by the CCGs, to develop an Implementation Plan. This is Based on current development costs this would require an estimated reflected in Section 14 together with the recommendations and next capital investment of circa £69 million pounds over a 20-year period. steps. The CCGs will need to review the finalised recommendations and share their intentions going forward with the wider GP/Primary The CCGs will need to identify a resource to progress the estates Care community as well as key partners across the individual agenda and based on current market prices a sum of £425k over the localities. Development of the Implementation Plan and actions will next five years would enable several priorities to be progressed using include undertaking further work to take forward key priories relevant activities such as Space Utilisation Studies, PIDs and including: Feasibility Studies. • Engagement with the wider CCG and Primary Care community An approach to the implementation of the PCES is outlined in Section • Sharing PCES with Partners through the Local Estates Forum 13 to support the CCG in the actions required to deliver the ambitions (LEF) of the Strategy. The CCGs will need to consider the necessary • Further development of a prioritised work plan to implement governance structures, capacity and capability to support a recommendations for improving current premises utilisation and

12 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

1. EXECUTIVE SUMMARY any potential developments that may be required to meet service commissioning plans • Undertaking key projects, including jointly with partners where required, to meet any bid timescales e.g. ETTF, next wave STP funding, and the potential offered by Section 106 opportunities.

This Strategy is a live document and offers a tool that will enable local organisations to determine their priorities and develop a robust Implementation Plan. It will be subject to regular review as STP strategies and plans continue to evolve and the CCG and partners move towards the further development of their Integrated Care System.

13 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

14 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

2. INTRODUCTION Primary care is at the forefront of demand for services and will primary care going forward is likely to be strongly influenced and continue to be the bed rock of NHS care as part of an integrated care shaped by the rapid changes that have occurred during the 2020 system. It is more than ever dependent on the provision of modern, Coronavirus pandemic. fit-for-purpose and flexible premises (supported by efficient, effective and innovative digital systems) from which to operate. The development of new commissioning models for ambulatory care, long-term conditions and urgent care, and the grouping of practices The Clinical Commissioning Groups (CCGs) also have a financial into Primary Care Network (PCN) arrangements, means and organisational responsibility to ensure the entire primary care neighbourhoods should consider the possible co-location of services estate is fit-for-purpose, has appropriate capacity, and achieves the that cross over primary care, community, and local authority services, best possible value for money – particularly in the context of the together with those elements of care currently delivered in secondary financial challenges facing the NHS both locally and nationally. care that could be integrated into commissioning models to deliver that care closer to home. Many health services are now delivered peripatetically or virtually from ‘hot desks’ in various locations, but general practice is still The objectives for this Primary Care Estates Strategy (PCES) is to largely delivered physically and face-to-face from consulting rooms inform and identify opportunities to: in well-established buildings. Changes in service models brought • Make the most of how existing primary care buildings are used. about by increasing use of technology will lead to changes in the way • Minimise or eliminate empty space and ‘void’ costs that existing premises are used in the future. Going forward, patients • Close or remodel premises which are not up to standard. are likely to have more contacts with a service digitally, with ‘virtual’ • Work with health and wider partners to better use all publicly consultations being delivered by telephone, email or video owned or leased estate within the same communities. conferencing through Telehealth, Skype, FaceTime, and other • Consider new build schemes where economically viable to existing and emerging digital platforms. Indeed, the delivery of achieve rationalisation of historic estates to enhance service

15 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

2. INTRODUCTION delivery and cost effectiveness. The outcome of the PCES will be to identify the condition and capacity of current premises and the space allocated for GMS Funding the primary care estate is currently undertaken by the NHS provision and provides an assessment of potential gaps in fit-for- reimbursing the rent and rates for general practices to provide and purpose, VFM premises required for the future. maintain quality premises as part of their contractual obligations. They do this either by owning or leasing appropriate premises. The space paid for is primarily used Monday to Friday with the majority unused over the weekend. Branch surgeries, funded through NHS reimbursement, may also offer opportunities for additional capacity and support service model flexibility; equally the failure to utilise such premises fully will continue to drain resources.

To assist the identification and development of estates opportunities that can contribute to maximising efficiency, consideration is given to how primary care buildings might absorb increased activity arising from changes in commissioning or population increases, both from natural growth and localised pipeline housing development. This will require the application of national guidance which specifies the ‘space maxima’ size required for a given number of patients to assess current shortfalls and quantify future need.

16 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

3. NATIONAL POLICY CONTEXT The prospect of resources being outstripped by demand, driven • Develop a more joined up primary care workforce, better able largely by an ageing population and an increasing prevalence of to dedicate the greatest amount of time to quality and health chronic diseases managed in primary care, presents a significant improvement for patients and local populations sustainability challenge to the way that care is commissioned from providers, both now and in the future. The General Practice Forward View (GPFV) is focused on four key themes: As part of a coordinated response to these challenges, the • An Estates and Technology Transformation Fund (ETTF) for Government has set out its ambitions in the NHS Five Year Forward primary care to:

View (FYFV) (NHS England et al 2014), the General Practice - Enable upgrades to practice premises and investment Forward View (GPFV) in April 2016, and more recently in the NHS in technology

Long Term Plan (LTP) (NHS England January 2019), all of which - Support better appointment, consultation, and require General Practice to change and develop to meet national workload management systems

targets and increasing patients’ needs. National policy drivers - Provide better record sharing across practices indicate that primary care needs to: • Steps to grow and develop the workforce • Work at scale making best use of new technologies • Plans to modernise infrastructure and technology and support • Develop and expand the workforce local practices to redesign the way modern primary care is • Provide for purpose premises offered to patients. • Offer improved signposting for patients to the most • Stipulates care redesign towards Primary Care Networks, appropriate service for them or (where appropriate) support federations and super-partnerships with a new voluntary GP selfcare Contract supporting integrated primary and community health services.

17 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

3. NATIONAL POLICY CONTEXT

Building on progress made since 2014 to address the slowdown in - Fundamentally redesign outpatient services, cut waiting funding growth, declining NHS performance, and workforce lists, and reduce delayed transfers of care

shortages, the NHS Long-Term Plan, was published in January 2019 - Allow all patients the right to access GP consultations via and sets out key ambitions for the service over the next 10 years telephone or online

along with a strategic direction towards place-based population - Provide patients the ‘right’ to access digital primary care health, all of which provides a clear thread from the FYFV towards services (e.g. online consultations), either via their more integrated, place-based care. The main commitments existing practice or the emerging digital-first providers

articulated in the plan set out significant ambitions for the - Implement the NHS app to provide a gateway for people development of primary care, which will have an impact on the to access services and information

management and use of strategic estates and the increasing use of - Enable people to be increasingly cared for and supported technology. Areas of focus for estates planning and technology at home, using remote monitoring and digital tools infrastructure include: • Changes to the payment system to support a shift from • Improving care outside hospitals, with increased funding for activity-based payments to population-based payments. primary and community care • General practices joining together to form PCNs; practices A shift towards integrated care and place-based systems, with an will enter network contracts which will include a single fund increasing focus on population health and ICSs is the main through which network resources will flow mechanism for achieving this transformation, supported by a new • All of England will be covered by Integrated care Systems ICS accountability and performance frameworks. (ICSs) by April 2021 and key responsibilities placed on PCNs • Development of ‘fully integrated community-based health PCNs are expected to take a proactive approach to managing care’ including increased capacity in community teams population health, moving towards assessing the needs of their local • Harnessing technology to: population to identify those who would benefit from targeted,

18 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

3. NATIONAL POLICY CONTEXT proactive support, with changes to the incentive scheme for GPs to encourage more personalised care.

19 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

20 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

4. LEICESTER, LEICESTERSHIRE & RUTLAND OVERVIEW Leicester, Leicestershire and Rutland (LLR) is located in the East • Derbyshire Health United Health Care Midlands served by three Local Authorities. The area borders • East Leicestershire & Rutland Clinical Commissioning Group Nottinghamshire to the north, Lincolnshire to the north-east and east, • East Midlands Ambulance Service NHS Trust Northamptonshire to the south-east, Warwickshire to the south-west, • Leicester City Clinical Commissioning Group Staffordshire to the west, and Derbyshire to the north-west. • Leicester City Council • Leicestershire County Council The following organisations operate across LLR and comprise • Leicestershire Partnership NHS Trust

the STP membership: • Rutland County Council

• University Hospitals of Leicester NHS Trust • Voluntary and Community Services (VCS) • West Leicestershire Clinical Commissioning Group

21 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

22 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

5. LLR STRATEGIC CONTEXT 5.1 System Overview organisations and local authorities to improve outcomes for patients and deliver care more efficiently, underpinned by the vision

The STP partnership focuses on three identified priorities: • Drive improvements in health and social care • Deliver core access and quality standards • Restore and maintain financial balance

The LLR Transformation and Sustainability Partnership identifies three key STP priority areas of improving health and wellbeing, care and quality and finance and sustainability, reflecting feedback from patients, carers and the public which prioritised: • GP services: access and availability, GP location and compassion • Hospital services: cleanliness, waiting times, accessibility, facilities, safe discharge The local system is coordinated through the LLR Sustainability and

Transformation Partnership (STP), known as Better Care The Community: care for the elderly, patients discharged from Together (BCT), was formed in 2014 to create improved and hospital and patients discharged from hospital, home services and sustainable health and care services for look after a population of availability of care homes. over one million people through integrating the activities of NHS

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5. LLR STRATEGIC CONTEXT 5.2 PC / PCN Strategy and social care to create an integrated person-centred out of hospital The Leicester, Leicestershire and Rutland health system has its care system. foundations in a resilient and effective General Practice. General Practice will continue to be the foundation of a strong, vibrant, joined Key to delivery of the new model of primary care are enabling up health and social care system. The approach focusses on patient strategies based on workforce, IT and estates. centred and integrated care, engaging local people who use services as partners in planning and commissioning, which results in the The practice and primary healthcare team will remain the core unit of provision of accessible high quality, safe needs-based care. care, coming together to collaborate in Networks or Federations, supported by community health care teams, offering a wider range of In response the national strategies including the GP Forward View services to manage patients appropriately in a setting closer to home, and the NHS Long Term Plan the area is implementing a Primary with increased access to rapid diagnostic assessment and, crucially, Care Strategy – the Leicester, Leicestershire and Rutland 2019/20- patients taking increased responsibility for their own health. These 2023/24 Primary Care Strategy (June 2019) - which was developed groups are known as Primary Care Networks (PCNs). Together they in partnership with system stakeholders and local GPs. This Strategy decide what services they are going to provide for their local patients supports the entire STP programme by putting GPs at the centre of to prevent and manage ill-health. patient care, based around population health delivered in Primary Care Networks. PCNs will expand the number of staff with different clinical and non- clinical skills sets to boost the practice team in primary care. These The Primary Care model puts GPs as expert clinical generalist will see new roles will include Physician Associates, Pharmacists, working in the community, together with specialists co-located in Medical Assistant and Physiotherapists and social prescribers. primary and community settings, supported by community providers

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5. LLR STRATEGIC CONTEXT From 1st July 2019, GP practices across LLR began working in The PCES provides a detailed baseline, housing growth forecast and twenty-five PCN groups. In the future teams will work across PCN level needs assessment, which will support the development of practices delivering care for the population of their PCN. a system wide long-term estates Implementation Plan and make the case for continued investment in primary medical care estate. A key There are seven PCNs in East Leicestershire and Rutland, eight action therefore in the STP Plan for Primary Care is to support covering West Leicestershire and ten for the City of Leicester. The practices to develop the primary care estate. City differs from the county in that the PCNS are less geographically contiguous which does not facilitate coherent analysis of the estate It is acknowledged that the role and responsibilities of Primary Care to determine a comprehensive strategy. Networks (PCNs) will develop as they further mature meaning that as PCN teams expand, their multi-agency and multi-specialty make- For the purpose of this report both the PCN footprint and the four up will be the catalyst behind real integrated working at a Health Needs Neighbourhoods (HNN) have been used. Neighbourhood level. To this end, the premises data and other To address the many challenges facing General Practice, including supporting information informing the strategy can also be deployed workforce, funding and demand, the LLR vision focuses on targeted to support planning at PCN and Health Needs Neighbourhood level. investment, improved premises and IT solutions.

It is recognised that investment in primary care premises is crucial to the successful implementation of the Primary Care Strategy. It will bring existing primary medical facilities up to date, address the growth in the number of new homes and associated population, ensuring there are appropriate facilities to support transformation across the healthcare system.

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6. HOUSING & POPULATION GROWTH PLANS The current national housing strategy is based on ‘Laying the sites or broad locations for growth for years 6-10 and, where Foundations: A Housing Strategy for England’ (2011) which identified possible, for years 11-15. that too few new homes are being built to meet current and future demand, and that housing has become increasingly unaffordable for Central to the requirements is ‘the presumption in favour of the majority of people. ‘Fixing Our broken Housing Market’ (2017) sustainable development’ with the need for the planning system to identified a new standardised methodology for assessing housing support communities through providing the supply of housing need on a council-by-council basis, replacing inconsistent methods required to meet present and future needs, ensuring greater housing used across different Local Authorities. This resulted in an updated delivery per annum, while also protecting the green space around the National Planning Policy Framework (NPPF), published in July 2018, City through prioritising brownfield over greenfield sites and local and alongside some further minor amendments in February 2019, policies to foster the development of small windfall sites. established a framework to reform the housing market and increase the supply of new homes in England. This was to be achieved This national policy approach is delivered through joint and individual through proposals which included planning for the right homes in the plans of the Local Authorities, comprising Leicester & Leicestershire right places, building homes faster, diversifying the market, and Authorities, working together to have a Joint Statement of Co- helping people now. operation Relating to Objectively Assessed Need for Housing (January 2017). This partnership approach includes Leicestershire The Framework stipulates that Local Planning Authorities (LPAs) County Council (with seven District/Borough councils) and two should use a robust evidence base to ensure that their Local Plan Unitary Authorities – Rutland and Leicester City – each responsible meets the objectively assessed needs for market and affordable for local planning and building control in the District and two housing in the housing market area including identifying sufficient key Highways authorities. sites to provide five years’ worth of housing together with developable

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6. HOUSING & POPULATION GROWTH PLANS Each LPA has identified its Local Plan and housing priorities through • Plan for a mix of housing based on current and future the undertaking of a series of evidenced-based exercises: The demographic trends, market trends and the needs of different Leicester and Leicestershire Housing and Economic Development groups in the community Needs Assessment (HEDNA 2017) has provided an integrated • Identify the size, type, tenure and range of housing that is assessment of future housing needs for Leicestershire between 2011 required in particular locations, reflecting local demand and 2031/36 with projections indicating a need for an average of • Where planning Authorities have identified that affordable 4,265 dwellings per annum to 2036 across the county. In addition, housing is needed, set policies for meeting this need the Strategic Housing Market Assessment (SHMA) (2014) identified • Multiplier (average number of persons per household) applied the housing need recommendations for the Leicester and (see Section 7.6 below for specific details). Leicestershire Housing Market Area (HMA) which covers all the authorities within Leicestershire County. Finally, the Joint Strategic An understanding of the number of homes that are deliverable Needs Assessment (JSNA) for Leicestershire (2015) identified the provides the basis for Local Authorities making judgements about the need for specialised and smaller, suitable units to meet the national five-year housing land supply in their area. The overall number of trend of an increasing proportion of older households and to meet the homes that could potentially be delivered on land identified as accommodation needs of young single people. These findings suitable for future residential use provides the basis for calculating underpin and reflect identified LLR regional issues including the need potential supply over the longer 15-year timeframe. Decisions about for affordable housing, and in particular the expected 75% increase the specific role of identified sites in providing a future supply of land in the total number of people aged 65 or more, necessitating housing is normally taken through the Local Plan review process. units to meet specialist requirements now and in the future. In delivering individual Local Plans there will be variance across LAs Each LPA has its own approach to housing development based on in terms of completions and their ability to meet the housing common principles including: requirements of their areas: There may be potential scope to absorb

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6. HOUSING & POPULATION GROWTH PLANS housing development across LA borders, for example, in order to Based on the SHELAA and Five-Year Land Supply (2017 update) the serve the specific population distribution, or to absorb unmet housing Council has identified a total of 21,923 housing units for the planning need into neighbouring LAs, which could lead to subsequent need period to 2032 (5,687 to 2022 and 16,236 to 2032) which could for cross-border infrastructure improvements, such as highways increase the population by circa 54,808, however the Council cannot development. identify sufficient land for this quantum of development.

In line with these planning requirements, each LLR LA identifies local Some 65% of Leicester City’s housing requirement falls within the housing issues and priorities for their area to: Leicester City Principal Urban Area (PUA), together with • demonstrate a rolling five-year supply of deliverable housing land development of the Sustainable Urban Extensions (SUEs) at • identify a supply of developable sites for the next 6-10 year period Hamilton and Ashton Green, and a significant number of smaller sites • and where possible, identify a supply of developable sites for in existing residential areas across the City. To meet the housing years 11-15. targets for the PUA outside the City, the Council is therefore working with Charnwood, Harborough and Blaby District Councils to explore Information from relevant LPA documents are outlined in the rest of options for the location of SUEs. this Section with more applied detail included in the relevant estate review sections of each LA area. 6.2 Housing Development in Leicestershire County Council Area 6.1 Housing Development in Leicester City Council Area Leicestershire County Council is a two-tier Authority where some Based on supply estimates Leicester City Council has declared an functions are delivered on a County-wide basis. Housing planning unmet housing need and will require assistance from other HMA and delivery is undertaken at the District or Borough Council level partners to deliver its unmet need up to 2031. comprising: • North West Leicestershire District Council (NWLDC)

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6. HOUSING & POPULATION GROWTH PLANS • Hinckley & Bosworth Borough Council (HBBC) 2032 (0-5 years 3,686; 6-10 years 17,151 and 11-15 years 18,394) • Charnwood Borough Council (CBC) which could increase the population by circa 81,819 over this period. • Blaby District Council (BDC) • Oadby & Wigston Borough Council (OWBC) Charnwood Borough Council proposes several SUEs to • Melton Borough Council (MBC) accommodate housing development with Leicester Principal Urban • Harborough District Council (HDC) Area the main priority for growth, including developments at Loughborough and Shepshed, with some to the east of Thurmaston, Overcrowding and the need for affordable housing are key issues for and Birstall in South Charnwood. Based on the SHELAA (2018) the North West Leicestershire District Council, with a focus on Ashby de council has identified a total of 31,908 housing units for the planning la Zouch, together with large scale residential developments in period to 2032 (0-5 years 5,258; 6-10 years 14,474 and 11-15 years Coalville, Measham and Kegworth. Based on the SHELAA (2019 11,879) which could increase the population by circa 71,217 over this update) the Council has identified a total of 30,180 housing units for period. the planning period to 2032 (0-5 years 3,010; 6-10 years 2,850 and 11-15 years 24,362) which could increase the population by circa Much of Blaby is part of the Leicester Urban Area with Blaby District 69,414 over this period. Council plans focused on extending this urban area through large scale housing developments at Lubbesthorpe and Enderby, together As a largely rural area, significant issues for Hinckley and Bosworth with development around Blaby. Affordable housing and increasing Borough Council includes access to services and facilities, house prices are growing issues for the District Council. Based on particularly health facilities; affordable and special needs housing for the SHLAA (2017) the council has identified a total of 22,766 housing an ageing population; and transport, with affordable homes a key units which could increase the population by circa 54,183 for the priority. Based on the SHLAA (2019 update) the Council has planning period to 2031. identified a total of 36,690 housing units for the planning period to

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6. HOUSING & POPULATION GROWTH PLANS Oadby and Wigston Borough Council focuses on Wigston, Oadby The spatial policy for the Borough identifies Melton Mowbray Main and South Wigston as key areas for new development up to 2031, Urban Area as the priority growth location to accommodate with the need for affordable housing a priority. This District Council approximately 65% (3,981 units) of the Borough’s housing need with area cannot meet its housing targets from currently identified sites. the remaining 35% being in the more rural settlements. Based on the Local Plan (2019) a total of 3,757 housing units have been identified which could increase the population by circa 9,167. Harborough District Council has identified potential Strategic This is only a 5-year supply as the Council is challenged to be able Development Areas for large scale housing development at Market to identify suitable and available sites for 6-10 years and 11-15 years Harborough, Lutterworth and Scraptoft. Based on the SHLAA (2015 due to the urban nature of the area. and 2016 update) the Council has identified a total of 23,281, housing units: in of which 3,457 would be delivered within 0-5 years ; 7,201 in Melton Borough Council has identified the development of a total of 6-10 years ; 6,307 in 11-15 years; and 6,307 in 16+ years, which 6,125 houses by 2036 meeting the housing requirement of an could increase the population by circa 60,329. average of 245 houses per year based on Appendix 5 of the Local Plan (October 2018) In total, should all proposed housing development be delivered, this would result in a potential population increase of circa 352,150 within These plans could increase the population by circa 2,744 within a the Leicestershire County Council Area over the next 15 years, with five-year timescale and up to 13,720 new residents by 2036. an increase of circa 55,000 people in five years, based on each individual LA’s predicted development quantum within its five-year The availability of affordable housing is an issue across the Borough land supplies. and the Council have identified a need for around 1,750 affordable houses and included these within this planning target.

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6. HOUSING & POPULATION GROWTH PLANS 6.3 Housing Development in Rutland County Council Area The population of Rutland is also projected to grow from a Based on the Rutland SHELAA 2019 the Council has identified a development site at Little Casterton which is included in the SHLAA requirement for circa 5,488 additional houses. for South Kesteven District Council but straddles both Authority areas. This will result in circa 650 houses being built within the Rutland County Council – has a high ratio of house prices to Rutland Council area and are therefore included in the Rutland household income creating a need for a significant increase in numbers. affordable housing. Based on the SHELAA (2018) the council is identifying a total of The County Council have identified Oakham and Uppingham as the 31,908 housing units for the planning period to 2032 (0-5 years most sustainable locations for new housing development, together 3,686; 6-10 years 17,151 and 11-15 years 18,394) which could with a priority development at Quarry Farm as part of a single increase the population by circa 11,740 people. extension on the north site of Stamford in conjunction with land located within South Kesteven District to create a larger urban 6.4 Overall Impact of Proposed Housing Development across extension to meet the housing need. LLR Over the time periods of the SHLAA and Local Plan documents a A key development is to create a new planned settlement, a garden total of circa 179k additional units are required to meet national community based on garden village principles on St George’s targets, providing housing for an increased population over the Barracks, North Luffenham when it is vacated by the MOD in 2022. period of circa 411k people. Due to the land constraints of Leicester This is expected to deliver up to 2,215 new homes over the lifetime City, their plans have an identified shortfall of just under 14k units, of the development commencing in 2024, of which at least 1,000 which cannot be delivered within the city boundaries. This homes will be delivered by 2036, with delivery expected to continue demonstrates the importance of the City working in partnership with beyond the current Plan period.

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6. HOUSING & POPULATION GROWTH PLANS surrounding Authorities councils to address these land constraints to meet its housing requirements.

In developing strategies to manage future population growth and housing needs, the infrastructure requirements to support these planned developments also need to be considered. The wider Midlands region as a whole has significant international and national road, rail and air links. The Prospectus for Growth (2017 and 2019) outlines how the ‘Midlands Engine’, a Public and Private sector Partnership (PPP), is working to improve transport connectivity between towns and cities within the Midlands and with other key centres elsewhere through the Transport for the East Midlands (TfEM) strategy which focuses on identifying and delivering major transport infrastructure that could help improve the Midlands’ long-

term economic growth. Central to TfEM are a number of transport infrastructure priorities, with a key focus on the SW-NE traffic routes of the A46 corridor. This includes considering alternative strategic link roads around the Leicester urban area which are currently restricted and congested, impacting on the potential of further development to the south and east of Leicester. Leicester Western Bypass and the M1 between junction 21 and 21a are also key priorities.

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6. HOUSING & POPULATION GROWTH PLANS The ‘A46 Expressway’ alone is expected to unlock 4,000 hectares of land in the Leicester urban area, for potential development.

This Prospectus outlines significant growth plans including the opportunity for the delivery of potentially 117,900 houses as new roads allow access to additional land for development. Whilst these schemes will not have immediate impact and are not within current SHLAA plans, further significant housing development by 2050 needs to be considered as part of long term strategic primary care estates planning.

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7. METHODOLOGY & PROCESS FOR THE REVIEW 7.1 General Approach • Recommend and identify priorities/actions and a framework The Primary Care Estates Strategy (PCES) review was funded for decision making and delivery support. through NHSE/I and commissioned from Leicester LIFT Company • Completion of further works to meet the requirements of Limited (LEL) by the CCGs to cover the LLR area under an explicit specific areas, based upon outcomes of the PCES and Contract and Project Brief to achieve the following outcomes: funding remaining, will be informed by this commission.

• LLR Primary Care Services Estate Strategy (PCES) The agreed brief for the commission was undertaken through two document based upon the three CCG and 25 LLR PCNs, independent elements: subsequently modified in February 2020 to be based on the three Local Authority (LA) structures broken down into seven District/ Workstream 1: completion of six Facet survey (6FS), as required, and Borough councils for the Leicestershire County Council area and 25 a strategic review of the PCE across the twenty-five PCN areas to PCNs retain and promote the operational integrity of these sub areas. • Evidence based review of PCE using existing and new data. • Summary of emerging strategic vision of Primary Care Workstream 2: production of an LLR Primary Care Estates Strategy. Strategy and how the estate can enable this. • Integration into the wider STP Strategic Estates Plan. • Set the economic context and consider funding implications and options for additional resources. • Identify priorities for improvement /investment and the financial impact of these. • Identify current and future population needs within CCG areas, and LLR as a whole, - including housing growth.

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7. METHODOLOGY & PROCESS FOR THE REVIEW This is summarised in the table below 7.2 Six Facet Building Surveys These were undertaken across LLR by building surveyors based Workstream 1 - 6 Facet Surveys CCGs to provide a full list of GP properties to be subject of six facet upon the industry standard 6FS methodology and process. (At the surveys. request of the CCGs, the documentary aspects associated with Facet CCGs to inform identified practices that the surveying company will be 5 (Statutory Compliance) was omitted). contacting them to arrange appointments/access to their premises.

Undertake 6 Facet Surveys of all identified premises. 6FSs assist occupiers and commissioners in financial planning, Complete all survey data and QA checks of assessments. investment and prioritisation by providing an overview of a building’s Workstream 2 – PMSES and Implementation Plan condition, use, quality and compliance. The six Facets are as follows: The activities marked * are dependent on all the 6F surveys having been completed Receive (from CCGs) current commissioning, service and estateFacet 1 Physical Condition information. Facet 2 Functional Suitability *Desk top review (estate) - existing data into agreed localities/groupings, create asset maps, develop base estate information and review Facet 6 Facet 3 Space Utilisation data as surveys are completed. Facet 4 Quality *Action planning based on issues arising from mapping to inform an Implementation Plan. Facet 5 Statutory Compliance (Fire, Health and Safety) *Draft Strategy and Implementation Plan incrementally as data processes Facet 6 Environmental Management are completed.

*Issue finalised Draft Strategy and high level Implementation Plan for comment. To compile the survey programme, the CCGs provided the list of *Revise Strategy in line with client comments. premises, the Gross Internal Area (GIA) of the relevant GP practice, *Issue final version of Leicester, Leicestershire and Rutlandand the NHS Contract Number for each practice. Primary Care Estates Strategy.

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7. METHODOLOGY & PROCESS FOR THE REVIEW It should be noted that the LIFTCo buildings in the city of Leicester reference guide when reading the 6FS results detailed later in this were excluded from the survey programme due to the nature of the Report. Lease+ contract which requires premises to meet current legislation regarding Health and Safety, and Condition B standard. Also The findings of the 6FS are presented in tabular form whilst the key excluded were Village Halls leased on a sessional basis in more rural issues arising from the survey are summarised against each premise. areas, as these are multiuse properties/environments and are not provided for comprehensive clinical services. Effective estate management of primary care premises will also need to ensure that all areas meet infection control standards through the Having agreed the list of premises the following process was replacement of inappropriate floor coverings in employed: consultation/treatment rooms, routine repairs and replacements, and • Survey programme undertaken June to September 2019 cyclical redecorations to achieve or maintain the Condition B • CCGs managed the appointment process, communicating standard. directly with each practice • Each premise was visited by a qualified Chartered Surveyor The approach to Risk and Backlog maintenance cost is defined by • Standard assessment and document processes were used the Royal Institute of Chartered Surveyors (RICS). Building • Individual reports were completed for each premise. components deteriorate and wear out with time and use. Backlog maintenance cost is the cost to upgrade estate assets that are below The Classification Index specifies the scoring grades for each Facet, condition B in terms of their physical condition and/or compliance with as set out by the Royal Institute of Chartered Surveyors (RICS) and mandatory fire safety. Risk cost is the projected costs for planned is an industry standard tool and results framework. This framework maintenance within a five-year time horizon to ensure that all is included as Appendix 1 along with a worked example as a components function adequately, preserve the value of the building, satisfy legal obligations and are maintained in Condition B. These

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7. METHODOLOGY & PROCESS FOR THE REVIEW Risk costs and the Backlog costs are added together as part of the The following general comments and explanations apply to the standard 6FS process and are shown in the sections as Total Risk results in all areas. Cost. 7.3 Survey Considerations In addition to the 6FS grading of Facet 3, the opening hours of each At the request of the CCG, the 6FSs did not review H&S/compliance of the premises has been collated using information from GP practice documentation; however, this does not obviate the need for ongoing websites. This is shown in the opening hours graphic in each effective estate management of the buildings, particularly in terms of PCN/HNN with the number of premises that meet each category as compliance with statutory Fire and H&S obligations. Access in line follows for assessing the space utilisation for a building. with the Disability Discrimination Act (DDA) will also need to be addressed by the CCG in order to satisfy guidance issued by DoH. Surgery Opening Hours Definitions All these elements of estate management and compliance should be Core 08.00-18.00 Mon - Fri. reviewed and managed through standard GMS contract Core plus (+) 08.00-18.00 plus extended hours either Mon-Fri management processes.

or weekends. 7.4 Premises Sizing Considerations Core minus (-) Less than full core opening hours of 08.00 -18.00 The NHS has guidelines for GP practices regarding the space they Mon - Fri. will reimburse under the contract for the provision of general medical

services. For premises planning this is the Gross Internal Area (GIA) The following sections present the results and analysis of primary and is a square metre (m²) measurement. The current maxima size care medical services estate across LLR. Each section is structured schedule based on NHS Premises Guidelines is summarised in the as appropriate, at unitary LA level then at PCN or Health Needs table below and needs to be used in considering options for a primary Network (HNN) level, or for Leicestershire at County Council, District care estate. An allowance of 0.08m² per registered patient has been / Borough Council, and then PCN level.

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7. METHODOLOGY & PROCESS FOR THE REVIEW used as the basis for assessing both current and future/calculated 7.5 Housing Considerations space requirements. The Strategic Housing Land Availability Assessment (SHLAA) Gross Internal Areas (GIA m²) - effective from 1 April 2013 housing impact information used is presented in tabular form and has PREMISES FOR 1 – 10,000 registered patient list size been broken down by five-year periods (0-5 years, 6-10 years and Number of patients 2,000 4,000 6,000 8,000 10,000 11-15 years). In some areas, where available, post- 15-year housing Type of Premises (See A A B B B data has also been included. This information has been used to notes (i) and (ii) identify the potential number of housing units planned for each Gross Internal Area (GIA 199 333 500 667 833 defined geographic area (i.e., District or County Council, PCN, or m²) Allowance HNN).

PREMISES FOR 10,001 – 20,000 registered patient list size Number of patients 12,000 14,000 16,000 18,000 20,000 Analysis of the planned housing development data has been undertaken, as requested by the CCG, on a PCN, HNN and Type of Premises (See B B B B B notes (i) and (ii) District/Borough Council basis. It needs to be noted that, due to the slightly different geography of PCN/HNN and District Council areas, Gross Internal Area (GIA 916 1,000 1,083 1,167 1,250 m²) Allowance the total number of proposed housing units across a PCN or HNN area may differ from the number reported in its associated Notes: (i) Type A – Single storey premises District/Borough Council area. This variability is further compounded • Type B – Two storey premises with 1 staircase and 1 lift • Where a staircase or lift is not built the GIA allowance should be by variations in potential new patient numbers due to patient flow, reduced accordingly. (ii) Exceptionally, where 400m² contractor premises need to be built which can be considered based on relative proximities of proposed on two storeys housing developments and existing practice buildings but cannot • NHS CD may add 35m² for 1 staircase and 1 lift. otherwise be precisely predicted. In sum, it is challenging to estimate the precise impact that a future population increase might have on

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7. METHODOLOGY & PROCESS FOR THE REVIEW any given practice premise. Accordingly, the analysis has identified Multiplier used potential patient flows to areas that are geographically adjacent e.g. Local Authority (Average No of Persons per neighbouring PCNs or council areas, which in turn has resulted in Household based on Govt. Table 427) possible net inward or outward migration across council boundaries Leicester City Council 2.50 and those of the administrative groupings of PCNs and HNNs. As a Leicestershire County Council Area consequence, housing numbers within LA and District Council • North West Leicestershire DC 2.23 SHLAA tables do not necessarily correspond with the numbers in • Hinckley & Bosworth BC 2.23 associated PCN/HNNs. • 2.29 Charnwood BC • 7.6 Population Impact of Housing Development Blaby DC 2.38 Potential increases in patient numbers have been calculated using • Oadby & Wigston BC 2.25 government issued data in Table 427 Change in Average Household • Melton BC 2.24 Size Local Authority Districts and England 2014-2039. • Harborough DC 2.25 Rutland County Council 2.14 For the council areas across LLR these range between 2.14 and 2.50 people per household and the appropriate figure is used to calculate 7.7 ‘Hotspots’ the population impact of the housing developments as shown in the As part of the housing and primary care estate analysis, ‘hotspots’ table below. have been identified where there is a significant housing or estate impact of major significance across multiple primary care premises, or where that impact needs to be considered across more than one PCN/HNN. Addressing such issues and challenges will require partnership and joint working.

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7. METHODOLOGY & PROCESS FOR THE REVIEW Based on the analysis of the primary care estate and planned housing development information, the risks and implications for each PCN or HNN are described and are linked with Hotspot information outlined in Section 8. Both the analysis and Hotspot detail provide a basis for action planning to inform an Implementation Plan.

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8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

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8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

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8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.1 Socio-economic Profile Birmingham to London Stansted Cross Country line. The city centre Leicester City Council (LCtyC) is a Unitary Authority covering the is very accessible by bus: 96% of Leicester’s population lives within urban area of Leicester totalling 28 square miles, excluding parts of a 400m walk of a bus stop and less than a 30- minute journey to the the wider urban area which fall within the County. The Council has city centre. an elected Mayor.

Geographically and culturally, Leicester sits at the centre of Leicestershire, Services across both the City and County tend to be centralised, including transport links which have a radial pattern within the City.

There is an ambitious five area strategy to develop the City, including: connecting together aspects of its economic life; improving public transport; transforming the Waterside area; increasing school provision; and attracting inward investment. If delivered as planned these changes will materially affect the population of the city, thus also impacting upon the provision of services.

Situated to the east of Junction 21 of the M1, Leicester has good road links with the confluence of the M1/M69 motorways and the A6/A46 Leicester has a large manufacturing sector with low average incomes trunk route. Leicester is also at the intersection of two major railway and limited job opportunities. The highest number of people are lines, the north–south Midland Main Line and the east/west employed in the Public Administration, Education & Health sectors.

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8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.2 Demographic Profile 80 increasing. Elderly populations tend to be clustered on the outer Leicester City has a current population of 355,218 (Public Health fringes of the City, particularly on the east side. Profile 2018) with projections indicating the population will grow quickly. Leicester has one of the largest ethnic minority populations in England, however White is the largest ethnic group in the City with 50.6 percent of the total population. There has been a steady growth in numbers of all ethnic groups since 2001, with most minority communities located predominantly in the north of the City.

8.3 Health Needs Leicester is in the lowest decile of deprivation nationally and has neighbourhoods that fall within the lowest 5% most deprived of all areas in the country. These neighbourhoods are located predominantly on the western side of the City and have a largely white population.

Leicester residents are less likely to have a higher-level qualification compared with the national average, and the City has high levels of benefit claimants and unemployment compared with both Compared to the national average, Leicester has a younger aged Leicestershire and the national average. Average household income population profile and a smaller percentage of pensioner households in Leicester is 20% below the national average and approximately and lone pensioner households, despite the number of people over 23% (17,100) of children are in low income families.

45 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE Leicester has high inequality in life expectancy and health compared Affordable housing need is significant, with an identified shortfall in to other parts of the country. Life expectancy in the City is highest in the City of 790 affordable units per annum over the next seven years the traditionally more affluent areas of south east Leicester, and (LLSHMA, 2008) and an overall affordable housing target of 4,065 lowest in the inner-city and the outer estates in the west. for the City for 2006-2026 an average of 204 new dwellings per year.

Premature mortality rates from circulatory disease and cancer in the Overcrowding is also an issue, particularly within ethnic minority City are higher than national averages, and there are relatively high households, however overall, average household size is expected to levels of respiratory disease, particularly asthma, across the fall, driven in particular by an increasing ageing population that population. Premature death from cardiovascular disease is highest typically tend to occupy smaller sized dwellings. in estates within the west of the City, and there is a particular concentration within the inner-City. More than half of residents have Some 65% of Leicester City’s housing requirement falls within the a high BMI with obesity levels highest in the outer estates. Leicester City Principal Urban Area (PUA), which together with the development of SUEs at Hamilton and Ashton Green, and additional 8.4 Housing smaller sites, will meet the City’s challenging housing targets. In The Leicester & Leicestershire Strategic Growth Plan (LLSGP) order to meet the housing targets for the PUA outside the City centre, (September 2018) established a demographic need for 1,692 the Council is working with Charnwood and Blaby DCs to explore dwellings per annum and a total of 33,840 new dwellings across options for the location of additional SUEs. Leicester City between 2011- 2036. Based on estimations of supply, the City has declared an unmet housing need and will require assistance from other HMA partners to deliver the required quantum up to 2031.

46 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE The table below shows the housing numbers based on the LLSGP 2018.

Estimated Projected Additional Ward Core Strategy Area dwellings Pts (2.5)

Abbey Suburbs 3,148 7,870 Aylestone Suburbs 312 780 Beaumont Leys Ashton Green 1,000 2,500

Strategic Belgrave 1,017 2,542 Regeneration Area

Braunstone Park & Rowley Outer Estates 202 505 Fields Castle Inner Areas 3,407 8,517 Eyres Monsell Outer Estates 33 82

Strategic Fosse 229 572 Regeneration Area

Humberstone & Hamilton Hamilton 372 930 Knighton Suburbs 160 400 North Evington Outer Estates 173 432 Rushey Mead Suburbs 334 835 Saffron Inner Areas 306 765 Spinney Hills Inner Areas 100 250 Stoneygate Inner Areas 88 220 Thurncourt Outer Estates 13 32 Troon Suburbs 219 547 Westcotes Inner Areas 341 852 Wycliffe Inner Areas 20 50 Total: 8,035 28,618

47 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.5 Map of Practices and Potential Housing in Leicester City

48 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.6 Specific Considerations for Leicester City Analysis Previously the City has worked across four defined Health Needs As illustrated in the map at the start of this section, GP practices are Neighbourhoods (HNNs): Leicester Central HNN; North and East organised into ten PCNs within the relatively small geographical City Leicester HNN; North and West Leicester HNN; and Leicester South area. These operate as administrative entities and do not align with HNN as per the map below: effective estate planning, which therefore needs to be approached Analysis has subsequently been undertaken at both PCN and HNN from a geographic perspective. level, and the following results are organised to reflect the HNN structure across Leicester City.

49 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.7 Leicester Central Health needs Neighbourhood (LC HNN)

50 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.7.1 Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Comme nts Six Facet Survey Summary NHS Contract Patient List GIA Map No. PCN Practice Name/Address Tenure Multi-site Code Size m² Physical Functional Space Quality Fire H&S Environmental Pre mise s Backlog Yr 1-5 Condition Suitability Utilisation Asse ssme nt Maintenance incl H&*S Brandon Street Surgery, Belgrave • LIFT building C82107 Health Centre, 52 Brandon Street, • May be subject to long lease with limited break opportunities 123 Millenium 7,731 245 Leasehold Single A* B* U* B* B* B* 9.0 £0 Leicester, LE4 6AW

• 1970s purpose-built surgery Dr AM Farooqi & Partners, East • Leasehold premises (NHSPS) which may be subject to long lease with limited break opportunities Leicester Medical Practice, 131 Aegis C82063 • Building Quality B/C, Functional Suitability/Quality C 134 Uppingham Road, Leicester LE5 12,143 1500 Leasehold Single B/C C F C B C 11.5 £128,450 Healthcare • Moderate cracking to the first floor requires further investigation 4BP • Investment required for routine repairs and maintenance and replacements eg windows if tenant liability • FRA recommended • Three 1920s residential properties converted for surgery use in 1960s Dr Pancholi & Partners, Spinney • Building Condition B/C, Quality C Hill Medical Centre, 143 St • Investment required for routine repairs and maintenance, cyclical redecoration and replacements eg PVCu windows reaching 138 495 Freehold Main B/C B F B C D* 10.5 £65,325 Saviours Road, Leicester LE5 3HX the end of their serviceable life, wash hand basins and worn floor coverings which do not meet infection control • Access audit recommended to identify potential improvements such as installation of an automated entrance door • Fully utilised and practice overall is below the recommended GIA space maxima for the registered patient numbers • 1900s converted premises • Building Condition B/C, Functional Suitability and Quality C Belgrave & C82024 21,082 • Investment required in internal and external maintenance and cyclical redecorations Spinney Hill • Investment required to ensure compliance with infection control and H&S eg worn/inappropriate floor coverings in clinical Dr Pancholi & Partners, 132 rooms Doncaster Road, Leicester LE4 139 374 Freehold Branch B/C C F C C D* 12.5 £49,410 • Replacement recommended of dated vanity units and aged fluorescent light fittings 6JJ • Some privacy issues associated with acoustics • No parking provisionn • Recorded as fully utilised although closed one afternoon a week • Practice overall is below the recommended GIA space maxima for the registered patient numbers • Access audit recommended Dr R P Pandya & Partners, East • 1900s converted property Park Medical Centre (Dr Pandya), • Internally, the surgery is in a reasonable condition, with the main requirement being for cyclical redecoration 140 368 Freehold Main B B U B B C* 10.0 £29,218 264 East Park Road, Leicester LE5 • No parking provision although surgery overall under the recommended GIA for registered patients 5FD • Under utilised • 1900s converted terraced domestic property Belgrave & C82037 10,552 • Building Condition B/C Spinney Hill Dr R P Pandya & Partners, East • In general, the building is in a satisfactory condition, and would benefit from cyclical redecoration within the next three years Park Medical Centre (Doncaster 141 271 Freehold Branch B/C B F B B C* 9.5 £16,846 • Some privacy issues associated with acoustics Road) 41 Doncaster Road, • No parking provision Leicester LE4 6LJ • FRA recommended • Fully utilised • Converted semi-detached residential property with later extension Dr B Modi, 122 Canon Street, Belgrave & C82084 • Cyclical redecoration and replacement WCs required 142 Leicester, LE4 6NL 3,285 93 Freehold Single B B F B B C* 9.0 £7,390 Spinney Hill • Fire doors require attention • Fully utilised • 1920s converted resident property • Building Condition B/C, Functional Suitability/Quality • Investment required for external maintenance eg areas of spalling brickwork, missing lead flashing between flat roof and adjoining building, polycarbonate rooflights etc Dr KS Morjaria & Partner, 10 Belgrave & C82651 • Investment required for routine repairs, maintenance, cyclical decorations and replacements eg cracked / blown plaster to 143 Broadhurst Street, Leicester LE4 4,046 103 Freehold Single B/C C F C C E* 12.5 £10,970 Spinney Hill walls, heavily worn carpet, aged and worn vanity units and aged and discoloured light fittings 6NF • Poor DDA provision and stairwell steep and narrow • No parking provision due to restrictions of the site • Small surgery which provides 2 clinical rooms and reported as fully utilised • Access audit recommended The Charnwood Practice, The • LIFT building Belgrave & C82667 Merlyn Vaz Health & Social Care • May be subject to long lease with limited break opportunities 144 7,436 586 Leasehold Single A* B* U* B* B* B* 9.0 £0 Spinney Hill Centre, 1 Spinney Hill Road, Leicester, LE5 3GH

51 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary NHS GIA Multi- Assessm Map No. PCN Contract Practice Name/Address Tenure Comme nts m² site ent Backlog Yr 1-5 Code Physical Functional Space Fire Premises Quality Env Maintenance incl Condition Suitability Utilisation H&S Assessment H&S

• Converted Victorian school used as a mix use community building • Sub-lease from NHSPS Dr ZS Osama & Partners, The • Practice occupies the majority of the ground floor Community Health Centre, The Leicester C82643 • Excessively noisy Melbourne Centre, Melbourne 12,953 450 Lease Single B A F C B E* 9.0 £183,050 153 Central • Investment for routine repairs, maintenance and cyclical redecoration required Road, Leicester LE2 0GU • Capital investment required to improve the patient offering : Reception, waiting room and entrance which require modernisation • Reported as fully utilised and below the assessed space maxima GIA for the patient list size

Heron GP Practice, The Merlyn Vaz Health & Social Care Centre, 1 • LIFT building 388 Lease Main A B U BB B* 9.0 £0 154 Spinney Hill Road, Leicester, LE5 • May be subject to long lease with limited break opportunities 3GH

Leicester •Practice housed on ground floor of 1960s purpose built Y02469 9,257 Central • Leased premises (LPT) which may be subject to a long lease with limited break opportunities Heron GP Practice, St Matthews • Cyclical redecoration programme and replacement of aged flooring and sink/vanity units in clinical areas recommended Health & Community Centre, • Evidence of historic leaks in the administration area, one at low level to a wall and one with water marks down an internal 63 Lease Branch B B U BBD 10.0 £24,105 155 Prince Philip House, Malabar Road, downpipe. Leicester LE1 2NZ • Consulting rooms unconventional shape, due to the existing layout of the building although smaller than average • Under-utilised although overall the practice is below the assessed space required for the current registered patients

Dr F Docrat, Shefa Medical Leicester C82080 Practice, St Peter's Health Centre, • LIFT building 4,855 199 Lease Single A* B* U* B* B* B* 9.0 £0 157 Central Sparkenhoe Street, Leicester LE2 • May be subject to long lease with limited break opportunities 0TA

Highfields Medical Centre, Merlyn Vaz Health & Social Care Centre, 1 • LIFT building 109 Lease Main A* B* U* B* B* B* 9.0 £0 158 Spinney Hill Road, Leicester, LE5 • May be subject to long lease with limited break opportunities Leicester C82642 3GH 9,836 Central Highfields Medical Centre, Belgrave Health Centre, Brandon Street, • LIFT building 130 Lease Branch A* B* U* B* B* B* 9.0 £0 159 Leicester, LE4 6AW • May be subject to long lease with limited break opportunities

• Converted Victorian building with 1980s extension • Building Condition/Functional Suitability and Condition C waiting area too small, internal circulation and access iussues and one patient WC • Investment required for internal and external maintenance, repairs and replacements including dated and heavily worn internal Leicester C82116 Highfields Surgery, 25 Severn 3,727 216 Lease Main C C O CC D* 15.0 £56,110 finishes and fluorescent lighting 160 City Central Street, Leicester, LE2 0NN • Surgery overcrowded and below GIA for registered patient numbers • No parking provisions due to site restrictions • Access audit, FRA and asbestos survey recommended

52 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary NHS GIA Multi- Assessm Map No. PCN Contract Practice Name/Address Tenure Comme nts m² site ent Backlog Yr 1-5 Code Physical Functional Space Fire Premises Quality Env Maintenance incl Condition Suitability Utilisation H&S Assessment H&S

• 1930 converted terraced former residential property with 1970s extension • Leased premises but awaiting lease • Building Condition/Functional Suitability and Condition C • Window replacement and external maintenance programme required • General modernisation of ceilings and lighting and cyclical redecoration required and replacement of carpets and wash hand Evington Medical Centre, 2-6 basins and fixed units in clinical rooms not to current infection control standards Halsbury Street, Leicester LE2 298 Lease Main C C U CB D* 13.0 £96,960 161 • Some privacy issues associated with acoustics 1QA • Under utilised • No parking provision • Access audit recommended owing to limited access to the main entrance and the lack of access to the upper floors for those with mobility issue C82088 The Fox's 8,871 • Asbestos survey recommended

• Two converted 1920s buildings with later extension • Leasehold premises and awaiting lease • Building Condition/Functional Suitability and Quality C Evington Medical Centre, 30 • Investment required for routine repairs, maintenance and replacement programme and cyclical redecorations to ensure that all Loughborough Road, Leicester, 211 Lease Branch C C F CB D* 12.0 £55,180 162 areas meet infection control standards eg flooring wash hand basins toilets etc and H&S LE4 5LD • Fully utilised • No parking provision • Access audit recommended

• Victorian residential conversion with two later 21stC extensions with conversion of an additional room to clinical use underway • Building Condition B/C, Functional Suitability/Quality C • Requires external and internal redecoration and replacement lighting and flooring in clinical areas • Some privacy issues associated with acoustics Dr KA Choudhry, Al-Waqas C82099 • Inadequate patient WC provision The Fox's Medical Centre, 91 St Peter's 4,269 243 Free Single B/C C F C C E* 12.5 £65,585 163 • No parking provision Road, Leicester LE2 1DJ • Access audit recommended to advise on improvements to the reception area, entrance and first floor (narrow and steep stairwells) • FRA review recommended • Reported as fully utilised but close one afternoon a week

Dr S D'Souza & Partner, St Peter's • LIFT building Health Centre, Sparkenhoe Street, 157 Lease Main A* B* U* B* B* 9.0 £0 165 • May be subject to long lease with limited break opportunities Leicester LE2 0TA

C82660 The Fox's 6,236 •1930s residential building converted and extended in 2000s • Leasehold premises Dr S D'Souza & Partner, 282 • Building Condition B/C 136 Lease Branch B/C B F BB D* 9.5 £25,820 166 Queens Road, Leicester, LE2 3FU • Routine maintenance and replacement required • Access audit recommended to identify potential improvements • Fully utilised

Dr R Kapur & Partners, St Peter's C82659 • LIFT building The Fox's Health Centre, Sparkenhoe Street, 2,717 142 Lease Main A* B* U* B* B* B* 9.0 £0 168 • May be subject to long lease with limited break opportunities Leicester, LE2 0TA

Dr R Kapur, Belgrave Health C82671 • LIFT building The Fox's Centre, 52 Brandon Street, 5,213 106 Lease Main A* B* U* B* B* B* 9.0 £0 169 • May be subject to long lease with limited break opportunities Leicester LE4 6AW

53 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

LCentral HNN: Building Age/Type 10

8

6

4

2

0 1800s 1900s 1960s 1970s 1980s 1990s 2000s 2010s

Purpose built Converted Village Hall

LCentral HNN: Surgery Opening Hours

3 6

14

Core Core + Core -

54 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.7.2 Key Issues from Appraisal and Mapping • The 6FS reports that 11 of the 23 premises are fully utilised, which Following the review and assessment of the PCE across the LCHNN, could suggest capacity implications at these practices. key issues for consideration include the following: • However, clinical rooms within 12 premises are reported by the • It is positively noted that sixteen of the premises surveyed scored 6FS as under utilised during week days (Map no’s 154, 155, 140, B for both functional suitability and quality (Map Nos 155, 138, 144, 157-159, 161, 168, 169 & 123), which indicates that potential 140-144 & 166), with eight of these practices housed within LIFT additional capacity could be created at these locations. buildings. • Evidence from utilisation surveys previously undertaken suggests • There are nine LIFT buildings across 23 premises (Map no’s that LIFT building footprints are often not fully utilized, which could 123,144, 154, 157-159, 165, 168, & 169) and 16 buildings are offer capacity for additional patient registrations. These properties leased (Map no’s 153 55, 134, 160 162, 165, 166, 168, 169, 123, could be further reviewed to identify capacity to absorb additional 144, 157-159). housing impact since they are a long-term financial commitment • Highfields Surgery (Map no. 160) is identified as a high priority and fully funded by the public sector. based on the 6FS alone. In addition, Evington Medical Centre • Spinney Hill Medical Centre (Map no.139) and Broadhurst Street main practice (Map no. 161) and Evington Medical Centre branch Surgery (Map no. 143) are closed on Thursday afternoons practice (Map no. 162) were rated as C for building condition, therefore capacity could be increased through the adoption of full functional suitability, and quality. All premises are of poor quality, operating hours. and together with the Community Health Centre (Map no.153), require capital investment for replacement to improve the patient 8.7.3 Risks & Implications for LC HNN offering. The impact of planned housing developments across LCHNN will • East Leicester Medical Practice (Map no. 134) is the only practice depend on the proximity of practices to the development sites and to have a reported GIA above the advised space maxima for their patient flow. list size; the rest are below the stated requirement.

55 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE LCHNN has mainly smaller scale planned housing developments Small developments in North Evington ward (173 units), across the Neighbourhood, as well as a single large development in compounded by a possible impact from a large housing development Belgrave ward (1,017 units) adding circa 2,542 new patients to be in nearby Troon, could add an additional 432 new patients to local absorbed by local lists. This new demand is likely (depending on practice lists across four practices located in the N&E HNN. (Map nos patient flow) to impact mainly on Belgrave and Spinney PCN 137 & 150) The impact will depend on patient flow but it is likely to practices – Nos 140, 142,143 and 164). With the exception of East fall on East Leicester Medical Practice (Map no. 134, 137, 138,140, Park Medical Centre, these practices are reported as fully utilised and 144, 150, 154, 158), The Willows (Map no. 137), East Park Medical have a reported GIA estimated as below the advised space maxima, Practice (Map no. 140), Spinney Hills Medical Centre (Map no. 138), suggesting they are unlikely to be able to accommodate additional The Heron Practice (Map no. 154), Charnwood Practice (Map demand within the existing demises. As East Park Medical Centre is no.144), Highfields Medical Centre (Map no. 158) and Humberstone reported as under-utilised, it may be able to offer some limited Medical Centre (Map. No. 150). Humberstone Medical Centre is a capacity, together with Broadhurst Street Surgery which is closed on LIFT building and is likely to be under-utilised, with potential available Thursday afternoons, so could potentially create some additional capacity to manage the demand from future housing developments, capacity through operating full opening hours. Some additional however most of these practices are reported as fully utilised, with a support, depending on patient flow, may be available to other reported GIA estimated to be below the advised space maxima, Belgrave and Spinney and Leicester Central PCNN practices located suggesting that accommodating additional patients will be further away (Map nos. 139, 144, 154, 158), hhowever, absorbing the challenging. The Willows has the potential to expand capacity by estimated number of new patients is likely to remain a challenge and operating at full hours. it is advised that a feasibility study is undertaken, involving Belgrave & Spinney Hill, The Fox’s and Leicester Central PCNs, to explore However, to fully understand actual and potential capacity, it is options to manage the impact of proposed housing developments, advised that a utilisation review and capacity study are undertaken such as consideration of new build and extension options. involving Belgrave & Spinney Hill, Leicester Central, Aegis and

56 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE Salutem PCNs, to assess capacity and explore options for managing The key issues for LCHNN are listed in the table below with an the impact of proposed housing developments. estimated cost for improvement/investment where identified: Premises / Issue Action A small development in Spinney Hills ward (100 units) will add circa Belgrave (Map Will be under pressure from new housing (See 250 new patients to be absorbed locally. Depending on patient flow, nos. Nos 140, Hot Spot No 21 working with Belgrave & this may impact on East Park Medical Centre (Map no. 140) Sayeed 142,143, 139, Spinney Hill, The Fox’s and Leicester Central Medical Centre (Map no. 151) and Al Razi Medical Centre (Map no. 144, 154, 158) PCNs) 152), both are in the same PCN but located in the N&E HNN area. North Evington Undertake a capacity review of identified The 6FS suggests that these practices may be able to absorb the premises involving Belgrave & Spinney Hill, new demand, therefore managing this through ‘business as usual’ is Leicester Central, Aegis and Salutem PCNs, to advised. confirm the impact of housing developments.

57 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.8 Leicester South Health needs Neighbourhood (LS HNN)

58 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.8.1 Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Patient GIA Multi- Backlog Yr 1-5 Map No. PCN Contract Practice Name/Address Tenure Physical Functional Space Fire Premises Comme nts List Size m² site Quality Env Maintenance Code Condition Suitability Utilisation H&S Assessment incl H&S

• 2010s Purpose built premises with additional space for secondary care services or another primary care practice • Leased premises which may have been developed by a third party developer Leicester Medical Group, Aylestone C82092 • May be subject to a long lease with limited break opportunities 115 Millenium Health Centre, Hall Lane, Leicester, 3,555 1,041 Lease Single B AUABB 8.0 £42,890 • The practice occupies 5 clinical rooms and there are an additional vacant 7 clinical spaces and associated offices on the first and second LE2 8SF floors • The building is under-utilised overall but provides opportunity for another tenant Dr G Singh, Sturdee Road Health & Leicester C82019 Wellbeing Centre, 182 Sturdee Rd, 124 5,041 220 Free Single A AFAA B* 5.0 £8,800 • Recently completed purpose built premises with a second phase 2 due to commence shortly City South Leicester, LE2 9DB

• A 1980s domestic property (which has been converted to provide office space) with existing extension with a new extension to be opened Saffron Health, Saffron Group shortly Leicester C82046 Practice, Saffron Lane, Leicester • The building is suitable for its purpose, with the new extension providing excellent, purpose-built facilities 125 17,337 627 Free Main B BFBBA 9.0 £48,406 City South LE2 6UL • 3 consulting rooms in existing premises programmed for reconfiguration/redecoration • New in-house new pharmacy • Branch surgery reportedly moving into the premises

• 1990s purpose built premises internally refurbished in the late 2010s Dr SA Bailey & Partners, The • Leasehold premises which may be subject to long lease and limited break opportunities Leicester C82100 Hedges Medical Centre, Pasley Rd, 126 6,050 482 Lease Single B AFAAC 6.0 £37,030 • Requres cyclical redecoration programme to maintain quality of the facilities City South Leicester LE2 9BU • Fully utilised and space sufficient for registered patient numbers

• 1970s purpose built leased premises • May be subject to long lease with limited break opportunities Dr DS Panacer, Walnut Street • Cyclical redecoration and replacement floor coverings required within the next 5 years in the administration/reception area Leicester C82662 127 Surgery, Walnut St, Leicester LE2 5,086 165 Lease Single B BFBB C* 9.0 £19,720 • Evidence of slipped slates on the roof which require replacing as present a H&S risk to general public plus evidence water ingress first City South 7LE floor ceiling • Fully utilised and below the assessed GIA for registered patient numbers • FRA review and access audit recommended

• 1800s Grade II listed converted school shared with Leicester City Assist practice Inclusion Healthcare, Charles Berry • Condition B/C, Quality C House, East Bond St, Leicester • Leased premises which may be subject to long lease terms with limited break opportunies 128 750 Lease Main B/C BFBC F* 10.5 £77,250 LE1 4SZ • Investment required for ongoing maintenance, repairs and replacement, eg lighting, and cyclical redecorations • Compartmentation survey and FRA review recommended • Practice is above the recommended GIA for its registered patient numbers Leicester C82670 982 City South • 2000s building constructed as a support centre / hostel for the homeless • Council-owned premises which may be subject to long lease with limited break opportunities Inclusion Healthcare, The Dawn • Functional suitability/Quality C as only one WC shared by staff and patients Centre, Conduit Street, Leicester 129 80 Lease Branch B CUCBC 12.0 £5,450 • 3 treatment/consulting rooms occupied although treatment used for storage LE2 0JN • Evidence of damp to the isolated wall areas within the WC and corridor which requires investigation • Requires cyclical redecorations replacement carpet in office • Provides services to homeless patients 4 mornings and therefore underutilised overall

• 1800s Grade II listed converted school shared with Inclusion Healthcare • Condition B/C, Quality C Leicester City Assist Practice, Leicester Y00344 • Leased premises which may be subject to long lease terms with limited break opportunies 130 Charles Berry House, 45 East 1,257 250 Lease Single B/C BFBC F* 10.5 £0 City South • Investment required for ongoing maintenance, repairs and replacement, eg lighting, and cyclical redecorations Bond Street, Leicester LE1 4SX • Compartmentation survey and FRA review recommended • Practice is above the recommended GIA for its registered patient numbers

59 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary

NHS Patient GIA Multi- Map No. PCN Contract Practice Name/Address Tenure Backlog Yr 1-5 Comme nts List Size m² site Physical Functional Space Fire Premises Code Quality Env Maintenance incl Condition Suitability Utilisation H&S Assessment H&S

• 1960s purpose built shared primary care facility shared with another primary care provider moving to a purpose built surgery • Building Condition B/C, Quality C Pasley Road Health Centre, Pasley • Leasehold premises which may be subjec to long lease terms with limited break opportunities Aegis C82626 Road, Eyres Monsell, Leicester • Investment required for routine repairs and maintenance, replacements eg boilers at end of useful life and cyclical redecorations 131 2,383 150 Lease Single B/C B F CB F* 10.5 £39,700 Healthcare LE2 9BU • Passive fire prevention measures survey recommended to ensure H&S compliance owing to penetrations through compartmentation • Clinical rooms do not meet current space standards • Access audit recommended • Overall the building will be under-utilised following relocation of second practice

• Victorian residential premises converted in the 1960s and extended in 2000s • Building Condtion B/C, Functional suitability/Quality C • Patient confidentiality compromised by privacy issues • Investment required for redecorations to improve quality Dr A Prasad & Partner, Clarendon Aegis C82122 • Internal circulation poor owing to narrow stairwells 135 Park Surgery, 296 Clarendon Park 5,537 325 Free Single B/C C F C BC 11.5 £39,175 Healthcare • Some privacy issues associated with acoustics Road, Leicester LE2 3AG • Insufficient WC provision • Main entrance not DDA compliant and no lift access to upper floors • Access audit and FRA recommended

Bowling Green Street Surgery Leicester Y02686 (Derbyshire Health United), 29-31 • Early 1900's converted leasehold premises (NHSPS) which houses dental practice on ground floor 156 4,685 650 Lease Single B B U BBD 10.0 £48,000 Central Bowling Green Street, Leicester, • Premises under utilised and above recommended GIA for patient list size LE1 6AS • 2013 purpose built three storey building with second for providing private accommodation • Leased premises which may have been developed by a third party developer C82669 Dr R Sahdev, 672 Aylestone Road, 167 The Fox's 4,127 692 Lease Single B A U BBB 9.0 £36,380 • May be subject to a long lease with limited break opportunities Leicester LE2 8PR • Routine maintenance, repairs and cyclical redecorations required

Leicester De Montfort Surgery, Student • LIFT building C82020 176 City & Health Centre, 100 Mill Lane, 22,419 544 Lease Single A* B* U* B* B* B 9.0 £0 • May be subject to long lease with limited break opportunities University Leicester, LE2 7HZ • Provides GP services to student population and subject to term-time fluctuations in use

• 2013 purpose built three storey building Dr P Khunti & Partners, Victoria Leicester • Leased premises which may have been developed by a third party developer (Assura) C82124 Park Health Centre, 203 Victoria 177 City & 23,700 1507 Lease Single B A F BA C* 7.0 £61,280 • May be subject to a long lease with limited break opportunities Park Road, Leicester, LE2 1XD University • Requires cyclical redecoration programme • Located on university campus and subject to term-time fluctuations in use

60 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

LS HNN: Building Age/Type LS HNN: 6 Facet Assessment 5

4

3 6 2

1 8 0 1800s 1900s 1960s 1970s 1980s 1990s 2000s 2010s

Purpose built Converted Village Hall

R A G LS HNN Practice GIAs

Victoria Park Health Centre 1507 1,896 LS HNN: Surgery Opening Hours 544 1,794 Dr R Sahdev, Aylestone Road 330 692 375 650 Clarendon Park Surgery 325 443 2 150191 Leicester City Assist Practice 101 250 79 830 Walnut Street Surgery 165 407 7 482484 Saffron Group Practice 627 1,387 5 220 403 Leicester Medical Group, Aylestone… 284 1041 0 500 1000 1500 2000

Calculated Current Core Core + Core -

61 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.8.2 Key Issues from Appraisal and Mapping • 11 buildings are leased (Map no’s 115, 126-131, 156, 167, 176 Following the review and assessment of the PCE across the LS HNN, &177). These premises may have been developed through a third- key issues for consideration include: party developer and may therefore be subject to long leases with • Ten of the 14 buildings are graded Condition A or B, and four (Map few break clause opportunities. Nos 128, 130, 131 & 135) are graded Condition B/C. It is • Seven practices have a reported GIA estimated as below the positively noted that Sturdee Road Health & Wellbeing Centre advised space maxima for their list size (Map no’s 128, 129, 130, (Map no. 124) achieved Condition A for physical condition, 115, 131, 156, 177 & 167). functional suitability and quality. • Six practices have a reported GIA above the advised space • 11 of the premises (85%) scored A or B for both functional maxima for their list size (Map no’s 124, 125, 127, 135, 176, & suitability and quality. Many are LIFT buildings which have a 126). specific lease structure that requires them to be maintained at a • Space could be an issue as the 6FS results state that nine of the high condition standard. 13 practices (75%) report full utilisation (Map no’s 124-128, 130, • The Dawn Centre and Clarendon Park Surgery (Map nos. 129 & 131, 135 & 177). This may present some problems in managing 135) were classified by the 6FS as below the required standard additional demand arising from proposed future housing for Functional Suitability and Quality and therefore require developments across the LS HNN. significant change and investment. • Five practices are reported to be under utilised (Map no’s 129, • Pasley Road Health Centre (Map no. 131) is assessed as less 115, 156, 176 & 167). One of these, De Montfort Surgery, (Map than acceptable and requires modernisation. no. 176) is a LIFT building. • Overall, the findings suggest there is a requirement for investment • Evidence from previous utilisation surveys suggests that LIFT in the short term to address backlog maintenance issues, and building footprints are often not fully utilised and therefore could issues of functional suitability and quality in order to achieve or offer spaces to accommodate additional patients. maintain Condition B standard.

62 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE • Pasley Road Health Centre (Map no.131) is reported to be fully capacity study are undertaken, involving Leicester City South, utilised, but currently operates at less than full core hours. Leicester Central, Fox’s and Leicester City and University PCNs. • All other premises reported as under utilised have unused rooms and therefore additional capacity during the week which suggests A number of small developments across the south of Castle and that capacity should be reviewed. Saffron may impact on Walnut Street Surgery (Map no. 127) within Leicester City South PCN and Victoria Park Health Centre (Map nos 8.8.3 Risks & Implications for LS HNN 127 & 177). Both practices are reported by 6FS to be full, and operate The LSHNN has a large planned development in Castle (3,407 units), full hours, and Walnut Street Surgery has a GIA estimated as below together with smaller scale planned housing developments spread the advised space maxima. This would suggest little available across the Neighbourhood, including in Saffron (306 units) and capacity. Aylestone (312 units) wards. These developments could potentially create a significant demand of over 10,000 new patients to be Springfield Road branch practice (Map no.133) and Clarendon Park absorbed by practices across five PCNs. Medical Centre (Map no. 135), reported to be fully utilised with GIAs estimated as below the advised space maxima, may feel an impact Inclusion Healthcare and Leicester City Assist are reported 6FS to from additional patients. Given the relatively small number of new be fully utilised and have reported GIAs estimated to be above the patients to be absorbed, a capacity review as part of ‘business as advised space maxima. Bowling Green Street Surgery (Map no. 156) usual’, is advised. is reported as under-utilised and Belgrave Health Centre (Map no. 169) and De Montfort Surgery (Map no. 176) are LIFT buildings and Small developments in Saffron (306 units) may add circa 765 new reported as under-utilised. This suggests there may be potential patients and there may be possible impact from planned capacity to accommodate additional demand. To fully understand the developments in neighbouring Westcotes ward. However, initial actual and potential capacity, it is advised that a utilisation review and

63 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE assessments suggest that improving estate efficiency within the The summarised issues for LSHNN are listed in the table below: current estate may cater for this uplift. Premises / Action Issue Planned housing developments across Aylestone (312 units) may Castle (Map Potential capacity implications due to new add over circa 780 new patients locally. Depending on patient flow, Nos 128, 130, housing. See Hot spot No 21 working with this additional demand may impact on Aylestone Health Centre, 156, 176, 127, Leicester City South, Leicester Central, Saffron Group Practice, The Surgery @ Aylestone (Map nos. 115, 129, 155) Leicester City & University and Fox’s PCNs to 125, 167), and Fox’s and Millennium PCNs in Leicester City South. undertake a feasibility study) Saffron Group Practice is reported as fully utilised with a reported Saffron ward Undertake a ‘business as usual’ capacity GIA below the advised space maxima, however the Surgery @ area study, involving Leicester City South and Aegis Aylestone and Aylestone Health Centre are reported as underutilised PCN practices, to assess the impact of indicating scope to create additional capacity. Aylestone Health housing and explore options for a shared PCN Centre is reported as having seven additional clinical spaces and solution associated offices on the first and second floors that have been Aylestone Identify potential of vacant space at Aylestone vacated. Operationalising this capacity could address any additional Health Centre. demand in this area.

A relatively small development in the centre of Eyres Mansell ward (33 units) will likely be managed through ‘business as usual’.at Sturdee Road Health & Wellbeing Centre, Pasley Road Health Centre and Hedges Medical Centre (Map no. 124, 126, 131).

64 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.9 Leicester North & West Health needs Neighbourhood (LN&W HNN)

65 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.9.1 Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary

NHS Map Patient GIA PCN Contract Practice Name/Address Tenure Multi-site Physical Functional Space Premises Comme nts No. List Size m² Quality Fire H&S Env Code Condition Suitability Utilisation Assessment

• C1930s converted premises with later extension Groby Road Medical Centre, Groby Rd, • Cyclical maintenance recommended Leicester C82005 Leicester, LE3 9ED 9,543 447 Free Single B B F BBC 9.0 • Ongoing investment to ensure that all areas meet infection control eg replacement flooring in consulting 108 Health Focus (1) rooms • Reported as fully utilised and below recommended GIA for patient list size

• Purpose built 1990s premises • Cyclical maintenance recommended Dr PR Jones & Partners, Oakmeadow Leicester C82008 • Ongoing investment to ensure that all areas meet infection control eg replacement flooring in consulting Surgery, Tatlow Rd, Glenfield, LE3 8NF 9,005 330 Free Single B B U BCD 11.0 109 Health Focus (1) rooms • Reported as under utilised although below recommended GIA for patient list size • FRA recommended

Dr A Nana & Partners, Hockley Farm • 2000s purpose built leasehold premises (NHSPS) Leicester C82053 Medical Practice, Hockley Farm Rd, • may be subject to long lease with limited break opportunities 10,899 Lease Single B B F ABB 8.0 110 Health Focus (3) Braunstone LE3 1HN 550 • cyclical redecorations only • access audit recommended in light of accessibility issues noted

•1900s converted end terraced residential premises with later exension • Refurbished in 2010 Dr GK Sharma & Partners, Fosse Leicester C82086 • Investigation required to determine the cause of water ingress to the wall Medical Centre, Fosse Rd North, 8,962 302 Free Single B B F BB C* 9.0 111 Health Focus • No lift to first/second floors creating access issues for persons with mobility issues Leicester LE3 5RR • Storage flagged as an issue in the building • Reported as fully utilised and below recommended GIA for patient list size

• 1990s converted domestic property with later extensions • Building would benefit from an extensive redecoration and replacement of lighting, furniture, flooring and removal of gas fires Manor Park Medical Practice, Parker • Wall-covering considered inappropriate and do not meet infection control 241 Free Main B B F BB D* 9.0 112 Drive Surgery, Leicester, LE4 0JF • No lift to first floor consulting rooms/waiting areas creating access issues for persons with mobility issues • Access audit and FRA recommended • Practice classified as fully-utilised but closed one afternoon each week and above the assessed GIA space maxima C82018 Millenium 15,726

• Converted 1980s public house with later exensions • Condition B/C Manor Park Medical Practice, Manor • Investment requred for external/internal maintenance, replacement and cyclical redecorations 709 Free Branch B/C B F BB C* 9.5 113 Medical Centre, Leicester, LE4 8EA • Proposals to create additional clinical rooms • Reported as fully utilised although the practice as a whole is above the assessed GIA • Enviromental conditions in basement (damp) make it unsuitable for its current use as storage

• Converted Victorian residential residential properties and evident in some rooms at the rear of the property • Building condition B, Functional Suitability/Condition C • Roof survey recommended to identify cause of water ingress/remedial works required • Cyclical redecoratings, flooring replacement to ensure all areas meet infection control and making good following water ingress • Replacement lighting recommended C82620 Dr S Shafi, Briton Street Surgery, Millenium 1,795 158 Free Single B/C C U CB D* 12.5 • Functionality of the surgery is limited as clinical rooms are small, corridors and doors narrow and limited 114 Leicester, LE3 9AA storage • Accessibility to first floor clinical room limited as no lift • No patient parking • Entrance ramp not compliant • Access audit recommended • Building under-utilised

66 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary

NHS Map Patient GIA PCN Contract Practice Name/Address Tenure Multi-site Comme nts No. List Size m² Code Physical Functional Space Premises Quality Fire H&S Env Condition Suitability Utilisation Assessment

• 1980s converted residential premises • Condition B/C, Functional Suitability/Quality C • Surgery 'tired' internally and requires replacement of floor coverings, patch repairs to plaster and redecoration Beaumont Lodge Medical Practice, The • No patient parking although good public transport 116 Surgery, Beaumont Leys, Leicester, 164 Free Main B/C C O CC C* 14.5 • Some privacy issues associated with acoustics LE4 0QR • Limited patient seating and waiting space and insufficient toilet provision including accessible toilets • FRA and access audit recommended • Classed as overcrowded with extended opening hours and overall the practice is below the recommended C82094 GIA for the number of patients Millenium 6,861 • Investment required to meet H&S eg installation of fire alarm system

• 1980s Purpose built surgery with later extension • Condition B/C Beaumont Lodge Medical Practice, • Small branch premises which functions well 117 Beaumont Lodge Surgery, Astill Lodge 168 Free Branch B/C B F BB D* 9.5 • Clinical rooms benefited from refurbishment late 2010s Rd, Leicester LE4 1EF • No patient parking • Reported as fully utilised but has limited opening hours • FRA and an access audit recommended

Dr RL Hazeldine & Partner, Westcotes • LIFT building Health Centre, Fosse Rd South, Lease Main A* B* U* B* B* 9.0 118 221 • May be subject to long lease with limited break opportunities Leicester LE3 0LP

• 1920’s residential property which was converted in the 1960s C82639 Millenium 6,876 • Condition B/C and Quality C • Small branch premises with 2 consulting and 1 treatment rooms Dr R L Hazeldine, Colwell Road • Reported as under-utilised with limited opening hours (closed 2 afternoons a week) although practice Medical Centre, Colwell Rd, Leicester, 123 Free Branch B/C B U CC D* 12.5 119 considers to be at full capacity and requring extension LE3 9AX • Investment required for routine repairs and maintenance, internally and externally, replacements eg lighting and cyclical redecorations throughout • FRA and access audit recommended

Westcotes Medical Practice. Y03587 • LIFT building Millenium Westcotes Health Centre, Fosse Rd 5,704 Lease Single A B U BB 9.0 120 415 • May be subject to long lease with limited break opportunities South, Leicester, LE3 0LP

• 1980s construction • Building Condition/Quality C • Evidence of water ingress which requires investigation and remediation Dr S Shafi (Westcotes 1), Westcotes C82059 • Requires investment in routine maintenance eg lighting replacement and cyclical redecorations Millenium GP Surgery, Westcotes Drive, 1,480 140 Lease M C B F CC D* 12.0 121 • Waiting area furniture in poor condition (ripped and taped up) and does not meet infection control Leicester, LE3 0QF • Understood the practice is due to move to an alternative building • No parking provision • Access audit recommended

Dr S Shafi (Westcotes 2), Westcotes C82653 122 Millenium GP Surgery, 2 Westcotes Drive, 1,550 Lease M C B F CC D* 12.0 Refer to Westcotes 1 Leicester, LE3 0QF

67 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary NHS Map Patient GIA PCN Contract Practice Name/Address Tenure Multi-site Comme nts No. List Size m² Physical Functional Space Premises Code Quality Fire H&S Env Condition Suitability Utilisation Assessment

• 1980 purpose built premises Dr F Rizvi & Partner, Heatherbrook • Extension works underway to create 2 additional clinical rooms and minor surgery • Building Condition B/C and Quality C Aegis C82623 Surgery, 242 Astill Lodge Rd, 3,570 147 Free Single B/C B F CB D* 10.5 • Investment required to bring original building up to a similar standard as the new extension eg replacement 136 Healthcare Leicester, LE4 1EF flooring to meet infection control, cyclical redecoration throughout • FRA, Access audit and asbestos surgery recommended • Reported as full and below the assessed space maxima for number of registered patients

• Victorian property convtedin the 1960s • Building Condition B/C, Functional Suitability and Quality C • Dated and requires redecoration to include floor and wall finishes Narborough Road Surgery, • Reported as full but closed one afternoon The Fox's C82119 2,218 151 Free Single B/C C F CB D* 11.5 164 Narborough Rd, Leicester LE3 0PE • No compliant accessible WC provision • Main entrance not DDA compliant and no lift access to upper floors • No parking provision • FRA and Access Audit recommended

• 1800s converted terraced property with 1980's extension. • Condition, Functional Suitability and Quality • Evidence of water ingress which requires investigation and remediation • Requirement for routine maintenance, repairs and replacement eg worn floor coverings, kitchen units and City Care C82114 Dr UK Roy, Fosse Rd South, 2,440 165 Free Single C C U BC D* 13.0 wash hand basins to meet infection control 170 Alliance Leicester LE3 0QD • Stability of boundary walls to the rear presents H&S concern and require demolition/rebuilding • Clinical spaces do not meet current space standards • Reception and office areas area very dated and require modernisation. • FRA review recommended

Dr RP Tew & Partners, Merridale City Care C82073 • LIFT building Medical Centre, 5 Fullhurst Ave, 14,856 Lease Single A* B* U* B* B* 9.0 171 1200 Alliance Leicester, LE3 1BL • May be subject to long lease with limited break opportunities

• 1990s purpose built with later extension • Building Condition B/C, Quality C Dr B Hainsworth, The Parks Medical • Requires investment in routine repairs, maintenance and replacement eg windows and doors, high City Care C82610 Centre, Aikman Avenue, Leicester 6,005 289 Free Single B/C B U CBB 11.5 pressure laminate vanity units/wash hand basins and floor covering to ensure meet infection control and life- 172 Alliance LE3 9PW expired plant and equipment eg boiler and electrical switchgear • Surgery under utilised with core opening hours • FRA recommended

• 1970s purpose built surgery which is shared by the practice and Leicestershire Partnership Trust • Building Condtion B/C, quality C The Practice - Beaumont Leys, • Leased premises (LPT) which may be subject to long lease and limited break opportunities City Care C82624 Beaumonth Leys Health Centre, • Requirement for cyclical redecoration and replacement floor coverings and ceilings throughout to improve 6,947 369 Lease Single B/C B F CBD 10.5 174 Alliance Littlewood Close, Baumont Leys quality Leicester LE4 0UZ • Insufficient toilet provision • Surgery fully utilised and under the assessed space maxima GIA for the number of patients • Access audit recommened

68 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

LN&WHNN: Building Age / Type LN&WHNN: 6 Facet Assessment

5

4 2

3 9

2 9

1

0 1800s 1900s 1970s 1980s 1990s 2000s R A G

Purpose built Converted Village Hall LN&WHNN: Surgery Opening Hours LN&WHNN: Practice GIAs

369 556 The Parks Medical Centre 289 480 11881200 4 Dr UK Roy, Fosse Road 165195 151177 7 Heatherbrook Surgery… 147 286 140 242 Westcotes Medical Practice 415.00456 344 550 Beaumont Lodge Medical Practice 332 549 144158 1258 Manor Park Medical Practice 950 9 302 717 Hockley Farm Medical Practice 550 872 330 720 Groby Road Medical Centre 447 763 0 200 400 600 800 1000 1200 1400

Calculated Current Core Core + Core -

69 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.9.2 Key Issues from Appraisal and Mapping • With the exception of Merridale Medical Centre (Map no. 171), Following the review and assessment of the PCE across the all practices are reported to have GIAs estimated below the N&WLHNN, key issues for consideration include: advised space maxima for their patient list size. • Two buildings are considered as priorities based on the 6FS • Sufficient capacity could be an issue as 6FS identify that 12 of alone (Map Nos 116 & 170). the 20 premises report full utilisation, with Beaumont Lodge • Eight of the 20 buildings are graded Condition A or B with nine Medical Practice (Map no.116) reported as over-utilised. (Map Nos 113, 114, 116, 117, 136, 164, 172 & 174) graded as • Eight of the twenty premises are reported to be under-utilised Condition B/C. (Map nos 109, 114, 118, 119, 120, 170, 171 & 172). • The seven premises rated C for either or both Functional • Parker Drive Surgery, Baxter’s Close Surgery, Colwell Road, suitability and Quality need to be addressed (Map nos 114, 116, and Westcotes Health Centre (Map nos. 112, 117, 119 & 120) 164, 170, 172,174 and 170). are classed as under utilised as they do not currently operate full • Briton Street Surgery (Map no.114), Beaumont Lodge Medical core opening hours. Practice (Map no.116), Heatherbrook Surgery (Map no.136) • Heatherbrook Surgery (Map no.136) is currently being extended. and, in particular, Fosse Family Practice (Map no.170) are • Narborough Road Surgery (Map no. 164) has vacant rooms on reported by 6FS to require modernisation and would benefit from the second floor which could potentially be converted for clinical refurbishment. use provided access issues are addressed. • Seven buildings are leased (Map no’s 110, 118, 120, 121, 122, • Two under utilised buildings - Westcotes Health Centre and 171 & 174). These premises may have been developed through Merridale Medical Centre (Map Nos 118/120 & 171) - are LIFT a third-party developer and may be subject to long leases with buildings which could offer ‘quick wins’ in providing additional few break clause opportunities. clinical space. • Based on the surveys, GIA assessment and mapping, it is unlikely that the potential growth in patient numbers from

70 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE proposed housing developments could be accommodated within Developments in Abbey and Fosse wards could add circa 8,442 new the existing estate profile. patients, impacting on nine practices in this HNN as well as two in Leicester South HNN (Map Nos 108, 111, 118,119, 121, 122, 170). 8.9.3 Risks & Implications for LN&W HNN Given the majority of these practices are reported to be fully utilised A number of large and small proposed housing developments are with GIAs below the advised maxima, they may not be able to absorb spread across N&WLHNN, with larger developments proposed in the new demand within existing demises. wards of Beaumont Leys (1,000 units) and Abbey (3,148 units), and smaller developments in Westcotes (341), Fosse (229), Braunstone Further capacity will be required to accommodate patient growth from Park & Rowley Fields (202). These developments will collectively add planned housing developments in Abbey, Beaumont Leys and Fosse circa 14,247 new patients to be absorbed by local practice lists. therefore undertaking a joint feasibility study is advised to assess the impact of housing, in order to provide options for a shared PCN The proposed developments in Beaumont Leys will add circa 2,500 solution. This may require replacement of premises and/or additional new patients which is likely to impact on Baxter’s Close branch new-build premises to promote the consolidation/integration of surgery and Heatherbrook Surgery (Map no’s 117 &136), and services, and opportunities for shared facilities. possibly Beaumont Lodge Medical Practice and Narborough Road Surgery (Map nos.116 & 164). All practices are reported by 6FS to The developments in Westcotes ward, although relatively small be full or over-utilised and have reported GIAs estimated to be below scale, could collectively add circa 852 new patients which, depending the advised space maxima. Whilst Heatherbrook Surgery is currently on patient flow, could impact on a number of premises across this being extended, it is unlikely that these practices will be able to area (Map Nos 114, 118/120, 122, 170). This includes Briton Street collectively absorb additional demand. Surgery (Map no. 114).

71 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE With the exception of Westcotes 2, all others are reported by 6FS to be under-utilised, which suggests there may be some capacity to absorb new demand. To determine current and potential space availability, it is recommended that a capacity review is undertaken as ‘business as usual’ to manage any new patient demand jointly with the PCNs impacted.

The summarised issues for N&WLHNN are listed in the table below Premises / Issue Action Beaumont Leys, Abbey Likely to have capacity implications (Map Nos 117, 136, 116, due to new housing (See Hot Spot No 174, 112) 20 joint working across the PCNs, to undertake a feasibility study) Fosse and Westcotes Likely to have capacity implications area (Map Nos 119, 108, due to new housing. (See Hotspot 20) 111, 118, 120, 121, 122, 170, 114, 164)

72 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.10 Leicester North & East Health needs Neighbourhood (LN&E HNN)

73 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.10.1 Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives. Six Facet Survey Summary NHS Backlog Yr Patient GIA Multi- Premises Map No. PCN Contract Practice Name/Address Tenure Physical Functional Space 1-5 Comme nts List Size m² site Quality Fire H&S Env Assessmen Code Condition Suitability Utilisation Maintenanc t e incl H&S Dr J G Astles & Partners, Willowbrook Medical Centre, • 1990s purpose built surgery in a good condition throughout 132 Thurnby Lodge, Leicester, LE5 408 Lease Main B A F ABE 7.0 £16,320 • Cyclical redecoration programme only recommended 2NL • Full utilised and below the recommended space maxima for the registered patient numbers Aegis C82029 12,048 Healthcare Dr J G Astles & Partners, • Purpose built community health facility which accommodates a range of health care services as well as GP surgery Springfield Road Health Centre, 200 Lease Branch B A F ABE 7.0 £14,250 • Programme to update lighting to circulation areas and cyclical redecoration recommendedp 133 Leicester LE2 3BB • Recorded as fully utilised but surgery closed one afternoon a week

• 2010s purpose built surgery Dr Roshan, The Willows Medical Aegis Y00137 • Nees for routine internal and maintenance programme to include cyclical redecoration Centre, Coleman Rd, Leicester 6,051 654 Free Main B A F AAC 6.0 £28,660 137 Healthcare • The surgery is considered to be fully utilised although above the assessed GIA space maxima for the registered LE5 4LJ patient numbers and has scope to create additional clinical rooms on the first floor if required

Dr AJJ Bentley & Partners, • 1990s purpose building with later extensions and refurbishment C82030 Downing Drive Surgery, Salutem 6,853 470 Free Single B/C A F BBE 8.5 £43,850 • Programme of internal and external maintenance, routine repairs and replacements including cyclical redecorations 145 Evington, Leicester LE5 6LP • Premises fully utilised with extended opening hours

• 1900's converted residential property with recent rear extension to the rear • Building Condition B/C, Functional Suitability/Condiiton C Johnson Medical Practice, • Poor quality with aged decor/finishes throughout and requires programme of redecorations, routine repairs and Melbourne St, Leicester LE2 maintenance 179 Free Main B/C C U CC F* 13.5 £37,060 146 0AS • Investiation required into potential structural movement include front boundary wall which requires rebuilding C82031 • Under utilised as two clinical rooms on the first floor that are rarely used Salutem 13,575 • Access audit recommmended to identify DDA improvements eg automated main entrance door • No parking provision

Johnson Medical Practice, Hilltop • 2000s purpose built modern facility Surgery, Hamilton, Leicester 0 Lease Branch B A F BBD 8.0 £55,970 • General items of external maintenance noted 147 LE5 1BJ • Assessed as fully utilised with extended opening hours

• 2000s purpose built premises which was extended circa 3 years ago • Building Condition B/C Dr J A Wood, St Elizabeth's • Floor coverings show heavy wear and are inappropriate in some of the clinical areas these and a number of dated Medical Centre, Netherhall Rd, 360 Free Main B/C A U ABC 8.5 £40,900 148 vanity units require replacement to meet current infection control standards Leicester LE5 1DR • Programme of cyclical redecoration needed • Generally under utilised and scope to increase capacity

Salutem C82676 5,478 • 1940s converted premises with later extension • Programme of external reparis and maintenance need to address timber fascias and soffits, aged cast iron rainwater goods • Internally the carpets show signs of age and wear requiring replacement as do vanity units, which are not up to Dr J A Wood, 10 The Common, 74 Free Branch B/C B U BB D* 10.5 £16,010 current infection control standards, and aged fluorescent lighting with LED fittings 149 Evington, Leicester LE5 6EA • Small branch premises which provide two clinical rooms with restricted opening hours and assessed as under utilised • No parking provision • FRA and Access Audit recommended

Dr TLH Sperry & Partners, C82033 Humberstone Medical Centre, • LIFT building Salutem 10,701 1,085 Lease Single A* B* U* B* B* 9.0 £0 150 Wycombe Rd, LE5 0PR • May be subject to long lease with limited break opportunities

• Two converted and extended Victorian residential properties and • Fully refurbished c 2011and generally in very good condition Leicester C82060 Sayeed Medical Centre, East 4,230 385 Lease 0 B A F AB D* 7.0 £26,525 • No parking provision 151 Central Park Rd, Leicester, LE5 5AY • Fully utilised with extended opening hours • access audit recommended

74 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

Six Facet Survey Summary

NHS Patient GIA Multi- Map No. PCN Contract Practice Name/Address Tenure Backlog Yr Comme nts List Size m² site Premises Code Physical Functional Space 1-5 Quality Fire H&S Env Assessmen Condition Suitability Utilisation Maintenanc t e incl H&S

• Two 1930s residential properties converted in 1998 • Building Conditon B/C Dr AK Vania, Ar Razi Medical • Maintenace of isolated areas of weathered mortar pointing to brickwork Leicester C82105 Centre, Evington Lane, 3,032 277 Free Single B/C B F BB D* 9.5 £22,080 • Investigation into staining from potential water ingress necessary 152 Central Leicester, LE5 5PQ • Cyclical programme of replacement of worn carpets, sanitary fittings and cyclical redecoration throughout • No parking provision • Fully utilised with extended opening hours

• 1940s residential property converted c1960 • Leasehold premises (NHSPS) which may be subject to long lease term and limited break opportunities • Building Conditon B/C, Functional Suitability and Quality C • External fabric maintenance require to number of blown double glazing units, entrance door glazing, timber fascias City Care C82614 Spirit Asquith Surgery, Welford and bargeboard which show signs of rot 4,119 165 Lease Single B/C C F CB D* 11.5 £26,850 173 Alliance Road, Leicester, LE2 6FQ • Internal maintenance programme for worn vinyl flooring, light fittings and aged, original electric meter and for cyclical redecorations to improve quality • Staff safety is an issue as there is no access control to the reception staff area • Car parking provision inadequate and scope to expand current car par • Access audit and FRA recommended

• 1970s purpose built premises which houses the GP surgery various other clinics • Leasehold premises (NHSPS) which may be subject to long lease term and limited break opportunities Spirit Rushey Mead Practice, City Care C82680 • Surgery 'dated' and requires programme of cyclical redecorations, replacement floor coverings, lighting, and Rushey Mead Health Centre, 4,643 Lease Single B A F BBE 8.0 £49,195 175 Alliance 355 upgrading high pressure laminate vanity units and wash hand basins to current infection control standards Lockerbie Walk, LE4 7ZX • Surgery reported to be fully utilised • Access audit should be undertaken to review the provisions to reception.

75 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE

N&EL HNN: Building Age/Type 5

4

3

2

1

0 1800s 1900s 1970s 1980s 1990s 2000a 2010s

Purpose built Converted Village Hall

N&EL HNN: Surgery Opening Times NE&L HNN: Practice GIAs

Spirit Rushey Mead Practice 355371 2 Spirit Asquith Surgery 165 330 4 Ar Razi Medical Centre 243277 Sayeed Medical Centre 338385 Dr TLH Sperry & Partners… 856 1,085 Dr J A Wood 434438 Johnson Medical Practice 937 1,086 Downing Drive Surgery 470 548 The Willows Medical Centre 484 654 Dr J G Astles & Partners 964 608 7

0 200 400 600 800 1000 1200

Calculated Current GIA Core Core + Core -

76 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE 8.10.2 Key Issues from Appraisal and Mapping operating with a reported GIA significantly below the advised Following the review and assessment of the PCE across N&ELHNN, space maxima. key issues for consideration include: • Capacity could be an issue since nine of the 13 practices report • The overall physical condition of the buildings based on 6FS is full utilisation. generally good or sound. • Four of the 13 practices are reported to be under utilised (Map • Eight practices were classified as Condition A, A or A,B for both no’s 146, 148, 149 & 150). functional suitability and quality (Map no’s 132, 133, 137, 145, • St Elizabeth Medical Centre and The Commons practice (Map 147 148, 151 & 175). nos. 148 & 149) do not operate full core opening hours. • Six practices (Map Nos 145, 146, 148, 149, 152 & 173) are • Johnson Medical Practice (Map no. 146) is reported to have graded Condition B/C vacant rooms on the first floor, however this building needs • No building scores below C for physical condition however attention so may not be suitable to accommodate additional Johnson Medical Practice (Map No 146) is identified as a priority patient numbers. based on 6FS alone. • Seven practices (Map nos. 132, 133, 147, 150, 151, 173 & 175) 8.10.3 Risks & Implications for LN&E HNN are leased. These premises may have been developed through Based on the surveys, GIA assessment and mapping, a third-party developer and may be subject to long leases with accommodating a potential growth in patient numbers from the few break clause opportunities. planned housing developments could be a challenge within the • Six practices have a reported GIA estimated to be below the existing estate profile. advised space maxima for their patient list size • Spirit Asquith Surgery, Willowbrook Medical Centre, Springfield N&ELHNN has a number of small-scale planned housing Road Health Centre and Spirit Rushey Mead Practice (Map no’s developments, with the largest developments at Rushey Mead (334 132, 133, 145, 148, 149, 151, 173 & 175) are estimated as units) adding circa 835 new patients to local lists; Humberstone and

77 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE Hamilton (372 units) adding circa 930 new patients; Troon (219 units) patient flow, possibly on practices in based in Leicester Central HNN adding circa 547 new patients; and Knighton (160 units) adding circa (Map nos. 139, 142 & 143). These practices are reported as full, with 400 new patients. reported GIAs below the advised space maxima.

The housing developments proposed in the north of Rushey Mead Absorbing this potential increased demand is likely to be a challenge are not located near any practice with the nearest being Beaumont and it is advised that a feasibility study is undertaken, involving City Lodge Branch Surgery and Heatherbrook Surgery (Map nos. 117 & Care Alliance and Leicester Central PCNs, to explore options to 136), which are both located in the neighbouring HNN (N&WLHNN). manage the impact of the proposed housing developments. Any impact is dependent on patient flow however, given these practices may also feel an effect from the large development in Planned housing developments in Humberstone and Hamilton ward Beaumont Leys, it is unlikely they will be able to absorb both impacts. may impact on Johnson Medical Practice (Map no. 147) and St. Depending on patient flow, Manor Medical Centre (Map no. 113), a Elizabeth’s Medical Centre (Map no. 148). Whilst Johnson Medical Millennium PCN practice, may also experience some pressure. All Practice is reported as full, with a reported GIA estimated as below three practices are currently reported as full, and therefore the advised space maxima, St. Elizabeth’s Medical Centre has a accommodating the new demand within the existing estates reported GIA estimated above the advised space maxima and is provision may be challenging. Consideration could be given to reported as underutilised and not operating full opening hours. This working with N&WLHNN PCNs, specifically Aegis Healthcare & suggests some potential solutions and a further capacity study is Millennium, in order to undertake a capacity review and explore advised to determine if the new patient demand can be options to manage this anticipated demand. accommodated within existing buildings. A small development in the west of Humberstone and Hamilton is likely to impact on Developments in the south of Rushey Mead are likely to impact on Humberstone Medical Centre (Map no. 150) which is a LIFT building Spirit Rushey Mead practice (Map no. 175) and, depending on and is estimated to be underutilised, and so may be able to absorb

78 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE additional new patients. It is therefore not a priority and any new estimated to be significantly below the advised space maxima for patient demand will be managed through ‘business as usual’. their existing lists. Though a relatively small number of new patients is predicted, consideration could be given to working with Fox’s and Small scale housing developments planned for Troon ward are likely City Care Alliance PCNs to undertake a capacity review of these to increase patient numbers at Humberstone Medical Centre (Map premises to assess options that could accommodate the additional no. 150) in North & East Leicester HNN, and East Leicester Medical demand. Practice (Map no.134 part of Aegis Healthcare PCN), based in Leicester Central HNN. Small housing developments planned across Stoneygate ward, depending on patient flow, may impact on Highfield Medical Centre East Leicester Medical Practice is reported as full, however has a (Map no. 160), Evington Medical Centre (Map no. 161) and Al Wagas reported GIA estimated to be above the advised space maxima. practice (Map no. 163), which are all reported as full or over-utilised Humberstone Medical Centre as noted above is reported to be under- with reported GIAs estimated to be below the advised space maxima, utilised, suggesting some potential additional capacity. As part of and the Ar Razi practice (Map no. 152) which is reported as full but ‘business as usual’ a capacity study could be undertaken jointly with has a reported GIA estimated to be above the advised space Aegis Healthcare and Salutem PCNs to determine the impact of maxima. 6FS reported that Highfield Medical and Al Wagas practices meeting new patient demand within the existing estate. close on a Thursday afternoon so some capacity could be created through operating full hours. Similarly, there may be scope to Three small housing developments planned for Knighton are likely to increase capacity at Ar Razi practice due to GIA being above the impact on Queens Road branch practice (Map no. 166) within Fox’s advised level. Given the relatively small number of potential new PCN and Spirit Asquith Surgery (Map no. 173) within City Care patients to manage, this could be accommodated across these four Alliance PCN. Both practices are reported to be fully utilised, operate practices and managed as ’business as usual’, including working with full or extended opening hours, and each has a reported GIA Fox’s and Leicester City Central PCNs to undertake a capacity

79 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

8. LEICESTER CITY COUNCIL AREA PRIMARY CARE ESTATE review to assess options to accommodate the additional demand The key issues for N&ELHNN are listed in the table below: within the existing estate profile. Premises / Issue Action Rushey Mead (Map Likely capacity issues due to new Significant housing in a Scraptoft (1,325) and surrounding areas will Nos 113, 175, 142, housing (See Hotspot no. 22 working impact a number of premises in the HNN. Some existing potential 139, 143) with the N&WLHNN PCNs and Leicester capacity might be able to absorb the impact if individually they were Central PCNs to undertake a capacity the only pressure; however, several housing development impacts review) on the same practice areas within a triangle of Scraptoft Thurnby and Scraptoft, Thurnby Will be under pressure from new housing Billesdon which indicates that incremental actions and solutions and Billesdon (Map (See Hot Spot No 17) working with Cross would not address the pressure, see Hotspot No 17. Nos 132, 137, 145, Counties, Harborough and Oadby & 147,148, 149, 150 Wigston. Based on 6FS utilisation data and the size of particularly the larger Humberstone and Undertake a further capacity study to proposed housing developments in this HNN, it is likely that Hamilton determine impact of additional patients increased estate capacity will be required. The first approach would and more detailed capacity assessment be to optimise the efficiency of the existing estate and seek options in existing primary care estate. in multi-share buildings to assign further space to primary care, Knighton Working with Fox’s and City Care where appropriate, working with neighbouring PCN partners. Alliance PCNs, undertake a capacity review of specified premises to assess options to accommodate additional patient demand.

80 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

81 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9. Results Overview of Primary Care Estate Leicestershire County Council Area

82 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

83 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The Leicestershire County Council boundary covers the area of the The County has a population of approximately 675,000 individuals is historic County of Leicestershire (except for the city which is now a well served by road and rail links and has its main administrative base Unitary Authority) covering an area of circa 776 square miles. The at County Hall in Glenfield. County forms a ‘higher tier’ authority with the boroughs of Charnwood, Hinckley & Bosworth, Melton and Oadby & Wigston, Principal responsibilities for the County Council include education whilst the Districts of Blaby, Harborough and North West (although a number of educational establishments have taken on Leicestershire form the second tier. Academy status), public health, adult and child social care, highways and transport, and strategic planning, along with other areas.

Leicestershire County Council published the Prospectus for Growth in February 2019 which will, if delivered in full, have a significant impact on the population location, density, spread and mobility in the period to 2050.

84 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.1 North West Leicestershire District Council Area 9.1.1 Socio-economic Profile North West Leicestershire District Council (NWLDC) comprises the north-west of the County of Leicestershire and is mainly rural, covering 108 square miles. Most of the southern part of the district lies within the National Forest, whilst the upland area of the Charnwood Forest lies in the south-east corner. The principal town is Coalville and other main settlements are Ashby-de-la-Zouch, Castle Donington, Ibstock, Kegworth and Measham.

North West Leicestershire benefits from excellent road transport links, located at the intersections of the M1 and A42 and has good road access to four major cities - Birmingham, Derby, Leicester and Nottingham. However, there are no passenger rail services in the district and bus service provision is variable. East Midlands Airport (EMA) is in the North of the County.

The area has proved attractive to inward investors and has recently seen high levels of employment growth. There are significantly more 9.1.2. Demographic Profile people employed in transport and logistics wholesale/retail, The population of the District was 93,500 at the 2011 Census and construction, professional, and other private services than are has grown by approximately 9,000 to date. NWL has an increasingly nationally. ageing population with a rapid increase in the number of residents

85 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE aged 45-54 and 65-74 in the last 10 years meaning 39.6% of the There are however high concentrations of working age people in population is over the age of 50. This is likely to increase further in Coalville and Castle Donington. Older people tend to be the future. By contrast, the number of 25-39 year olds has decreased concentrated in the Measham/Appleby Magna area whereas over the same period. younger people are concentrated around Ashby de la Zouch and Ellistown. Migration is broadly characterised by young adults moving away from the District and younger families with children moving in.

White British remains the majority ethnic group at over 95% of the total population, which is a significantly higher percentage than for Leicestershire, the wider East Midlands and England.

9.1.3. Health Needs The District is the 200th most deprived council in England (of 354) and (excluding Leicester City) is the most deprived in Leicestershire with pockets of deprivation concentrated in Coalville, Greenhill, Ibstock, Measham, Moira, Ashby and Castle Donington. Health and life expectancy for both men and women in North West Leicestershire is generally similar to the England average, with life expectancy 7.3 years lower for both men and women in the most deprived areas of North West Leicestershire than in the least deprived areas. About 12% (2,100) of children live in low-income families.

86 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The proportion of the workforce with higher level educational accommodate an additional 30,000 houses in strategic development attainment (25.4%) is lower than the proportion for England and East areas and smaller settlements up to 2032 (the majority – 24,362 units Midlands. - are anticipated between 2028-32). It is predicted that this increase in new dwellings could increase registered patient numbers within the Levels of breastfeeding initiation are worse than the England District by 69,414. average, as are estimated levels of adult excess weight, with 18.1% (171) of children in Year 6 classified as obese. Rates of violent crime and early deaths from cancer are however better than average.

9.1.4. Housing The Housing and Economic Needs Development Assessment (HEDNA) identified an Objectively Assessed Need (OAN) of 481 additional dwellings each year, equating to a total of 9,620 new dwellings required between 2011 and 2031. The need for affordable housing is an identified issue, with an estimated level of annual need for an additional 199 affordable dwellings over the period 2011 to 2031. There was an increase of 17% in overcrowding in housing between the 2001 Census and the 2011 Census, however this is less than the East Midlands and England.

The NWL SHELAA Part 1 – Assessment of Potential Housing Sites (Maps page 14 onwards) 2019 identifies settlements which could

87 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Commentary on areas with significant housing uplifts is shown in the Heather 431 991 39 392 table below: Hugglescote 9 21 9 30 1602 Settlement No of Projected Delivery Period Ibstock 1,732 3,984 130 1602 additional Additional Isley Walton 4,740 10,902 4740 units Pts (based 0 - 5 yrs 6-10 yrs 11-15 on 2.30 (2017- (2023- yrs Kegworth 713 1,640 180 118 415 people/unit 22) 27) (2028- ) 32) Langley Priory 102 235 102 Long Whatton 67 154 67 Acresford 111 255 111 Measham 993 2,284 9 984 Albert Village 141 324 141 Moira 371 853 43 328 Appleby Magna 1,123 2,583 1123 Ashby De La New Packington 561 1,290 561 Zouch 4,498 10,345 974 800 2724 Oakthorpe 362 833 362 Bardon 79 182 79 Overseal 55 127 55 Blackfordby 216 497 72 144 Packington 157 361 4 153 Boundary 200 460 200 Ravenstone 1,271 2,923 42 37 1192 Breedon on the Sinope 10 23 10 Hill 226 520 1 43 182 Castle Swannington 163 375 163 Donington 2,468 5,676 450 283 1735 Thringstone 115 265 115 Coalville - Whitwick 2,417 5,559 7 2410 Urban Area 5,163 11,875 936 1514 2713 Coleorton, Wilson 29 67 29 Griffydam & Woodville 53 122 53 Newbold 433 996 4 16 413 Worthington 246 566 246 Diseworth 62 143 1 52 Total: 30,180 69,414 3,010 2,850 24,362 Donington Le

Heath 143 329 86 57 Donisthorpe 411 945 23 388 Ellistown 309 711 309

88 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.1.5. Map of Practices & Housing Developments

89 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.2. NWL Hub 1 Review of Estate

90 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.2.1. Premises Assessment This premises assessment is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our team’s assessment of the potential to develop, extend or rationalise the estate to support the proposed new service and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Backlog Contract Practice Name/Address Tenure Functional Space Fire Enviro Premises Yr 1 - 5 Comments No. List Size m² site Condition Quality Code Suitability Utilisation H&S nm'l Rating Mainten'ce incl H&S • Building Condition B/C Ibstock & Barlestone • High priority based on 6-facet survey Surgery, Ibstock House, • Notable short term investment to address backlog/H&S/quality issues 48 132 High Street, Ibstock, 514 Free Main B/C B O C B E* 12.5 £98,560 • Ongong investment to ensure all areas meet infection control standards LE67 6JP • Practice under advised GIA space maxima for registered patient numbers • Building at maximum capacity.

C82012 11,006 • Building Condition C • Small branch premises with 3 clinical rooms Ibstock & Barlestone • High priority based on 6-facet survey Surgery, Westfields, 49 129 Free Branch B/C C FCB D* 11.5 £43,610 • Short-term investment for backlog/H&S/functional suitability/quality issues Barlestone, CV13 0EN • Access audit recommended • Practice under advised GIA space maxima for registered patient numbers • Reported as fully utilised however closed one afternoon per week

• Premises leased from NHS Property Services Castle Medical Group, 118 • May be subject to limited break opportunities 50 C82014 Burton Road, Ashby de la 17,745 885 Lease Single B A UAAE 7.0 £46,200 • Space under-utilised owing to the vacant (fit-out) space in the building Zouch, LE65 2LP • Could provide expansion space to create additional capacity

• Building Condition C • High priority based on 6-facet survey Measham Medical Unit, • Signficant short term investment for backlog, H&S and quality issues 51 C82017 High Street, Measham, Nr 14,149 631 Free Single C B OCBE 13.0 £232,340 • Roof leaking and quote obtained for replacement at £100k Swadlincote, DE12 7HR • Reported as overcrowded • Under the advised space maxima for the current registered patient numbers

91 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

NW Hub 1: 6-Facet Assessment

1 1

2

R A G

NW Hub 1: Surgery opening hours NW Hub 1: Practice GIAs

Measham Medical Unit 631 1132 1

885 Castle Medical Group 0

Ibstock & Barlestone 643 3

0 200 400 600 800 1000 1200 1400 1600

Current Calculated Core hours Core + Core -

92 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.2.2. Key Issues from Appraisal and Mapping Surgery (Map No 50) reports under-utilisation owing to vacant Following the review and assessment, key issues for consideration (fit-out) space. However, the practice’s reported GIA of 885m² is across NWL H1 area are: still below what would be expected for its registered list prior to • All four buildings were purpose built for healthcare between the the influx of patients from the closed practice -circa 1,420m² 1970s and 2010s.The overall condition of buildings is relatively would be the actual level expected for the current patient list of poor: Two of the four NWL H1 premises are graded B/C, with circa 17,745. (This may have been resolved since the date of the one rated C. Building quality is classified as C in three of the four 6FS through fitting-out and commissioning some of the known premises which highlights the requirement for investment to vacant space built into this development). address backlog maintenance to achieve Condition B standard. • Ibstock (map No 48) practice is over utilised on the 6FS and has • Two of the premises - Westfield Surgery at Barlestone and a total GIA reported as below the advised space maxima, despite Measham Medical Unit (Map Nos 49 & 51) - have relatively high having been extended using s106 contributions. backlog risk costs for their size, with £170,000 identified as high • The remaining premises (Ibstock House, Barlestone branch, and priority spending required to address immediate premises issues Measham Medical Unit practice) report full or over utilisation; across both sites. however, the Westfield Surgery at Barlestone (Map No 49) is • Ibstock & Barlestone premises (Map Nos 48 & 49) require closed one afternoon per week and therefore extended opening investment to improve quality and physical condition/ fitness for hours could provide additional capacity. purpose, and quality of the premises, as identified in the 6FSs. • The Surgery at Ashby de la Zouch (Map No 52) was closed when 9.2.3. Risks & Implications for NWL Hub 1 6FSs were undertaken (Oct 2019), and its registered patient list Based on 6FS utilisation data, coupled with proposed housing appears to have been absorbed by Castle Surgery (Map No 50). development data, it is likely that there will be insufficient capacity • Each practice is reported to be below the advised space maxima within the existing estate to meet increased primary healthcare based on current registered patient numbers only the Castle needs, , especially in noting the closure of The Surgery, Ashby De

93 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE La Zouch and dispersal of its patient list (which appears to have been The summarised issues for North West Leicestershire Hub 1 are taken up mainly by the Castle Medical Group (Map No 50), as listed in the following table: mentioned previously). Premises / Issue Comments Castle Medical Confirm the GIA of this practice. There is significant housing development planned across the NWL Group, Ashby Secure funding for fit-out of the expansion H1 area which could add a total of circa 38,000 people to local GP (Map No 50) space. registered lists, which will present a significant challenge for all Monitor capacity as new housing developments practices. emerge to determine if further action is needed Measham Measham Medical Unit will not have sufficient Consideration should be given to the optimisation of existing practice Medical Unit future capacity and requires significant premises through more efficient utilisation of space and undertaking (Map No 51) investment. feasibility studies to identify appropriate solutions such as investing Consideration of PCN options to support this in new or additional buildings or working collaboratively with area - may need to include a new-build option. neighbouring PCNs. Ibstock, Coalville Likely capacity issues due to new housing (See and Whitwick Hot Spot No 9 working with adjacent NWL Hub An early capacity study should be considered to assess the impact (Map No 48) 2 & NWL Hub 3 PCNs) of the closure of the practice on service provision in Ashby-de-la- Barlestone, Likely capacity issues due to new housing (See Zouch, whilst feasibility studies should be considered to identify Newbold Verdon, Hot Spot No 2 working with adjacent Bosworth appropriate solutions for the Hub overall, which may include new Market Bosworth PCN) buildings and, where appropriate, working with neighbouring PCNs. and Desford (Map No 49)

94 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.3. NWL Hub Review of Estate

95 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.3.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Backlog Comments No List Size m² site Functional Space Fire Enviro Premises Code Condition Quality Yr 1 - 5 Suitability Utilisation H&S nm'l Rating Mainten'ce • Building Condition B/C • High priority based on 6-facet survey • Short term investment to address backlog and H&S and quality issues Markfield Medical Centre, • Ongong investment to ensure all areas meet infection control standards 56 C82028 24 Chitterman Way, 7,135 397 Lease Single B A FABE 7.0 £23,680 • Practice under advised space maxima for current registered patient numbers Markfield, LE67 9WU • Only 9 clinical rooms out of 11 regularly used • Leasehold premises and may have been delivered via 3rd party developer (Assura) • may be subject to long lease periods with limited break opportunities.

• Recently extended and refurbished Long Lane Surgery, • Leasehold premises and may have been delivered via 3rd party developer (Assura) 55 C82050 Beacon House, Coalville, 14,196 1087 Lease Single B A FABD 7.0 £46,950 • may be subject to long lease periods with limited break opportunities. LE67 4DR • Above the GIA space maxima for the number of registered patients • Full utilisaton reported • Condition B/C • Leasehold premises and may have been delivered via 3rd party developer (Assura) Broom Leys Surgery, • may be subject to long lease periods with limited break opportunities 53 C82072 Broom Leys Road, 7,875 459 Lease Single B/C B OCBF 12.5 £86,710 • Ongoing investment to ensure all areas meet infection control standards eg floor coverings in clinical Coalville, LE67 4DE rooms • Ongoing investment for routine repairs/replacements and cyclical redecoration • Below GIA space maxima for number of patients and overcrowding reported

• Leasehold premises may have been delivered by 3rd party developer (Primary Health Investments Ltd) • may be subject to long lease and limited break opportunities • Ongoing investment to ensure all areas meet infection control standards 54 C82096 Hugglescote Surgery, 8,237 717 Lease Single B/C B FBAB 8.5 £81,515 eg floor coverings in clinical rooms, • Ongoing investment for routine repairs/replacements and cyclical redecoration • Practice above the advised space maxima for the current registered patient numbers • Reported as fully utilised

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9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

NW Hub 2: Building Age/Type NW Hub 2: 6-facet Assessment 3 0

1 2

1

3

0 1980s 1990s 2000s 2010s

Purpose built Converted Village Hall R A G

NW Hub 2: Practice GIAs NW Hub 2: Surgery Opening hours

717 Hugglescote Surgery 660 1 459 Broom Leys Surgery 600

1087 2 Long Lane Surgery 1000

397 1 Markfield Medical Centre 750

0 200 400 600 800 1000 1200

Current Calculated Core Core + Core -

97 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.3.2. Key Issues from Appraisal and Mapping such as extending opening times, extensions/reconfigurations to Following review and assessment, key issues for consideration existing buildings, or new building development. across NWL PCN Hub 2 include the following: • The overall physical condition of the buildings based on 6FS is There is significant housing development planned across the PCN currently satisfactory. area which could add a total of circa 19,700 to local GP registered • Two of the four buildings graded Condition B, two Condition B/C. lists, presenting a significant challenge for practices as they currently • All four buildings (Map no’s 53, 54, 55 & 56) are leased. It is exist. For the purposes of this assessment only housing understood that there are lease issues at Broom Leys Surgery developments north of Ibstock, Coalville and Markfield (where data following purchase of the lease by Assura. has been drawn from the Hinckley & Bosworth Local Authority • Each premise is reported as fully utilised. SHLAA information) are factored into these numbers. Acknowledging • Hugglescote Surgery and Long Lane Surgery (Map Nos 54 and the NHS Choice Framework, and depending upon patient flows, 55) are above the advised space maxima for current registered there may be some overlap with practices in adjoining PCNs, and patient numbers. consideration of a joint approach to estate solutions is advisable. • Broom Leys Surgery, Coalville and Markfield Surgery (Map Nos 53 and 56) report full utilisation or overcrowding and are estimated North West Leicestershire has significant proposed housing as below the advised space maxima. However, Markfield Surgery development and plans for the PCN are focused on proposed (Map no. 56) regularly has only 9 of its 11 consulting rooms in use. settlements at Coalville (5,163 units), Ravenstone (1,271 units), Donington le Heath (143 units), and Ellistown (309 units). Proposed 9.3.3. Risks & Implications for NWL Hub 2 developments at the boundary of the PCN at Markfield (1,567 units) Based on 6FS utilisation data and the scale of proposed housing are drawn from the Hinckley & Bosworth SHLAA. development it is likely that increased estate capacity will be required. This may be in the form of improved utilisation of existing buildings,

98 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The practice catchment areas extend towards (but not into) Groby The summarised issues for North West Leicestershire Hub 2 are and Ratby in the Bosworth PCN, however there is the possibility of listed in the following table: overlap with practices in the adjacent PCN. A solution may see the Premises / Issue Comments replacement of premises which are not considered appropriate for Whitwick, Coalville Likely capacity issues due to new long-term future use, which would also serve to consolidate/integrate Hugglescote & Ibstock housing (See Hot Spot No 9 working with services and provide opportunities for shared facilities. (Map Nos 53, 54, 55) NWL Hub 2 & NWL Hub 3 PCNs)

Markfield (Map No 56) Likely capacity issues due to new Based on 6FS utilisation data and the scale of planned housing housing (See Hot Spot No 1 working with development, it is unlikely there will be adequate capacity within the Bosworth and Soar Valley PCNs) existing estate to meet the needs arising from the subsequent population increase. As a first step a utilisation study of the buildings should be undertaken to assess the current utilisation and to identify scope for improving utilisation, either through extending opening hours (e.g. Broom Leys Surgery - Map No 53) or by maximising or extending existing accommodation.

This will inform appropriate solutions including, where appropriate, working for joint solutions with neighbouring PCN/CCG partners.

99 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.4. NWL Hub 3 Review of Estate

100 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.4.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Backlog Contract Practice Name/Address Tenure Comments No. List Size m² site Functional Space Fire Envir Premises Yr 1 - 5 Condition Quality Code Suitability Utilisation H&S onm'l Rating Mainten'ce incl H&S Castle Donington Surgery, • Below GIA space maxima and reported as being fully utilised with full opening hours 57 C82007 53 Borough Street, Castle 9,811 571 Lease Single B B FBBD 9.0 £25,090 • Waiting room capacity exceeded on occasions Donington, DE74 2LB • Access audit recommended • Quality assessed as Condition C • Investment required to address backlog maintenance The Surgery Whitwick 58 C82045 6,686 278 Free Single B B FCBC 10.0 £19,420 • Below GIA space maxima and fully utilised Road, Coalville, LE67 3FA • Reported to be at maximum capacity • Extension proposed to create 2 additional clinical rooms

• Condition B/C • Leasehold premises (NHSPS) Dr Pavel, Whitwick Health • May be subject to long lease periods with few break opportunities 59 C82052 Centre, North Street, 4,065 300 Lease Single B/C B UBBD 10.5 £71,100 • Assessed as being above the advised space maxima for the registered patient numbers Whitwick, LE67 5HX • Vacant space in the Centre owing to relocation of other services out of the building • May be opportunities to increase capacity • External maintenance required

Manor House Surgery, Mill • Below GIA space maxima 60 C82102 4,432 202 Lease Single B B FAA D* 7.0 £15,565 Lane, Belton, LE12 9UJ • Reported as being fully utilised • Condition B/C • Clinical spaces too small for function • Waiting room provision insufficient Dr Virmani, Whitwick • Leasehold premises (NHSPS) Health Centre, North • May be subject to long lease periods with limited break opportunities 61 C82120 3,559 300 Lease Single B/C B UBBD 10.5 £10,600 Street, Whitwick, LE67 • Assessed as above the advised space maxima for registered patient numbers 5HX • Vacant space in the Centre owing to relocation of other services out of the building • May be opportunities to increase capacity • Investment for backlog maintenance and H&S issues (eg radiator covers, smoke seals etc) • External maintenance required

101 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

NW Hub 3: 6 facet assessment

0

2

3

R A G

NW Hub 3: Practice GIAs NW Hub 3: Surgery Opening hours

285 Dr Virmani, Whitwick HC 300

355 Manor House Surgery 202 2 325 Dr Pavel, Whitwick HC 300

535 The Surgery Whitwick Road 278 3

785 Castle Donnington 571

0 100 200 300 400 500 600 700 800 900

Calculated Current Core Core + Core -

102 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.4.2. Key Issues from Appraisal and Mapping vacant space in the Centre due to relocation of some services to Following review and assessment, key issues for consideration other buildings and utilisation may need to be examined further across NWL PCN Hub 3 include the following: to explore options for increasing capacity.(it is understood that a • The overall condition of buildings is good or satisfactory. previous proposal to relocate one of the practices to new build • Quality of The Surgery, Whitwick Road (Map no. 58) scores C, premises was not achieved). indicating the requirement for investment to address backlog maintenance and quality issues across PCN premises in order 9.4.3. Risks & Implications for NWL Hub 3 to achieve Condition B. Whitwick Health Centre scores B/C for Whilst no building is deemed to be a high priority on the basis of Building Condition. 6FSs, the proposed number of housing developments across the • Space may present an issue at Castle Donington, Whitwick PCN will present challenges in terms of capacity across the existing Road and Manor House (map Nos 57, 58 & 60) which are estate. Circa 28,000 additional patients could join local GP registered reported as being fully utilised and are also assessed to be below lists, with the majority in the north of the PCN in Castle Donington the space maxima GIA, and all currently operating at full opening and surrounding district, and smaller but still significant additional hours. anticipated numbers in Whitwick. • Four of the PCN’s practice premises are leased (Map no’s 57, 59/61 & 60). One is owned by former GP partners, one by Housing development plans for NWL H3 are focused on settlements NHSPS, and the third may be through a third-party developer. at Donington, Isley Whatton, Langley Priory, Breadon on the Hill and These premises may be subject to long lease periods with limited Disworth. Developments at Kegworth (713 units) may, depending on break clause opportunities. patient flows, be supported by practices in the adjacent Rushcliffe • The two remaining practices based in Whitwick Health Centre CCG. The main impact of this population growth is likely to be at Castle Donington Surgery (map No 57) which is assessed as full and appear to be above the advised space maxima based on registered patient numbers. 6FS findings suggest that there is

103 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE currently below the required space maxima based on its existing The summarised issues for North West Leicestershire Hub 3 are patient list size. listed in the table below: Premises Impact Comments A utilisation study is recommended as a first step to assess Whitwick, Coalville Likely capacity issues due to new operational efficiency of the building (following the 2018 extension) Hugglescote & Ibstock housing in Ibstock, Heather, Coalville, which will inform next steps. This building/site appears to have (Map Nos 58, 59, 61) Swannington, Whitwick, Ravenstone, potential for further development and is strategically important as the Donington le Heath Ellistown Bardon Hill only facility for this community and will need to accommodate new & Hugglescote (See Hot Spot No 9) patients that will emerge from additional housing. working with NWL Hub 1 & NWL Hub 2 PCNs) There may be opportunity to Whitwick Health Centre (an NHSPS building) is anecdotally reported increase estate co-location. to have sufficient space however it is in Condition B/C for building Castle Donington and Likely capacity issues due to new quality and has a number of small clinical rooms based on NHS Belton (Map Nos 57 & housing in Castle Donington, Isley requirements 60) Walton, Langley Priory, Diseworth,

Breadon on the Hill & Belton (See Hot Based on 6FS utilisation and proposed housing development data, it Spot No 10) is that there may be insufficient capacity within the existing estate to

meet the increased future primary healthcare needs of a growing population.

104 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.5. Hinckley & Bosworth Borough Area There are two large neighbouring urban areas in the south of the 9.5.1. Socio-economic Profile Borough - Hinckley and Burbage and Barwell and Earl Shilton, with Hinckley and Bosworth Borough Council area covers 105 square a largely rural area in the west. miles of rolling countryside in south west Leicestershire and comprises the three towns of Hinckley, Earl Shilton and Market The local economy today retains higher-than-average levels of Bosworth, together with the villages of Barwell, Burbage, Stoke manufacturing despite the decline of traditional manufacturing and Golding, Groby, Shackerstone and Twycross. coal mining industries.

Many employed people travel to work by car and the main form of public transport in the District is the bus, with limited train services.

9.5.2. Demographic Profile Hinckley and Bosworth has a population of 112,423 (2018 Public Health Profile), with a continuing trend for older people making up an increasing proportion of the population.

105 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE lower for men and 5.0 years lower for women in the most deprived areas of Hinckley and Bosworth than in the least deprived areas.

There are pockets of multiple deprivation around Earl Shilton, Hinckley, Barwell and Burbage. with about 11% (1,900) of children living in low income families. Bagworth and Thornton also suffer from income deprivation affecting children and is ranked within the 10% most income deprived areas in England.

Diseases of the circulatory system and cancers are responsible for the majority of deaths. Burbage area has the highest rates of limiting long term illness though this may be explained by the ageing population in this area. Key issues for Hinckley and Bosworth are access to services and facilities, particularly health facilities, Hinckley & Bosworth’s population is less diverse than some affordable and special needs housing for an ageing population, and neighbouring areas and the small resident Black and Minority Ethnic transport. population (3.5%) is fairly dispersed.

9.5.4. Housing 9.5.3. Health Needs Based on the SHLAA (2019 update) the council is identifying a total The health of people in Hinckley and Bosworth is varied compared of 36,690 housing units for the planning period to 2032 (0-5 years with the England average. Life expectancy for both men and women 3,686; 6-10 years 17,151 and 11-15 years 18,394) which could is higher than the England average, with life expectancy is 4.7 years increase the population by circa 81,819 people.

106 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Projected Delivery Period Peckleton 107 239 13 57 37 No of Additional 11-15 0 - 5 yrs 6-10 yrs Ratby 1,070 2,386 1,070 Settlement additional Pts (based yrs (2017- (2023- units on 2.23 (2028- Ratcliffe Culey 94 210 94 22) 27) people/unit) 32) Shakerstone 64 143 64 Sheepy Bagworth 466 1,039 16 450 Magna 287 640 287 Barlestone 874 1,949 45 773 Sibson 45 100 7 38 Barton in the Stanton Under Beans 26 58 26 Bardon 42 94 42 Barwell 2,950 6,579 2,593 29 358 Stapleton 55 123 42 13 Botcheston 42 94 42 Stoke Golding 798 1,780 798 Burbage 10,349 23,078 801 3,752 6,525 Thornton 21 47 21 Carlton 168 375 12 99 57 Twcyross 842 1,878 1 374 469 Congerstone 11 25 11 Wellsborough 174 388 174 Desford 1,905 4,248 1551 1,330 Witherley 272 607 272 Earl Shilton 3,885 8,664 78 1573 2,338 Total 36,690 81,819 3,686 17,151 18,394 Fenny Drayton 104 232 104 Groby 2,988 6,663 768 2,220 Higham on the Hill 67 149 67 90 Hinckley 5,093 11,357 110 3,657 1,326 Kirkby Mallory 83 185 83 Market Bosworth 558 1,244 512 46 Markfield 1,567 3,494 338 1,229 Nailstone 677 1,510 22 655 Newbold Verdon 977 2,179 190 1,453 Norton Juxta Twycross 29 65 17 12

107 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.5.5. Map of Practices & Housing Developments

108 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.6. Hinckley Central PCN Review of Estate

109 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.6.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary g NHS Yr 1 - 5 Map Contract Patient List GIA Functional Space Fire Premises Mainten'ce No. Code Practice Name/Address Size m² Tenure Multi-site Condition Suitability Utilisation Quality H&S Environm'l Rating incl H&S Comments • Condition B/C • Leasehold premises may have been delivered via 3rd party developer (Assura) and subject to long lease periods with limited break opportunities. Castle Mead Medical • Requires investment to address backlog maintenance issues and bring premises up to Condition B 63 Centre, Hill Street, 533 Leasehold Main B/C B F B B D 9.5 £61,570 • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in consultation/treatment Hinckley, LE10 1DS rooms, • Routine repairs and replacements and cyclical redecorations required • Full utilisation reported and assessed below GIA space maxima C82075 10,417 • Condition B/C • Requires investment to address backlog maintenance issues and bring premises up to Condition B Castle Mead Medical • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in clinical areas Centre, 28 Pine Close, 64 129 Freehold Branch B/C B F B B D* 9.5 £34,130 • Full utilisation reported and assessed below GIA space maxima however, operates restricted Monday - Friday opening hours Stoke Golding, Nuneaton, • Current capacity 4 afternoons when premises closed CV13 6EB

• Leasehold premises (NHS) • May be subject to long lease periods with limited break opportunities The Centre Surgery, • Clarify liability for external repairs Hinckley Health Centre, 65 C82082 5,492 80 Leasehold Single BBFBBC 9.0 £13,157 • Practice occupies a small area with the Health Centre Hill Street, Hinckley LE10 • FRA recommended as evidence of missing/painted over smoke seals 1DS • Full utilistation reported • Below GIA space maxima

• Leasehold premises and leased from former partner • Above GIA space maxima for number of registered patients Station View Health • Full utilisation reported but only 13 out of 17 clinical rooms in use at time of survey 62 C82043 Centre, Southfield Road, 12,366 1084 Leasehold Single BAFBBC 8.0 £38,775 Hinckley, LE10 1UA

• Condition B/C • Requires investment in short term to address backlog maintenance (worn carpets, boiler at end of serviceable life) and H&S • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in clinical areas Maples Family Medical • FRA review recommended owing to absence of fire doors and escape arrangements observed during inspection 66 C82047 Practice, Hill Street, 10,243 662 Leasehold Single B/C A F A B D* 7.5 £56,405 • Automation of entrance door recommended to improve accessibility Hinckley, LE10 1DS

110 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE Hinckley Central: Building Age/Type Hinckley Central: 6-facet assessment

3 0

2

1

5 0 1960s 1980s 1990s 2000s 2010s R A G Purpose built Converted Village Hall

Hinckley Central: Practice GIAs Hinckley Central: Surgery Opening Hours

819 Maples Family Medical Practice 662 1

989 Station View Health Centre 1084

439 The Centre Surgery 80 1 3

833 Castle Medical Group 662

0 200 400 600 800 1000 1200

Current GIA Calculated Core Core + Core -

111 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.6.2. Key Issues from Appraisal and Mapping development/maximising existing buildings including other NHS Following the review and assessment, key issues for consideration premises. This would include improved utilisation e.g. extending across Hinckley Centre PCN include the following: opening times, or extensions/reconfigurations to existing buildings or • All five buildings are purpose built for health, one in the the requirement for new building development. Where appropriate, 1960’s, three in the 90’s and one in the 2010’s solutions may be more effective by working with neighbouring PCN • The overall physical condition of the buildings based on the partners where practice premises overlap. 6-facet survey is currently satisfactory with two out of the five buildings graded Condition B, with three of the remaining five There is significant housing development in Hinckley and Burbage graded Condition B/C. which are served by both the Hinckley Central and Fosseway PCN • All buildings are reporting full utilisation with four out of the practices. This will inevitably have the greatest impact on Station five buildings assessed as being under the assessed space View Health Centre, Castle Mead Medical Centre, Hinckley, The maxima. Centre Surgery, Maples Family Medical Practice Burbage Surgery • No buildings are identified as a priority based on the 6-facet Hinckley and Hollycroft Medical Centre (Map Nos 62, 63, 65, 66 and survey alone. 74 & 79 from Fosseway PCN). • Four of the premises (Map no’s 62, 63, 64 & 65) are leased. One is owned by NHS PS, one by a former GP partner and Based on the surveys, GIA assessment and mapping, the practices two by a 3rd party developer and may be subject to long lease will not be able to accommodate, within the existing estate profile, the periods with limited break clause opportunities. likely growth in patient numbers from the planned housing developments therefore consideration of a joint approach to solutions 9.6.3. Risks & Implications for Hinckley Central PCN for the area is advised to potentially include the hospital and other The CCG aim of rationalisation/development of the estate for GMS NHS premises locally. and FYFV is to consider Primary Care Networks or sites for

112 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The premises at Stoke Golding (Map No 64) are likely to come under The summarised issues for Hinkley Central PCN are listed in the pressure from additional housing locally and are in need of table below: investment to improve the quality of the building. However, it also has spare capacity in terms of utilisation. As the surgery currently has Premises Impact Comments additional capacity of circa 22 hours per week (Mon-Fri) to achieve Hinckley and Burbage Will be under pressure from new housing full opening hours. Following a desktop assessment there is little (Map Nos 62, 63, 65, and there may be opportunities for space to extend within the current site footprint however there is a 66 and 74,79) consolidation based on delivering field next door. Depending on where the proposed housing actually additional estate capacity (See Hot Spot goes there may be opportunities going forward to look at additional No 4 working with Hinckley Central PCN) capacity should this be required in the future. Stoke Golding (Map Premises improvements required, add

No 64) capacity through extending opening hours and monitor for future housing impact.

113 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.7. Bosworth PCN Review of Estate

114 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.7.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Contract Practice Name/Address Tenure Multi-site Comments No. List Size m² Backlog Code Functional Space Fire Premises Condition Quality Environm'l Yr 1 - 5 Mainten'ce Suitability Utilisation H&S Rating incl H&S • Condition B/C Heath Lane Surgery, Heath • Ongoing investment to ensure that all areas meet infection control standards by replacing floor coverings and vanity units in clinical areas 69 C82121 Lane Surgery, Earl Shilton 14,598 648 Freehold Single B/C AFABD 7.5 £88,920 • Investment required for routine repairs and replacements and cyclical redecorations to bring premises up to Condition B LE9 7PB • Former school building converted in 2006 • Leasehold premises and may have been delivered via 3rd party developer (Assura) Desford Medical Centre, The • May be subject to long lease periods with limited break opportunities 72 C82650 Old School, 54 Main Street, 4,687 224 Leasehold Single BBFBCE 10.0 £13,810 • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in clinical areas Desford LE9 9GR • Some external repairs required • Practice plans to convert garage to create addition storage space and remodel reception office to create more office space

• Condition B/C • Ongoing investment to ensure all areas meet infection control standards eg floor coverings in consultation/treatment rooms, wash hand basins etc Newbold Verdon Medical • Investment required to address backlog maintenance and H&S 67 Practice, St Georges Close, 369 Freehold Main B/C BFCBC 10.5 £58,460 • Insufficient waiting space on occasions Newbold Verdon, LE9 9PZ • Practice under advised GIA space maxima across the two buildings for registered patient numbers • Full utilisation reported • Automation of entrance door recommended to improve accessibility C82051 11,261 • Functional suitability and Quality classified Condition C Newbold Verdon Medical • Clinical spaces do not meet current recommendation but adequate Practice, Back Lane, Market • Internal layout requires remodelling to improve quality of facilites 68 215 Freehold Branch B C F C B E* 11.0 £23,000 Bosworth, Nuneaton • Investment required for short-term investment to address backlog maintenance, functional suitability and quality issues CV13 0LD • Practice under advised GIA space maxima across the two buildings for registered patient numbers • Full utilisation reported • Listed building • Considered not fit for purpose as GP surgery Groby Surgery, 26 Rookery 70 C82628 3,604 120 Leasehold Single BCUBB F* 11.0 £34,321 • First floor impractical with no DDA access for staff Lane, Groby LE6 0GL • CCG considers premises unsuitable long term due to fitness for purpose, lack of extension/modification potential owing to listed building status and site constraints

• Converted residential property which provides 2 GP consult and 1 nurse treatment room Ratby Surgery, 122 Station • Unusual layout with domestic bathrooms for staff WC facilities 71 C82634 3,853 237 Freehold Single BBFBBB 9.0 £25,729 Road, Ratby LE6 0JP • Reported to be fully utilised • CCG considers premises unsuitable for long-term

115 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Bosworth: Building Age/Type

3

2

1

0 1800s 1970s 1980s 1990s 2000s

Purpose-built Converted Village Hall

Bosworth: Practice GIAs Bosworth: Surgery Opening Hours

237 Ratby Surgery 290

Groby Surgery 120 290 2

Newbold Verdon Medical Practice 584 880 3

224 Desford Medical Centre 460

648 1 Heath Lane Surgery 1020

0 200 400 600 800 1000 1200

Current GIA Calculated Core Core+ Core-

116 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.7.2. Key Issues from Appraisal and Mapping • Heath Lane Surgery in Earl Shilton (Map No 69) added six new Following the review and assessment, key issues for consideration consulting rooms in 2019 taking the total number up to 28 across Bosworth PCN are: however, these are reported through the survey as ‘almost • Three of the buildings are purpose built for healthcare and range always utilised’. in age from 1800’s builds to 2000s. • The overall condition of buildings is relatively good or 9.7.3. Risks & Implications for Bosworth PCN satisfactory. Based on the 6 Facet utilisation data and the scale of proposed • The buildings housing Groby and Ratby Surgeries (Map Nos 70 housing development it is likely that increased estate capacity will be and 71) have been identified by the CCG as having no long-term required. Consideration should be given to additional new buildings future owing to the fitness for purpose of the buildings and the or significant consolidations, in addition to optimising use of existing lack of extension/modification potential arising from listed practice premises through efficient utilisation of space and feasibility building status and site constraints. studies to identify appropriate solutions including, where appropriate, • All practices are estimated to be operating below their required working with neighbouring PCN partners. GIA based on the advised space maxima. • All practices, except Groby (Map No 70), report full utilisation Groby and Ratby will be under pressure from new housing which is which means that space may become a particular issue across unlikely to be met from current capacity and the CCG has identified the PCN. that both these properties should be replaced. • Two of the PCN’s practices Groby and Desford Medical Centre Housing developments at the north west edges of the PCN include (Map no’s 70 & 72) are leased. One of the buildings is reported to be owned through a 3rd party developer and the other by a Barlestone, Market Bosworth, Nailstone, Newbold Verdon and former GP partner and may be subject to long lease periods with Twycross with an additional number of dwellings in four smaller limited break clause opportunities. village developments. The housing around Desford plus surrounding

117 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE villages in itself could see the local practice population essentially The summarised issues for Bosworth PCN are listed in the following doubling its size by 2030. table: Premises Impact Comments Although some natural flow may take some patients towards Groby and Ratby Current estate poor, will also be under pressure from new housing in Markfield, Warwickshire North CCG much of the impact of housing is likely to (Map Nos 70 & 71) Groby and Ratby (See Hot Spot No 1 fall on Newbold Verdon Medical Practice main site, the branch at working with NWL Hub 2 and Soar Valley Market Bosworth and Desford (Map Nos 67, 68 & 72) as well as the PCNs) Barlestone branch surgery (NWL PCN Hub 1, Map No 49). Barlestone, Newbold Will be under pressure from new housing in Twycross, Barlestone, Newbold Verdon and Market Heath Lane Surgery (Map No 69) in Earl Shilton sits in the southern Verdon, Market Bosworth and Desford Bosworth (See Hot Spot No 2 working with NWL reaches of the Hub; however, Barwell practice in the adjacent Hub and Soar Valley PCNs) (Map Nos 67,68, 72) Fosseway PCN (Map No 78) is only circa 2 miles away. The Earl Earl Shilton (Map Nos Will be under pressure from new housing Shilton practice catchment area extends towards but not into Barwell between Earl Shilton and Barwell (See 69) in the Fosseway PCN and vice versa giving an overlap with the Hot Spot No 3 working with Fosseway PCN) Barwell practice. Both practices will come under significant pressure

going forward.

Consideration should be given to extensions or additional new, in addition to optimising use of existing practice premises through efficient utilisation of space for the short to medium term while working with neighbouring PCN/CCG partners.

118 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.8. Fosseway PCN Review of Estate

119 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.8.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Contract Practice Name/Address Tenure Multi-site Comments No. List Size m² Backlog Code Functional Space Fire Premises Condition Quality Environm'l Yr 1 - 5 Mainten'ce Suitability Utilisation H&S Rating incl H&S • Purpose-built 1990s building • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in clinical areas The Orchard Medical • Investment required for ongoing repairs and maintenance 80 Practice, Orchard Road, 460 Freehold Main BBFBCD 10.0 £71,505 • Recommendation to replace lighting Broughton Astley, LE9 6RG • Practice below recommended GIA for practice population

C82093 11,621 • Purpose-built 190s building • Rated B/C for physical condition and C for quality The Orchard Medical • Investment required for ongoing repairs and maintenance and to bring up to Condition B Practice, Ullesthorpe 81 130 Freehold Branch B/C BUCB C* 11.5 £27,350 • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings in clinical areas Surgery, Station Road, • Operates restricted Monday - Friday opening hours Ullesthorpe, LE17 5BS • Current capacity 5 afternoons when premises closed

• Converted building which nevertheless is considered fit-for-purpose • Building Condition B/C The Old School Surgery, • Ongoing investment to ensure that all areas meet infection control standards by replacing inappropriate floor coverings and vanity units in clinical 73 C82027 Hinckley Road, Stoney 7,733 497 Leasehold Single B/C BOBA D* 10.5 £52,260 Hinckley Road, Stoney areas Stanton, LE9 4LJ Stanton, LE9 4LJ • Investment required for ongoing repairs and maintenance • There are plans to extend the premises • Premises undergoing significant refurbishment/extension at time of survey doubling current capacity and providing additional facilities eg minor The Burbage Surgery, Tilton 74 420 Freehold Main CCF C* C* C* 13.0 £1,500 surgery Road, Burbage, LE10 2SE • All other areas to be remodelled and refurbished • Converted residential property which forms general practice space on ground floor and residential flat on first floor • Functional Suitability and Quality C The Burbage Surgery, • Clinical dimensions unsuitable for consulting/treatment and major change required 75 Wolvey Surgery, 7 The 76 Freehold Branch B C U C B F* 12.0 £16,900 • Operates restricted Monday - Friday opening hours Square, Wolvey LE10 3LJ • Investment required to ensure that all areas meet infection control by replacing inappropriate floor coverings and wash hand basins in clinical areas C82054 11,008 • GP sessions held one afternoon per week held which are providing a local service for patients The Burbage Surgery, Sessional • Unlikely that the environment will be compliant for any consultation requiring invasive clinical procedures 76 Sapcote Surgery, Sapcote n/a Outreach BAFBB D* 8.0 £0 lease Village Hall LE9 6FG

The Burbage Surgery, • GP sessions held one afternoon per week held which are providing a local service for patients Sharnford Surgery, Sessional • Unlikely that the environment will be compliant for any consultation requiring invasive clinical procedures 77 n/a Outreach BBFAB F* 8.0 £2,500 Evergreeen Hall, Sharnford, lease LE10 3PJ • Converted 1930's residential property • 1970s single-storey extension • Building Condition B/C Barwell & Hollycroft Medical • Functional Suitability and Quality C Centre, Barwell Medical 78 502 Leasehold Main B/C CFCCC 12.5 £99,330 • Clinical areas do not meet current space standards Centre, Jersey Way, Barwell • Investment required to ensure that all areas meet infection control by replacing inappropriate floor coverings and wash hand basins in clinical areas LE9 8HR • Requires major repairs/capital replacements in short term C82061 13,424 • Access audit recommended

• Purpose built 1980s building with 1990s extension • Building Condition B/C Barwell & Hollycroft Medical • Investment required to ensure that all areas meet infection control by replacing inappropriate floor coverings and wash hand basins in clinical areas 79 Centre, Hollycroft Medical 348 Leasehold Branch B/C AFBBC 8.5 £71,420 • Proposal to extend building to provide additional clincal space Centre, Hinckley LE10 0XN • Investment required for ongoing repairs and maintenance to ensure statutory compliance

120 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Fosseway: Building Age/Type Fosseway: 6 Facet assessment

3

1

2 3

1

5 0 N/K 1900s 1930s 1950s 1960s 1970s 1980s 1990s

Purpose-built Converted Village Hall R A G

Fosseway: Practice GIAs Fosseway: Surgery Opening Hours

850 Barwell & Hollycroft Medical Centre 950

496 The Burbage Surgery 870 4 497 The Old School Surgery 590 5

590 Orchard Medical Practice 870

0 200 400 600 800 1000 0

Current GIA Calculated Core Core+ Core-

121 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.8.2. Key Issues from Appraisal and Mapping from former GP partners and may be subject to long lease Following the review and assessment, key issues for consideration periods with limited break clause opportunities. across Fosseway PCN include the following: • Barwell & Hollycroft Medical Centre Main and branch surgeries • Four of the buildings are purpose built for healthcare and range at Barwell and Hinckley (Map Nos 78 & 79) are reported to be in age. under their space maxima and the accommodation at Barwell • Two premises are village halls which offer once weekly usage by requires updating. practices • Seven of the nine PCN practice premises are reported to be • The overall physical condition of the buildings based on the 6- either full or over utilised. facet survey is mixed with 4 of the 9 buildings graded Condition • The Burbage Surgery (Map No 74) is currently undergoing B, with four of the remaining five graded Condition B/C and one refurbishment and extension. graded C. • The Old School Surgery, Stoney Stanton (Map No 73) is • Functional suitability is classified C at the Burbage Surgery, the estimated to be operating below the space maxima GIA. branch practices and at Wolvey, Barwell & Hollycroft Medical • Orchard Medical Practice main and branch (Map Nos 80 & 81) Centre (Map Nos 74, 75 and 78). are jointly reported to be operating below space maxima GIA and • Building Quality is rated C at Burbage Surgery main and branch there is limited opportunity to extend opening hours to increase practices, Barwell & Hollycroft Medical Centre and Ullesthorpe capacity. It has been noted that land is ear-marked under S106 Surgery, (Map Nos 74, 75, 78 & 83). for a new-build development for Broughton Astley but has not • Investment is required to address backlog maintenance issues, progressed. those of functional suitability and quality in order to achieve • This PCN offers three GP sessions one afternoon per week held Condition B standard. in local village halls in Sapcote (one session) and Sharnford (two • Two of PCN’s premises are sessional leases in village halls (Map sessions) (Map Nos 76 & 77) which are providing a local service no’s 76 & 77) and three of the (Map no. 73, 78 & 79) are leased for patients.

122 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.8.3. Risks & Implications for Fosseway PCN in Fosseway and Station View Health Centre, Castle Mead Medical Based on the surveys, GIA assessment and mapping, the practices Centre, The Centre Surgery, Maples Family Medical Practice, (Map will not be able to accommodate, within the existing estate profile, the Nos 74 & 79 and 62, 63, 65, 66 in Hinckley & Central PCN). likely growth in patient numbers from the planned housing developments therefore it is likely that increased estate capacity will There is proposed housing identified in the Blaby SHLAA which are be required. For example, Barwell & Hollycroft branch surgery in likely to impact on premises in the PCN. These include significant Hinckley and the main Burbage surgery in Burbage (Map Nos 78, 79 amounts in Sapcote and Broughton Astley together with smaller, yet & 74) are reported to be fully utilised and operate full core opening not insignificant developments proposed at Elmsthorpe, Huncote, hours. Croft, Stony Stanton and Sharnford. These developments, depending on patient flow, will impact on the main practices at Stoney Barwell practice (Map No 78) sits in the north of the PCN however, Stanton and Broughton Astley and will also have an impact on the Heath Lane Surgery, Earl Shilton in Bosworth PCN (Map No 69) is outreach surgeries housed in Village Halls at Sapcote and Sharnford only circa 2 miles away. The Barwell practice catchment area (Map Nos 73,80, 76 & 77). extends towards but not into Earl Shilton and vice versa giving an overlap with the Earl Shilton practice. Both practices will come under The Old School Surgery (Map No 73) in Stoney Stanton has plans significant pressure going forward therefore should be considered approved by Hinckley and Bosworth Council to extend the current together in future planning. building. The CCG has agreed to an increase in capacity at this site based on the GIA of the former branch building (which is now closed). There is significant housing development identified in Hinckley and These premises once extended will need to be monitored to identify Burbage which are served by both the Hinckley Central and if resulting housing pressures significantly impact on the revised GIA Fosseway PCN practices. This will inevitably have the greatest capacity. Consideration may need to be given in the future of working impact on Burbage Surgery Hinckley and Hollycroft Medical Centre

123 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE with South Blaby and Lutterworth PCN depending on how the patient The outreach premises of the Burbage Surgery (Map Nos 76 and 77) flow develops from the new demand. clearly provide a valuable service for the local populations based on three sessions per week however, it is unlikely that the environment The Orchard Medical Practice in Broughton Astley (Map No 80) will will be compliant for any consultation requiring invasive clinical come under pressure from significant housing development which procedures. As the Sapcote and Sharnford housing comes on line could result in 4,000 additional patients. Based on the survey the the limitations of a village hall environment may become current building whilst suitable, appears ‘tired’ requiring investment unsustainable. Options to look at co locations with other public to improve the fabric and efficiency of the building. It is understood services could be considered if premises in these areas are required that S106 land has been identified for this area therefore there may for the long term. be scope to consider this building’s long term future and consider if an alternative plan of remodelling, extending or a new build will be Based on the surveys, GIA assessment and mapping, the Fosseway the most appropriate PCN has some plans in place to increase capacity but this may not be sufficient to accommodate the long-term impact of housing Housing developments at Lutterworth, Bitteswell and Ullersthorpe developments. It is also unlikely, even working with adjacent PCN’s, will add new patients to be absorbed by local lists, together with a that the increased need could be met from existing primary care small development at Gilmorton Depending on patient flow this may premises. impact Ullesthorpe Surgery (Map No 81) which has two clinical rooms and is open five 1/2 days per week. Extending to full opening times will give a further two and a half days capacity which should be able to manage any pressures in the medium term.

124 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The summarised issues for Fosseway PCN are listed in the table Ullersthorpe (Map Extend opening to double the capacity of the below: No 81) premises and monitor housing impact. Premises Impact Comments Sapcote and Determine if facilities are required here in the Barwell (Map Nos Will be under pressure from new housing Sharnford long term and seek potential joint 78) between Earl Shilton and Barwell (See Hot agency/service options for reprovision. Spot No 3 working with Bosworth PCN)

Hinckley and Will be under pressure from new housing and Burbage there may be opportunities for consolidation Map Nos 74,79 based on delivering additional estate capacity and 62, 63, 65, (See Hot Spot No 4 working with Hinckley 66) Central PCN) Stoney Stanton Monitor impact following planned extension. (Map No 73) Broughton Astley Consider long term options of current building (Map No 80) and assess if there are opportunities based on the Section 106 land identified. Expanding capacity in Broughton Astley may enable non patient facing activities at Ullersthorpe to be transferred to provide additional clinical scope at that site in the medium/ longer term.

125 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.9. Charnwood Borough Council Area 9.9.1. Socio-economic Profile Charnwood District covering 108 square miles sits centrally between the three cities of Nottingham, Leicester and Derby, with the university and market town of Loughborough, the largest settlement. The south and west of Charnwood are largely rural. Loughborough and Shepshed, to the north, are the main social and economic areas, and priorities for growth.

The Borough has excellent access to both the M1 motorway to the west, Midlands Main Line to the east and East Midlands Airport in the North East.

9.9.2. Demographic Profile Charnwood has a current population of 182,643 (2018 Public Health Profile), with a continuing trend for older people making up an increasing proportion of the population; the number of people aged 55 and over expected to increase by about 44% and the number of people aged 85 and over expected to increase by 182% by 2028. The largest ethnic group in Charnwood is White reflecting 84% of the district's population with 6% of the Borough’s population being made up of Black and ethnic minority groups.

126 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.9.3. Health Needs 9.9.4. Housing The health of people in Charnwood is varied compared with the The priority location for growth will be the Leicester Principal Urban England average. Life expectancy for both men and women is higher Area, where provision will be made for at least 5,500 new homes than the England average, with life expectancy is 8.4 years lower for between 2011 and 2028. A focus of development is the area to the men and 8.4 years lower for women in the most deprived areas of east of Thurmaston in Charnwood and north of Hamilton in Leicester Charnwood than in the least deprived areas. City, creating an opportunity for approximately 3,250 homes to be delivered by 2028, together with a sustainable urban extension of at Five of Leicestershire’s ten most deprived neighbourhoods fall within least 1,500 homes planned to the north of Birstall in south Charnwood, with pockets of deprivation in Loughborough, Charnwood. Thurmaston, Syston and Mountsorrel. This is reflected in lower than average incomes, poor health and lower levels of educational House prices remain out of reach for many people, compounded by attainment. About 12% (3,400) of children live in low-income families. a lack of affordable housing, particularly in rural communities, and specialist housing such as homes for the elderly and students. Estimated levels of adult excess weight are worse than the England Between 2011 and 2031 the estimated number of affordable homes average and 17.9% (276) of Year 6 children are classified as obese, required to address outstanding and newly arising needs is 180 though this is better than the average for England. houses a year.

127 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Projected Delivery Period No of Additional Newtown 11-15 199 456 199 Settlement additional Pts (based 0 - 5 yrs 6-10 yrs Linford/Markfield yrs units on 2.29 (2017- (2023- people/unit) (2028- 22) 27) 32) Queniborough 794 1,818 130 601 63 Anstey 1,399 3,204 363 598 438 Quorn 1,205 2,759 84 472 649 Anstey/Glenfield 380 870 250 130 Ratcliffe on the 20 46 20 Barkby 807 1,848 277 530 Wreake Barkby Thorpe Rearsby 213 488 147 66 (incl Barkby Rothley 1,127 2,581 268 742 117 Thorpe/ 3,338 7,644 1,000 1,197 1,141 Barkby) Seagrave 103 236 73 30 Barrow Upon Shepshed 3,760 8,610 763 1,929 1,068 1,437 3,291 333 679 425 Soar Sileby 1,348 3,087 292 987 69 Birstall 150 344 95 10 45 Syston 1,651 3,781 52 607 992 Burton on the 387 886 5 382 Thrussington 124 284 124 Wold Thurcaston 793 1,816 293 500 Cossington 279 639 Thurmaston 809 19 269 521 Cotes 707 1,619 280 427 Walton on the 12 27 12 Cropston 261 598 78 183 Wolds East Goscote 324 742 250 74 Wanlip 19 44 310 829 650 Hathern 142 325 142 Woodhouse/ 5 71 130 Hoton 793 1,816 120 673 Woodthorpe Loughborough 6,057 13,871 1,304 2,391 2,362 Wymeswold 17 343 112 Mountsorrel 339 776 218 102 19 Total: 31,908 73,069 5,258 14,474 11,897 Newtown 483 1,106 483 Linford

128 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.9.5. Map of Practices & Housing Developments

129 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.10. Soar Valley PCN Review of Estate

130 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.10.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Backlog Comments No. List Size m² site Functional Space Fire Premises Yr 1 - 5 Code Condition Quality Env Suitability Utilisation H&S Rating Mainten'ce incl H&S • 1980s building • Building Condition B/C • Ongoing investment to ensure that all areas meet infection control standards through the replacement Barrow Health Centre, 27 of inappropriate floor coverings in clinical rooms 84 C82062 High Street, Barrow upon 8,439 635 Lease Single B/C B F B B E 9.5 £66,132 • Investment for routine repairs and replacements and cyclical redecorations to maintain Condition B Soar, LE12 8PY • Recommendation for compartmentation survey and review of fire doors reviewed in line with FRA owing to observations during 6-facet survey

Alpine House Surgery, 86 • 1930s former residential property with later 19902 and 2000s extensions 85 C82095 Rothley Road, 9,519 436 Free Single B/C B F B C C* 10.5 £25,590 • Building Condition B/C Mountsorrel, LE12 7JU • Based on physical elements noted during survey access audit and FRA recommended • Functional Suitability/ Quality C • Major changed needed to improve functional suitability Charnwood Surgery, 39 • Modernisation and improvement required with investment in routine repairs and replacements 86 C82097 Linkfield Road, 1,691 88 Lease Single BCUCC D* 13.0 £17,370 • Assessed as under-utilised on basis that there is scope to increase opening hours to provide Mountsorrel, LE12 7DJ additional capacity; • Access audit and FRA recommended as a result of observations during 6-facet survey

• Banks Surgery being extended at time of surgery to provide 2 additional clinical rooms Banks Surgery, 9 The 87 C82600 5,785 249 Lease Single BAFAB D* 7.0 £28,260 • Existing space will benefit from refurbishment Banks, Sileby, LE12 7RD • Assessed, on 6-facet survey as full but potential to increase opening hours to provide further capacity

• 1990s single storey purpose-built premises Highgate Medical Centre, • Building Condition B/C 88 C82644 5 Storer Close, Sileby, 4,288 182 Free Single B/C B O B B D* 11.5 £32,470 • Assessed as overcrowded but some scope to increase opening hours to provide additional capacity LE12 7UD • Investment required for ongoing repairs/replacement and maintenance

Cottage Surgery, 37 Main • 1960s building 89 Y00252 Street, Woodhouse Eaves, 3,158 114 Free Single B/C B F B B E* 9.5 £32,960 • Building Condition B/C LE12 8RY • Investment required for ongoing repairs and maintenance • 1980s purpose-built premises • Building Condition B/C Anstey Surgery, 21a The 82 C82032 7,418 332 Free Single BAFBBD 8.0 £18,200 • Clinical rooms under-sized but recent investments in handwash facilities and furniture improve Nook, Anstey, LE7 7AZ suitability • FRA recommended owing observations during survey

• 1980s building with later extension • Functional Suitability/Quality C owing to clinical room dimensions (too small for function) and accessibility for patients with mobility issues to first floor 83 C82034 Quorn Medical Centre 9,127 311 Free Single BCOCCD 14.0 £34,010 • Ongoing investment so that all areas meet infection control standards through replacement of worn floor coverings/wash hand basins in clinical rooms • Modernisation required but limited by site constraints

131 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Soar Valley: Building Age/Type Soar Valley: 6-facet assessment 4

3 2

2 4

1 2 0 1930s 1950s 1960s 1970s 1980s 1990s

Purpose-built Converted Village Hall R A G

Soar Valley: Practice GIAs Soar Valley: Practice Opening Hours

311 Quorn Medical Centre 740 182 Highgate Medical Centre 333 114 Cottage Surgery 268 88 3 Charnwood Surgery 110 249 Banks Surgery 440 4 332 Anstey Surgery 590 436 Alpine House Surgery 780 635 Barrow Health Centre 680 1

0 100 200 300 400 500 600 700 800 900

Current GIA Calculated Core Core+ Core-

132 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.10.2. Key Issues from Appraisal and Mapping • Banks Surgery (Map No 87) is currently being extended to Following the review and assessment, key issues for consideration increase capacity and the existing space will benefit from across the Soar PCN area include the following: refurbishment and, whilst assessed on the 6-facet survey as full, • Seven of the premises built between the 1960’s to 1980’s are there is the potential to increase opening hours to provide further purpose built for health use with one being a converted 1930’s capacity. residential building. • Charnwood Surgery (Map No 86) was assessed as underutilised • Building condition for The Barrow Health Centre, Alpine House on the basis that there is scope to increase opening hours to Surgery, Highgate Medical Centre, and Cottage Surgery are rated provide additional capacity. B/C • At present it remains business as usual for the premises in • Quorn Medical Centre is rated C particularly in terms of clinical Mountsorrel premises (Map Nos 85 and 85), however, it is room dimensions which are too small for function and the lack of understood that there have been discussions about a potential accessibility to clinical rooms on the first floor for patients with merger for the two practices. The decision about the future for the mobility issues. Quorn Medical Centre and Charnwood Surgery two practices could drive a different estate solution. (Map Nos 83 and 86) are also rated Condition C for Quality. • Three of the 8 premises (Map no’s 84, 86 & 87) are leased. One 9.10.3. Risks & Implications for Soar Valley PCN is owned by NHS PS and two by former GPs and may be subject Based on the 6 Facet utilisation data and the scale of proposed to long lease periods with limited break clause opportunities. housing development it is likely that increased estate capacity will be • Charnwood Surgery is identified by the 6FS as under-utilised required. • Remaining practices are assessed as full or over utilised and appear to be below the expected space maxima GIA. The Soar Valley PCN stretches across a wide geographic from • Highgate Surgery and The Cottage Surgery (Map Nos 88 and 89) Barrow Upon Soar in the north, Woodhouse Eaves in the west, Sileby do not operate the full core opening hours. in the East and Anstey in the south. The proposed housing

133 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE developments which affect the practices in the PCN totals around are likely to have the greatest impact on the practices in Anstey and 8,234 units across the Soar Valley PCN and could add over 18,876 depending on patient flows, Mount Sorrel (map Nos 82, 85 and 86) people to the local GP registered lists, presenting a significant as well practices in the adjacent Watermead PCN to the south of the challenge for practices which operate, in the main from smaller A46. premises which provide limited opportunities for reconfiguration. The southern impact of this can be considered in Hot Spot No 1 working with Bosworth and NWL Hub 2 PCNs. Even with this As it is unlikely there will be adequate capacity within the existing potential need, the approach for Mount Sorrel (Alpine House and estate to meet all the needs arising from the larger planned housing Charnwood Surgery Map Nos 85, 86,) at this time is also judged as developments a series of feasibility studies is recommended, working ‘business as usual’ ensuring through the standard GMS contracting where appropriate with partners in adjacent PCNs/CCGs. process that improvements are made at Charnwood Surgery.

Sileby has planned housing development however the two premises Barrow Health Centre (Map No 84) is also considered a low priority (Map Nos 87, 88) serving the area are not considered of significant for action however housing development at Quorn will also put the concern at this stage but will need monitoring through business as Medical Centre (Map No 83) under considerable pressure. It appears usual mechanisms. Highgate Medical Centre has an extension to be well below its advised space GIA maxima and is not considered ongoing. Banks Surgery is pressured at certain points of the week. A suitable for the future. These areas are considered in need of further further day per week would be available if both surgeries opened for assessment and included as Hot Spot 8. the full five days Mon-Fri. Owing to the closure of the Mahavir Practice in East Goscote (Map Housing developments in the south of the PCN area along the A46 No 94) Watermead PCN, it is possible, depending on patient flows, corridor, including Cossington, Rothley, Thurcaston and Cropston, that smaller housing developments in Thrussington, Rearsby, East could potentially add a further 5,629 new patients between towns and Goscote and Queninborough may have some influence on Soar

134 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE Valley premises. The main impact, however, is for Watermead and Syston, Vale and Melton PCNs. It is proposed that this risk is managed through Hot Spot 5 which will assess the issues across a triangle made up of East Goscote, Thurmaston and Beeby which should then de-risk the impact on the Soar Valley PCN.

The summarised issues for Soar Valley PCN are listed in the table below: Premises Impact Comments Anstey (Map No 82) Will be under pressure from new housing (See Hot Spot No 1 working with Bosworth and NWL Hub 2 PCNs) Barrow on Soar, Current volume and condition of estate Quorn (Map Nos 83 & cannot handle current and future 84) patient numbers with the planned housing. Consideration of potential for consolidation and new build in this area. See Hot Spot No 8. Sileby Review the impact of the current extension, consider expanding to full opening at both sites and monitor under standard GMS contact processes

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9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.11. Watermead PCN Review of Estate

136 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.11.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Backlog Comments No. List Size m² site Functional Space Fire Premises Yr 1 - 5 Code Condition Quality Env Suitability Utilisation H&S Rating Mainten'ce incl H&S Birstall Medical Centre, 4 • 2000s purpose-built premises 91 Whiles Lane, Birstall, LE4 520 Lease Main BAFAB C* 7.0 £22,400 • Review of FRA recommended based on observations during 6-facet survey 4EE • Assessed as fully-utilised but practice is jointly above GIA space maxima for patient list size • Converted residential property C82091 7,964 • Building Condition B/C Birstall Medical Centre, 2 • Ongoing investment so that all areas meet infection control standards through replacement of worn 92 Border Drive, Leicester, 171 Free Branch B/C B F A B D* 8.5 £17,590 floor coverings and cleaning/replacement of seating LE4 2PF • Access audit recommended and review of FRA based on observations during survey • Scope to extend opening hours to increase capacity

Silverdale Medical Centre, • 1960s converted residential property benefitted from extensive refurbishment/extension 93 C82627 6 Silverdale Drive, 5,525 352 Lease Single BAFAB C* 7.0 £18,560 • Good condition and functional suitability Thurmaston, LE4 8NN • Below GIA space maxima • 2000s purpose built premises Thurmaston Health • Ongoing investment so that all areas meet infection control standards through replacement of worn 95 C82678 Centre, 573a Melton Road, 7,124 1161 Lease Single BBOABC 10.0 £105,690 floor coverings Thurmaston, LE4 8EA • Investment required for routine maintenance/replacements and cyclical redecorations • Assessed as overcrowded but above GIA space maxima • 1920s converted residential premises • Ongoing investment so that all areas meet infection control standards through replacement of worn Greengate Medical Centre, floor coverings/wash hand basi9ns 90 C82003 1 Greengate Lane, Birstall, 11,563 436 Free Single BBFBBC 9.0 £42,540 • Investment required for routine maintenance/replacements (eg boiler) and cyclical redecorations LE4 3JF • Access audit, FRA review and asbestos survey recommended as a result of observations during 6- facet survey

137 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Watermead: Building Age/Type Watermead: 6-facet assessment

2 0

1

1

4

0 1900s 1960s 1970s 1980s 2000s R A G Purpose-built Converted Village Hall Watermead: Surgery Opening Hours Watermead: Practice GIAs

436 Greengate Medical Centre 890 1

1161 Thurmaston Health Centre 600 2 352 Silverdale Medical Centre 416

691 1 Birstall Medical Centre 620

0 200 400 600 800 1000 1200 1400

Current GIA Calculated Core Core+ Core-

138 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.11.2. Key Issues from Appraisal and Mapping accommodate additional clinics; the 6 Facet survey reported that Following the review and assessment, key issues for consideration there is scope to extend within the existing curtilage. across the Watermead PCN area include the following: • There may be some potential to create a small amount of capacity • The overall condition of buildings is good for condition and in some other PCN practices as the 6 Facet survey identified that functionality Birstall Medical Centre (Map no. 91) has one clinical space that • The quality of facilities and functionality of Birstall Medical Centre is used mainly for administration and Birstall Medical Centre (Map no.91) are rated as excellent and similarly very good at branch practice (Map no. 92) has a first floor room that could be Silverdale Medical Centre (Map no.93) and Thurmaston Health converted to a clinical space; both practices also have a reported Centre (Map no. 95). GIA above their advised space maxima. • Birstall Medical Centre is rated B/C for Building condition • Silverdale Medical Centre (Map no.93), though having a reported • Three of the PCN’s practices (Map no’s 91, 93 & 95) are leased. GIA estimated to be below the advised space maxima, closes two These premises may have been developed through a 3rd party weekday lunchtimes so could optimise capacity through developer and may be subject to long lease periods with limited increasing operating hours. break clause opportunities. • Based on the surveys, GIA assessment and mapping, the • All practices are assessed as full and Thurmaston Health Centre Watermead PCN may be able within the existing estate profile to (Map no.95), is considered over-utilised though the reported GIA accommodate some but not all the likely growth in patient is estimated to be above the advised space maxima and the numbers from the planned housing developments across the practice operates extended hours. This may present some PCN area. problems in meeting additional demand. • Greengate Medical Centre (Map no. 90) is considered fully 9.11.3. Risks & Implications for Watermead PCN utilised and reported as requiring two further clinical spaces to The Watermead PCN stretches across the south Charnwood area below the A46, with four practices around Birstall the premises at

139 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE East Goscote has closed during the period this project has been be on Alpine House Surgery and Charnwood Surgery (Map no’s 85 undertaken. The proposed housing developments which are likely to & 86), also Soar Valley PCN practices. directly affect the practices in the PCN totals around 8,095 units across the south Charnwood area and could add over 18,537 people By far the most notable pressure on premises from housing to local GP registered lists, presenting a significant challenge for development is this area is a triangle made up of East Goscote, practices which operate, in the main, from smaller premises which Thurmaston and Beeby including Syston, Barkby and Barkby provide limited opportunities for reconfiguration. Thorpe. The closure of the Watermead PCN Mahavir Medical Centre (Map no.94) in September 2019, suggests the main impact of the Greengate Medical Centre and Birstall Branch in Leicester (Map No’s housing development at East Goscote, Syston and smaller 90, 92) are assessed as being manageable on the basis of business developments at Rearsby, Ratcliffe on the Wreake and Thrussington as usual and able to handle short to medium term demand and in the is likely to fall on the two practice in Syston (Map Nos 16, 17) in the case of Birstall branch could increase opening by a session per week adjacent Syston, Vale and Melton PCN. However, the development to provide added capacity. at Barkby and Barkby Thorpe could impact the Birstall Medical Centre, Silverdale Medical Centre, Thurmaston Medical Centre Depending on patient flow, the Watermead PCN practices may have premises (Map Nos 91, 93 & 95). This issue is included as Hot Spot a secondary pressure from the impact of housing developments north 5. of the A46 at Cropton, Thurcaston and Rothley which may add around 8,065 new patients to be absorbed by local practices to the north and south. However, looking at current practice catchments, it is likely the largest impact from developments at Anstey and Cropton will be on Anstey Surgery (Map no. 82 Soar Valley PCN) and the greatest impact from developments at Thurcaston and Rothley will

140 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The summarised issues for Watermead PCN are listed in the table below: Premises Impact Comments Thurmaston, Birstall, Will be under pressure from new housing (Map Nos 91, 93, 95) between East Goscote, Thurmaston and Beeby including Syston, Barkby, Barkby Thorpe and Queniborough (See Hot Spot No 5 working with Syston, Vale and Melton PCN)

141 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.12. Carillon PCN Review of Estate

142 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.12.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Comments No. List Size m² site Code Functional Space Fire Premises Backlog Condition Quality Env Yr 1 - 5 Mainten'ce Suitability Utilisation H&S Rating incl H&S • 1980s purpose built premises • Building Condition B/C • Refurbished in 2018 Pinfold Medical Practice, • NHS leased building and may be subject to long lease periods with limited break opportunities 96 C82011 Pinfold Gate, 11,498 520 Lease Single B/C A F A B E 7.5 £ 72,300 • Investment required for routine maintenance/replacements and cyclical redecorations Loughborough, LE11 1DQ • Investment required for routine maintenance/replacements and cyclical redecorations • Assessed as full and below GIA space maxima

Bridge Street Medical • Converted 1900s building with 2010s extension 97 C82026 Practice, 20 Bridge Street, 8,325 457 Free Single BAFAAD 6.0 £37,030 • Refurbished in 2018 Loughborough, LE11 1NQ • Assessed as fully utilised and below GIA space maxima • Converted 1900s building with 1980s extension • Building Condition, Functional Suitability and Quality rated C • Requires signficant capital investment to bring up to acceptable standard Park View Surgery, 24-28 98 C82035 Leicester Road, 7,516 479 Free Single CCUCC F* 14.0 £118,815 • Assessed as overcrowded and below GIA space maxima Loughborough, LE11 2AG • Access audit and review of FRA recommended based on observations during survey • CCG acknowledges that the premises are not fit-for purpose • Practice has considered relocation to development precinct but prefers to own rather than lease new premises • 1960s converted building with 1990s extension • Building Condition B/C • Quality C Woodbrook Medical • Clinical rooms not adequately sized 99 C82070 Centre, 28 Bridge Street, 9,735 549 Free Single B/C B F C B D 10.5 £93,060 • Ongoing investment so that all areas meet infection control standards through replacement of Loughborough, LE11 1NH inappropriate floor coverings in clinical areas • Investment required for routine maintenance/replacements and cyclical redecorations • Access audit recommended

• 1960s construction with 1980s extension • Building leased from Loughborough University and may be subject to long lease periods with limited break opportunities Student Medical Centre, • Building Condition, Functional Suitability and Quality rated C 100 C82111 Loughborough University, 18,538 526 Lease Single C C O C B E* 14.0 £75,600 • Investment to ensure all areas meet infection control standards by replacing inappropriate floor Ashby Road, LE11 3TU coverings and worn wash hand basins in clinical areas • Investment required for routine maintenance/replacements and cyclical redecorations • Access audit recommended

143 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Carillon: Building Age/Type Carillon: 6-facet assessment 2

2 2 1

1 0 1900s 1960s 1970s 1980s R A G Purpose-built Converted Village Hall

Carillon: Surgery Opening Hours Carillon: Practice GIAs

526 Student Medical Centre 1750 1 549 Woodbrook Medical Centre 790 2 479 Park View Surgery 610

457 Bridge Street Medical Practice 700

520 Pinfold Medical Practice 880 2

0 500 1000 1500 2000

Current GIA Calculated Core Core+ Core-

144 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.12.2. Key Issues from Appraisal and Mapping • All except of Park View Surgery (underutilised) were noted as Following the review and assessment, key issues for consideration full or over utilised. across the Carillon PCN area include the following: • The estate is generally in less than satisfactory condition based 9.12.3. Risks & Implications for Carillon PCN on 6FS assessment. The proposed housing developments which directly affect the • Two buildings are identified as priorities based on the 6FS alone. practices in the Carillion PCN total around 6,061 units and are Park View Surgery and Student Medical Centre (Map Nos 98 & centered around Loughborough. This could add around 13,880 100) people to the local GP registered lists. However, it is likely that the • t is acknowledged that the Park View Surgery is not fit for impact on the Student Medical Centre will be lower, given that purpose but the practice has considered relocation to a patients are drawn from the student population at Loughborough developer option but no progress made as the practice prefers University. to own rather than lease new premises. • Two of the buildings are purpose built for health care but were In addition, housing developments in neighboring Beacon PCN, and built between 40 and 60 years ago. detailed in the estates assessment for that PCN, could impact on the • There of the buildings are converted residential properties practices in Carillion PCN. A joint approach to solutions with practices originally build between 60 and 120 years ago. in the adjacent Beacon is recommended. • Two of the buildings are leased (Map no’s 96 & 100). One is Based on surveys and utilisation data, it is expected that absorbing owned by NHS PS and the other leased from Loughborough the impact of the increased number of patients from the planned University and may be subject to long lease periods with limited break clause opportunities. housing developments will be a significant challenge for practices in the PCN and the condition of the estate needs improvement. • All practices are below the estimated GIA space maxima for their

registered patient list size.

145 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The summarised issues for Carillion PCN are listed in the table below: Premises Impact Comments Loughborough Will be under pressure from new housing 9 premises (Map Nos in Loughborough and notable estate 96, 97, 98, 99, 100 condition issues to be addressed in this and Beacon PCN area. (See Hot Spot No 6 working with premises 101,102, Beacon PCN). Opportunity for premises 103, 105) improvement, consolidation and increased co location. Pinfold Medical Premises improvements required however Practice, Woodbrook some could be negated if a wider estates Medical Centre, Park development solution is to be pursued View and Student based on Hot Spot 6 and may include Medical Centre (Map extension/ Nos 96, 98,99 &100) replacement of poor quality facilities and promote co-location/integration.

146 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.13. Beacon PCN Review of Estate

147 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.13.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Backlog Comments No. List Size m² site Functional Space Fire Premises Yr 1 - 5 Code Condition Quality Env Suitability Utilisation H&S Rating Mainten'ce incl H&S • 1900s Grade II Listed school building converted in 2010s to a high standard for the practice Charnwood Medical • Premises reported to be at maximum capacity Group, Rosebery Medical 101 630 Free Main AAFAA C* 5.0 £31,000 • Practice overall above GIA space maxima Centre, Roseby Street, Loughborough, LE11 5DX

Charnwood Medical • Purpose-built 1980s GP surgery Group, Outwoods Medical • Investment required for routine maintenance/replacements and cyclical redecorations 102 C82041 12,757 156 Free Branch B B F B B D* 9.0 £ 25,540 Centre, 4 Beaumont Road, Loughborough, LD11 2JB Charnwood Medical • Purpose-built 1980s GP surgery Group, Forest Edge • FRA recommended 103 Medical Centre, Old Ashby 158 Free Branch B B F B B D* 9.0 £ 22,520 • Investment required for routine maintenance/replacements and cyclical redecorations Road, Loughborough, LE11 4PQ • Original building constructed 1830 with 1990s purpose-built extension Forest House Surgery, 25 • Building Condition B/C 104 C82064 Leicester Road, Shepshed, 11,806 652 Free Single B/C B F B B E 9.5 £71,080 • Investment required for routine maintenance/replacements and cyclical redecorations LD12 9DF • Ongoing investment so that all areas meet infection control standards through replacement of • 1990s construction Dishley Grange Medical • Investment required for routine maintenance/replacements and internal/external cyclical redecorations 105 Practice, 32 Maxwell Drive, 377 Lease Main BBFBBC 9.0 £46,890 Loughborough, LE11 4RZ C82103 7,644 Dishley Grange Medical • Original 19th century converted school with 1990s extension Practice, Hathern Surgery, • Building Condition B/C 106 235 Lease Branch B/C B U B B C 10.5 £ 55,189 5 Cross Street, Hathern, • Investment required to prevent building requiring major repair LE12 5LB • Under utilised owing to restricted opening hours could provide limited increased capacity through • 1980sti building f ll i h • Building Condition B/C Field Street Surgery, Field • Functional suitability and Quality C 107 C82656 Street, Shepshed, LE12 2,252 416 Lease Main B/C C F C B D 11.5 £ 72,740 • Building 'tired' and would benefit from internal refurbishment 9AL • Access audit recommended

148 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Beacon: Building Age/Type Beacon: 6 Facet assessment

3 0

2 2

1

5

0 1800s 1900s 1980s 1990s

Purpose-built Converted Village Hall R A G

Beacon: Practice GIAs Beacon: Surgery Opening Hours

416 0 Field Street Surgery 115 1 612 Dishley Grange Medical Practice 610

652 Forest House Surgery 890

944 Charnwood Medical Group 930 6 0 200 400 600 800 1000

Current GIA Calculated Core Core+ Core-

149 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.13.2. Key Issues from Appraisal and Mapping • Hathern Surgery branch practice (Map no.106) is reported as Following the review and assessment, key issues for consideration under-utilised as the practice is closed on a Tuesday and across the Beacon PCN area include the following: Thursday afternoon, indicating some scope for limited increased • The overall condition, quality of facilities and functionality of most capacity through operating full core opening hours. buildings is good or satisfactory. • Based on the surveys, GIA assessment and mapping, it is unlikely • Field Street Surgery (Map no. 107), reported by the 6 Facet the potential growth in patient numbers from the planned housing survey to be tired and would benefit from an internal developments could be accommodated within the existing estate refurbishment, is rated B/C for Building condition (B/C: currently profile. in B but may fall to C within 5 years where C means less than acceptable facility requiring capital investment) and C for 9.13.3. Risks & Implications for Beacon PCN functional suitability and quality. A small housing development at Hathern will add around 325 new • Three of the seven PCN premises practices (Map no’s 105, 106 patients locally and will impact on Hathern Branch Surgery (Map no. & 107) are leased, one is owned by an NHS Trust and two by 106). The practice is reported as under-utilised due to being closed former GP partners and may be subject to long lease periods with two afternoons per week and the 6FS reports the main Dishley limited break clause opportunities. Grange Medical Practice has a planning application and S106 funds • All practices are above the assessed GIA space maxima for their for refurbishment/extension of the Hathern branch. This suggests the patient list size with the exception of Forest House Surgery (Map potential increase in new patients can be accommodated by Hathern no. 104), which has a reported GIA estimated to be below the Surgery should be managed as of ‘business as usual’. advised space maxima. • Six of the seven practices report full utilisation of space, which The proposed housing developments which significantly impacts on may present some problems in managing additional demand. the practices in the Beacon PCN are centered around Loughborough

150 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE and Shepshed which could add around 27,700 people to be absorbed practices (Map no’s 59, 60 & 61) located east of Shepshed near by local GP registered lists. Whitwick are likely to be too far away and the distance between these practices and the development will reduce any potential patient flow The housing development at Loughborough would impact on four in that direction. This is an area for further action and is identified as Beacon practices (Map no’s 101, 102, 103 & 105) and also a number Hot Spot 7. of practices in Carillion PCN within the town. Current capacity and condition and classification as fully utilised suggests that significant With the exception of Hathern, where work is currently ongoing it is potential growth in patient numbers from the planned housing without likely, based on the 6 Facet utilisation data and the scale of proposed cannot be accommodated from practices reported as ‘full’ without housing development, that increased estate capacity will be required. further utilisation efficiency or additional capacity being developed. This area is identified as Hot Spot 6.

A large planned housing development at Shepshed adding around 8,500 new patients to be absorbed by local practice lists, is likely to impact on Forest House Surgery (Map no. 104) and Field Street Surgery (Map no. 107). Both premises require improvement and are reported as fully utilised so unlikely to be able to absorb the large additional demand even with full opening hours. The nearest practices are two Beacon PCN practices (Map no. 103 & 105) to the east of Loughborough. Due to the impact of the significant planned development at Loughborough, these buildings are unlikely to be able to offer solutions. Three North West Leicestershire Hub 3 PCN

151 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The summarised issues for Beacon PCN are listed in the table below: Premises Impact Comments Hathern Complete current improvement works and Map No106 monitor situation, treat as ‘business as usual’. Loughborough Will be under pressure from new housing in 9 premises (Map Loughborough and notable estate condition Nos 101,102, 103, issues to be addressed in this area. (See Hot 105) and Carillion Spot No 6 working with Carillion PCN). PCN premises Opportunity for premises improvement, No’s 96, 97, 98, consolidation and increased co location. 99, 100.

Shepshed Premises improvements required at both sites Map Nos 104 & however some could be negated if a wider 107 estates development solution is to be pursued based on Hot Spot 7.

152 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.14. Blaby District Council Area 9.14.2. Demographic Profile 9.14.1. Socio-economic Profile The population for Blaby of 101,526 is increasing and ageing with Blaby District covers an urban and rural area of circa 50 square population density that is higher than regional and national averages. miles to the south west of Leicester City. Blaby’s age structure is broadly in line with the regional and national Blaby has low levels of deprivation and unemployment with averages though there is a higher proportion of people 60+ in the employment concentrated in the professional and technical District and by 2036, the portion of residents 60+ is expected to occupations. increase to approximately a third of the total population.

153 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE Blaby has very little ethnic diversity, predominantly comprised of 9.14.4. Housing white residents, who account for around 91% of the local There is an objectively assessed housing need (OAN) for the District population. of 557 dwellings per annum, which amounts to a total housing requirement between 2011 to 2031 of 11,140 dwellings. There is also 9.14.3. Health Needs a projected need for 924 dwellings per annum, amounting to a total Blaby is one of the 20% least deprived districts/unitary authorities in housing requirement of 17,560 dwellings between 2031 to 2050. England; however, about 9% (1,500) of children live in low-income The focus for new housing development is the Principal Urban Area families. Life expectancy for both men and women is higher than the (PUA) of Leicester City with plans to extend this urban area England average, with life expectancy 3.3 years lower for men in the significantly through large scale housing developments at most deprived areas of Blaby than in the least deprived areas. Lubbesthorpe and Enderby. Outside the PUA, development is focused within the larger settlements of Blaby and villages in the Levels of smoking, estimated levels of adult excess weight, number centre of the District with lower levels of growth planned in the of children classified as obese, early deaths from cardiovascular southern parts of the District. diseases, TB and the percentage of people in employment are all better than average. Affordable housing within the District is a growing issue due to a shift in age demographics and as house prices are rising faster than incomes.

154 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The SHLAA (2017) identifies a range of developments across a 15 year period for the Blaby area.

No. of additional Projected additional Pts Settlement units (based on 2.38 people/unit)(

Aston Flamville 5 12 Blaby 1,599 3,806 Braunstone Town 191 455 Cosby 824 1,961 Countesthorpe 1,402 3,337 Croft 763 1,816 Elmesthorpe 558 1,328 Endeby 1,241 2,954 Glenfield 1,269 3,020 Glen Parva 1,035 2,463 Huncote 462 1,100 Kilby 144 343 Kirby Muxloe 3,916 9,320 Leicester Forest East 271 645 Littlethorpe 564 1,342 Lubbesthorpe 4,248 10,110 Narborough 345 821 Sapcote 1,557 3,706 Sharnford 167 397 Stoney Stanton 587 1,397 Thurlaston 97 231 Whetstone 1,521 3,620 Total 22,766 54,183

155 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.14.5. Map of Practices & Housing Developments

156 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.15. North Blaby PCN Review of Estate

157 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.15.1. Premises Assessment The premises assessment is based on local estates knowledge including reviewed 6 Facet survey data from 2019 where this was available and our team’s assessment of the potential to develop, extend or rationalise estate to support the proposed new service and the CCGs commissioning objectives.

Six Facet Survey Summary

NHS Map Patient GIA Multi- Contract Practice Name/Address Tenure Backlog Comments No List Size m² site Code Physical Functional Space Fire Premises Yr 1-5 Quality Env Condition Suitability Utilisation H&S Assessment Maintenanc e incl H&S

• Building Condition, Functional Suitability and Quality C • 1960s purpose-built leased premises • Requirement for major works to be undertaken in the short term to address backlog maintenance and repairs/replacement of life expired plant, investigation required to electrical cabling and replacement of the fire alarm system Forest House Medical • Functionally the space is not satisfactory due to the dimensions of the clinical Centre, 2a Park Drive, 10 350* Lease Main CC FCCC 13.0 £132,105 spaces and unsuitability of first floor areas Leicester Forest East, • The spaces were reported as being fully utilised with the exception of the first floor LE2 2FN • Significant capital investment or replacement required to bring the building up to a C82066 14,962 suitable standard • Recommended that statutory compliance issues are urgently assessed in light ofshortcomings observed during survey visit • Overall the practice is above the recommended GIA space maxima

• 1990s purposed built premies undergoing significant construction work to refurbish Warren Lane Surgery and extend the current facilities to crease an additional 5 clinical spaces, minor (Forest House), 11 330 Free Branch C* C* O* C* C* 15.0 £0 surgery unit, additional staff and office space Warren Lane, Leicester • Assessment of the accommodation was not possible owing to the nature of the Forest East, LE3 3EW constructions works

Enderby Medical • 1800's converted terrace house with connecting extension Centre, Shortridge • Leased premises which may may be subject to long lease periods with limited 12 C82631 6,687 365 Lease Single BB FBB D* 9.0 £24,400 Lane, Enderby, LE19 break clause opportunities 4LY • The premises were assessed as fully utilised and below the GIA space maxima

• Two detached 1930's converted residential properties and linked by a first floor level bridge with later extensions Glenfield Surgery, 111 • Some investment required for backlog and routine maintenance issues, cyclical 8 C82056 Station Road, 14,014 646 Free Single B/C A FABE 7.5 £45,290 redecorations and ensure all areas meet infection control Glenfield, LE3 8GS • Access audit and fire risk assessment recommeded to help identify and manage risks in the building

The Limes Medical • 1800s Victorian House with later extensions Centre, 65 Leicester • Investment required for backlog and routine maintenance issues, cyclical 9 C82055 14,591 532 Free Single B/C B FBB D* 9.5 £42,640 Road, Narborough, redecorations and ensure all areas meet infection control LD19 2DU • Recommended that the FRA is reviewed and an access audit is carried out

• 1930s converted semi-detached residentialpremises with later extension. undertaken. Kings Way Surgery, 23 • Some investment required for backlog and routine maintenance Kingsway, Narborough 6 349 Free Main BB FBBD 9.0 £28,260 issues/replacements, cyclical redecorations and ensure all areas meet infection Road South, Leicester control LE3 2JN C82039 10,535 • Review of FRA, asbestos survey and acess audit recommended • Assessed as fully-utilised and practice overall below the GIA space maxima Kings Way Surgery, Thorpe Astley • 2000s purpose built facilities housed within Thorpe Astley Community Centre 7 120* Lease Branch BA UABC 8.0 £13,200 Community Centre, • Leasehold premises with notional rent payable to the District Council Lakin Drive, Thorpe

158 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

North Blaby: Building Age/Type North Blaby: 6 facet Assessement 2

2

1

5

0 1800s 1930s 1960s 1970s 1980s 1990s 2010s

Purpose built Converted Village Hall R A G

North Blaby: Practice GIAs North Blaby: Surgery Opening hours

469 Kings Way Surgery 833 1 532 The Limes Medical Centre 850 3 646 Glenfield Surgery 1000

365 Enderby Medical Centre 525 3 680 Forest House Medical Centre 1000

0 200 400 600 800 1000 1200

Current Calculated Core Core+ Core -

159 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.15.2. Key Issues from Appraisal and Mapping assessed during the survey due to the ongoing refurbishment Following the review and assessment, key issues for consideration works which will provide 5 more clinical spaces – adding circa across the North Blaby PCN area include the following: 360m2 to the GIA. Consideration could be given to undertaking a • Three of the premises are purpose built for health care, two are capacity review following refurbishment. converted residential properties and date from the 1800’s and • The Kings Way Surgery branch premises (Map no 7) is identified 1930s respectively. as underutilised in the 6 facet survey - there are 3 consultation • The PCN has three leased buildings (Map no’s 7, 10 & 12); one is rooms in total but the majority of the time only 2 of the 3 rooms are owned by Blaby DC, the others may have been developed through in use and the practice is shut on Mondays and Fridays. Local a 3rd party developer and all may be subject to long lease periods capacity could be increased by the practice operating full core with limited break clause opportunities. hours. • Two buildings Forest House Medical Centre (Map no.10) and Warren Lane Surgery (Forest House) (Map no.11) are identified 9.15.3. Risks & Implications for North Blaby PCN as a high priorities based on the 6FS scores alone. The majority of proposed housing developments, totaling around • Space appears to be a key issue with six out of seven of the 11,335 units across the North Blaby PCN, are focused along the M1 practice premises being reported as fully or over utilised (Map no’s corridor and could add over 26,900 people to the local GP registered 6, 8, 9, 10, 11 & 12) all operate full and, for Map no’s 9, 10 & 12, lists, presenting a significant challenge for practices. The largest extended hours, developments are at Lubbersthorpe (4,248 units), Kirby Muxloe • Kings Way branch surgery is closed on Monday and Fridays. (3,916 units), Glenfield (1,296 units) and Enderby (1,241 units) and • All have reported GIAs estimated to be significantly below the are likely to have a significant impact on the PCN. The potential advised space maxima for their list sizes. increase of circa 25,500 new patients to the PCN’s registered lists would require an additional GIA of circa 1,500 m². Based on the • The general condition, functional suitability and space utilisation surveys, appraisal and mapping, the North Blaby PCN is unlikely to of the Warren Lane Surgery branch practice (Map No.11) was not

160 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE be able to accommodate the potential growth in patient numbers from The key issues for North Blaby PCN are listed in the table below: the planned housing developments within the existing estate profile. Premises / Issue Action Depending on patient flow, the M1 corridor developments are likely M1 Corridor: Glenfield, Will be under pressure from new to impact on practices no’s 7, 8, 9, 10, 11, and 12 which are all fully Leicester Forrest East, housing (See Hot Spot No 11 utilised and have reported GIAs significantly below their advised Kirby Muxloe, Enderby, working Leicester Health Focus space maxima. Narborough, Huncote, PCN) Littlethorpe & A small development at Braunstone (191 units), adding over 450 new Lubbersthorpe patients locally, will impact on Kings Way Surgery (Map no. 6) which Forest House and Work with Forest House & the 6 Facet survey reports is in good condition, operates full hours, Warren Lane Surgery Warren Lane Surgery to address is fully utilised and has a reported joint GIA significantly below the key estate condition issues for the advised space maxima. Depending on patient flow, there may also short term, as part of ‘business as be a potential impact on this practice from a large Leicester City usual’ housing development at Glen Parva (1,035 units) which could add around 2,450 new patients locally; however, there are three City practices that may be more likely to pick up this impact.

161 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.16. South Blaby & Lutterworth PCN Review of Estate

162 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.16.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives. Six Facet Survey Summary NHS Patient Backlog Map Practice GIA Multi- Physical Contract List Tenure Functional Space Fire En Premises Yr 1-5 Comments No. Name/Address m² site Conditio Quality Code Size Suitability Utilisation H&S v Assessment Maint'nce n incl H&S • 2000s purpose built building which forms part of Lutterworth Medical Centre, and generally the building has been well maintained. The Wycliffe Medical • Investigations required as part of maintenance regime into cause of roof leak and Practice, Gilmorton blockage of drainage system 2 C82025 10,853 450* Lease Single BA FAB C* 7.0 £21,250 Road, Lutterworth, • Leased premises which may have been developed through 3rd party developer LE17 4EB and subject to long lease periods with limited break clause opportunities • FRA recommended to review passive fire prevention measures • Below GIA space maxima and assessed as fully utilised

• 2000s purpose built building which forms part of Lutterworth Medical Centre, and The Masharani generally the building has been well maintained. Practice, Gilmorton • Leased premises which may have been developed through 3rd party developer 5 C82611 6,136 350* Lease Single BA FAB C* 7.0 £14,000 Road, Lutterworth, and subject to long lease periods with limited break clause opportunities LE17 4EB • FRA recommended to review passive fire prevention measures • Below GIA space maxima and assessed as fully utilised

• Purpose built 2000s premises Northfield Medical • Leased premises which may have been developed through 3rd party developer 3 Centre,Villers Court, 11,997 638 Lease Main BA FAB D* 7.0 £28,720 and subject to long lease periods with limited break clause opportunities Blaby, LE8 4NS • Below GIA space maxima and assessed as fully utilised • Building Condition C C82068 • 1930s converted residential property with 1970s extension with current extension works to provide additional clinical rooms Hazelmere Medical • Ongoing investment to ensure that all areas meet infection control standards by 4 Centre, 58 Lutterworth 7,520 326 Free Main CA FCB F* 10.0 £63,590 replacing worn floor coverings and wash hand basins Road, Blaby, LE8 4DN • Requires investment to address backlog and routine maintenance issues and improve patient offering • FRA recommended when building works completed • 1970s purpose-built premises with later extensions • Ongoing investment to ensure that all areas meet infection control standards by Countesthorpe Health replacing worn floor coverings and wash hand basins Centre, Central Street, 1 C82002 10,936 669 Free Branch BA FABC 7.0 £46,960 • Requires investment to address backlog and routine internal and external Countesthorpe, LE8 maintenance issues 5QJ • Below GIA space maxima and assessed as fully utilised

163 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

South Blaby & Lutterworth: South Blaby & Lutterworth: Building 6 facet Assessment Age/Type 4 0

3 1

2

1 4 0 1930s 1970s 2000s

Purpose built Converted Village Hall R A G

South Blaby & Lutterworth: Practice GIAs South Blaby & Lutterworth: Surgery Opening Hours 669 Countesthorpe Health Centre 900

Hazelmere Medical Centre 326 600 1

638 Northfield Medical Centre 916

The Masharani Practice 350 500 1 3

450 The Wycliffe Medical Practice 833

0 200 400 600 800 1000

Current GIA Calculated Core Core + Core -

164 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.16.2. Key Issues from Appraisal and Mapping Countesthorpe (1,402 units) and Lutterworth, including Bitteswell, Following the review and assessment, key issues for consideration (3,143 units), which could add collectively around 18,240 new across the South Blaby & Lutterworth PCN area include the following: patients to be absorbed by the PCNs practice lists. These • 3 of the 4 buildings are purpose built for healthcare. developments are likely to impact on practices no’s 1, 2, 3, 4 and 5, • The overall condition of buildings is good or satisfactory with no together with a Fosseway PCN practice no. 73; these practices are building being a priority based on the 6FS alone. all fully utilised and have reported GIAs significantly below their • Three buildings are leased (Map no’s 2, 3 & 5) which may have advised space maxima therefore unlikely to be able to absorb the been built through a 3rd party developer and may be subject to additional demand. long lease periods with limited break clause opportunities. • Hazelmere Medical Centre (Map no. 4), a 1930s construction, is The key issues for South Blaby and Lutterworth PCN are listed in the of poor quality and not in satisfactory condition based on the 6FS table below. requiring improvement within the next 12 months. Premises / Issue Action • Space appears to be a key issue with all practice premises Blaby and Likely capacity issues due to new reported through the 6FS as fully utilised. Countesthorpe housing (See Hot Spot No 12) • All practices operate full and, for Map no’s 1, 3 & 4, extended Lutterworth, Will be under pressure from new housing hours and all have reported GIAs estimated to be below the Bitteswell, and (See Hot Spot No 13 working with advised space maxima for their current list sizes. Ullersthorpe Fosseway PCN)

9.16.3. Risks & Implications for South Blaby & Lutterworth PCN The majority of proposed housing developments are focused around four locations adjacent to the M1 in the South Blaby and Lutterworth PCN area – these are Blaby (1,599 units), Whetston (1,521 units),

165 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.17. Oadby & Wigston Borough Council Area 9.17.1. Socio-economic Profile Oadby and Wigston is a relatively small urbanised Borough of circa 9 square miles that shares its boundaries with Leicester City, Blaby District and Harborough District and sits within the Leicester City Principal Urban Area (PUA).

The Borough is crossed by three main transport routes that serve the City of Leicester but public transport links within Oadby and Wigston are in general poor though the Borough has access to the Leicester to Birmingham railway line via South Wigston Station.

166 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.17.2. Demographic Profile The ethnic and cultural composition of the Borough is diverse with Oadby and Wigston has a population of 57,056 (2018 Public Health the Black and Minority Ethnic (BME) population (28%), almost triple Profile). The Borough has a higher than Leicestershire and England the Leicestershire County average of 11.07 %. average population percentage over the age of 74 years old. (10.7% - 2011 Census). 9.17.3. Health Needs The health of people in Oadby and Wigston is varied compared with the England average. Life expectancy for both men and women is similar to the England average. Life expectancy is 13.5 years lower for men and 9.5 years lower for women in the most deprived areas of Oadby and Wigston than in the least deprived areas.

Though social deprivation is fairly low in the Borough as a whole, there are pockets of relative deprivation, with South Wigston having the highest level of social deprivation. Though there are low levels of unemployment, about 12% (1,100) of children live in low income families. 18.3% (105) of Year 6 children are classified as obese. The estimated levels of adults smoking are better than average with the rate of statutory homelessness worse than average.

9.17.4. Housing There are wards within the Borough that are considered affluent, which impacts on house prices and overall, the area has the second

167 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE lowest average house price in Leicestershire. The Local Plan (April Oadby District Centre 76 185 Areas within the Leicester PUA: 2019) states the Objectively Assessed Need (OAN) or Oadby and 0 Wigston is a requirement of 2,960 new dwellings for the period 2011 • Wigston 159 388 to 2031, including the need for affordable housing, which the Council • South Wigston 43 105 • Oadby 32 78 has identified as a priority. Wigston, Oadby and South Wigston will Stoughton Grange Direction for Growth be key focus areas for new development up to 2031. Allocation 300 732 Wigston Direction for Growth Area 1,050 2,562 Due to the urban nature of Oadby and Wigston it is difficult to identify Cottage Farm Direction for Growth Area 250 610 sufficient land to meet their required housing targets for longer term Total: 3,757 9,167 planning therefore the figures in the table below are only for a five year period as identified in the Local Plan. Projected No. of additional Settlement Additional Pts (based units on 2.25 people/unit) New additional homes allocated on land within the town centre of Wigston and the district centre of Oadby 205 500 New additional homes on allocated Direction for Growth Allocations 1,159 2,828 New additional homes on smaller allocation sites 244 595 New additional homes within the Kilby Bridge Settlement boundary 40 98 New additional homes on windfall sites 70 171 Wigston Town Centre 129 315

168 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.17.5. Map of Practices & Housing Developments

169 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.18. Oadby & Wigston PCN Review of Estate

170 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.18.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Patient Map GIA Multi- Backlog Contract Practice Name/Address List Tenure Physical Comments No. m² site Functional Space Fire En Premises Yr 1-5 Code Size Conditio Quality Suitability Utilisation H&S v Assessment Maint'nce n incl H&S • 1950s converted residential property with extension • Investment required for backlog and routine maintenance issues, cyclical redecorations • Clinical rooms adon't meet current standards and admin/office space and waiting area are small Rosemead Drive • No DDA access to First floor clinical rooms 43 Surgery, 103 Rosemead 119 Free Main BC F B B E* 10.0 £18,472 • Premises assessed as fully utilised and practice overall is below the GIA space Drive, Leicester LE2 5PP maxima • Investment required for backlog and routine maintenance issues, cyclical C82048 4,474 redecorations and ensure all areas meet infection control and H&S/fire stafety issues noted during the survey visit ie lack of fire doors to upstairs rooms, fire alarm/detection, accessibility issues

• 1930s converted residential building • Some investment required for backlog and routine maintenance issues, cyclical Harborough Road redecorations and H&S 44 Surgery, Oadby LE2 80* Free Branch BC U B B E* 11.0 £18,277 • Investment required to ensure all 4LE • Practice has restricted opening hours and space therefore assessed as under- utilised

• 1980s purpose built premises • Investment required to ensure all areas meet infection control standards and H&S Severn Surgery, 159 • Investment required for backlog and routine maintenance issues, cyclical 47 C82112 Uplands Road, Oadby 4,052 184 Free Single BB U B B E* 10.0 £25,710 redecorations LE2 4NW • Assessed as under-utilised with restricted opening hours • Access audit recommended to review the current access provision to the first floor and the narrow corridors within the surgery • Building Condition, Functional Suitability and Quality C The Central Surgery, • 1960s purpose built premises with later extension 42 C82021 Brooksby Drive, Oadby 9,026 307 Free Single CC OBCC 14.0 £68,630 • Investment required to ensure all areas meet infection control standards and H&S LE2 5AA • Investment required for backlog and routine maintenance issues, cyclical • Building Condition and Quality C • NHS PS leased premises which may be subject to long lease with limited break clause provision • 1990s purpose built premises which also provides accommodation for community South Wigston Health services and a first floor call centre 46 C82079 Centre,80 Blaby Rd, 8,101 829* Lease Single CB FCCE 12.0 £124,600 • Investment required for ongoing maintenance, refurbishment and modernisation South Wigston LE18 4SA and H&S • Clinical rooms do not meet current space standards • Review of FRA recommended to address items observed during survey visit eg Ifire door signage, missing smoke brush seals Two Steeples Medical • 2010s purpose built primary care facility which requires only cyclical redecorations Centre - Wigston Central 45 C82071 12,447 1025* Lease Single BA FABC 7.0 £41,000 • Leased premises which may have been developed through 3rd party developer Surgery, Abington Close, and subject to long lease periods with limited break clause opportunities Wigston LE18 2EW Two Steeples Medical • 2010s purpose built primary care facility which requires only cyclical redecorations Centre - Bushloe 41 C82013 11,308 1025* Lease Single BA FABC 7.0 £41,000 • Leased premises which may have been developed through 3rd party developer Surgery, Abington Close, and subject to long lease periods with limited break clause opportunities Wigston LE18 2EW

171 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Oadby & Wigston: Building Age/Type Oadby & Wigston: 6 Facet Assessment

3

1 2 2

1

4 0 1930s 1950s 1960s 1970s 1980s 1990s 2000s 2010s

Purpose built Converted Village Hall R A G

Oadby & Wigston: Practice GIAs Oadby & Wigston: Surgery Opening Hours

1025 Bushloe Surgery 900 1 1025 Wigston Central Surgery 930

829 South Wigston Health Centre 390 3

307 The Central Surgery 700

184 Severn Surgery 340 3 199 Rosemead Drive Surgery 350

0 200 400 600 800 1000 1200

Current Calculated Core Core+ Core -

172 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.18.2. Key Issues from Appraisal and Mapping reported GIAs above the advised space maxima. Whilst the GIAs Following the review and assessment, key issues for consideration were provided by the CCG, a potential concern exists over their across the Oadby and Wigston PCN area include the following: accuracy, with the suggestion that the GIAs provided might • The overall condition of buildings is fair or satisfactory. include LPT space as well as primary care space; therefore, it is • Five of the seven buildings were purpose built for healthcare recommended that this matter be reviewed by the CCG in however one of these dates back to the 1960s. advance of any subsequent follow-up work on these Practices. • Two of the seven buildings are converted residential premises • Harborough Road and Severn Surgeries (Map no’s 44 & 47) are dating from the 1930s and 1950s respectively. reported as under utilised. • Two buildings are leased providing space for 3 practices (Map • Central Surgery, Oadby, and Severn Surgery (Map nos. 42 & 47) no’s 41, 45 & 46) one is owned by NHS PS the other possibly by are estimated to be below the advised space maxima for their a 3rd party developer. These may be subject to long lease periods patient numbers. with limited break clause opportunities. • Harborough Road branch surgery (Map no. 44) is only open in the • Central Surgery and South Wigston Health Centre (Map nos. 42 mornings and generally under-utilised. & 46) have notable risk costs and are in need of modernisation to bring the premises up to standard and improve the patient 9.18.3. Risks & Implications for Oadby & Wigston PCN offering. There are a small number of proposed housing developments across • Central Surgery is identified as a priority based on 6FS alone the Oadby and Wigston PCN totaling just under 3,757 units over 5 • Space appears to be a key issue with the majority of practices years potentially adding circa 9,167 people to the local GP registered (Map no’s 41, 42, 43, 45 & 46) being reported as fully or over lists. The largest developments are at Wigston (1338 units), with a utilised. small development at South Wigston (43 units), and a planned • South Wigston Health Centre and the two practices in Two housing development at Stoughton (835 units). There are also Steeples Medical Centre (who have the same GIAs) have smaller planned developments at Cottage Farm (250 units), near

173 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE Oadby, together with a few small developments in Oadby (108 units). The key issues for Oadby and Wigston PCN are listed in the table below: Stoughton, Thurnby and Bushby are small communities between Premises / Issue Action Oadby, Evington and Scraptoft. Planned housing development may Wigston Clarify the GIAs for the two practices in add a significant number of new patients to be absorbed by local Two Steeples & review what scope practice lists but these areas are covered by other practice there is to take on additional housing catchments rather than those in Oadby and they do not currently impact. appear to have large numbers of patients registered from this area Oadby Undertake an optimisation study to and is more likely to fall to practices in N & E Leicester HNN or Cross explore scope to consolidate the Counties PCN. primary care estate in Oadby South Wigston Review the suitability of these premises There appears to be a number of estate challenges for Oadby and going forward with NHS PS & consider Wigston PCN in order to deliver the new models of care underpinning an Options Appraisal for the Long-Term Plan and the expected growth in patients from new refit/refurbishment programme or a full housing. A ‘one public estate’ approach would be recommended to reprovision of a new facility based on deliver multi agency, co located services for the local population. multi service co location. However, as the Borough Council does not appear to be able to identify sufficient land for their housing targets within their boundary the impact of this may need to be reviewed in partnership with LA planning officers

174 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.19. Melton Borough Council Area 9.19.2. Demographic Profile 9.19.1. Socio-economic Profile Melton has a current population of 51,100 (2018 Public Health Melton, the 10th smallest district in England by population covering Profile). It is an ageing population, with the number of people aged 186 square miles, is a mainly rural Borough in the north-east part of 65 and over projected to increase by 92% with a 192% increase in Leicestershire. The Borough borders South Kesteven, in the number of people aged 85 and over, between 2011- 2036, Lincolnshire, to the east, Rutland to the south, Charnwood to the together with a trend for younger people to migrate out of the west, and Rushcliffe, Newark and Sherwood in Nottinghamshire to Borough. the north.

The Birmingham to Peterborough rail line runs through the Borough, and the Borough is criss-crossed by the A607 (Leicester-Grantham) and the A606 (Nottingham-Oakham).

175 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.19.3. Health Needs 9.19.4. Housing Melton Borough is in the 40% least deprived Districts nationally. The ‘Melton Local Plan (October 2018) identifies the construction of However, there are pockets of deprivation, particularly in and around 6,125 houses by 2036 meeting the housing requirement of an Melton Mowbray. About 10% (900) of children live in low income average of 245 houses per year based on Appendix 5 of the Local families. Plan (October 2018) These plans could increase the population by circa 2,744 within a five-year timescale and up to 13,720 new The health of people in Melton is varied compared with the England residents by 2036. average. Life expectancy varies across the Borough, with life expectancy 5.8 years lower for men and 3.8 years lower for women The availability of affordable housing is an issue across the Borough in the most deprived areas of Melton than in the least deprived areas. and the Council have identified a need for around 1,750 affordable houses and included these within this planning target. Levels of GCSE attainment, smoking, early deaths from cardiovascular diseases and early deaths from cancer are better than Melton Mowbray Main Urban Area is identified as the priority growth average. location based on the Boroughs special policy to accommodate approximately 65% of the Borough’s housing need with the A significant percentage (18.9%) of the population of Melton Borough remaining 35% being in the more rural settlements therefore more is obese, though the percentage of Year 6, children classified as sites will be confirmed over the planning period based on that split. obese (14.0%) is better than the average for England. This includes the intention of the Local Authority to develop both a Melton North Sustainable Neighbourhood Plan and a Melton South Sustainable Neighbourhood Plan to address the impact of circa 3,981 units in those two areas by 2036.

176 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The figures in the table below are for sites identified over five years as identified in the Local Plan Appendix 1 (October 2018). No. of Projected additional Settlement Additional Pts (based on 2.24 units people/unit) Ab Kettleby 10 22 Asfordby Hill 87 195 Asfordby 225 504 Bottesford 357 800 Croxton Kerrial 59 132 Easthorpe 21 47 Frisby on the Wreake 118 264 Gaddesby 36 81 Great Dalby 37 83 Harby 141 316 Hose 76 170 Long Clawson 130 291 Melton Mowbray 716 1,604 Old Dalby 51 114 Scalford 23 52 Somerby 102 228 Stathern 120 269 Thorpe Arnold 24 54 Waltham on the Wolds 299 670 Wymondham 55 123 Total: 2,687 6,019

177 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.19.5. Map of Practices & Housing Developments

178 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.20. Syston, Vale & Melton PCN Review of Estate

179 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.20.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives. Six Facet Survey Summary NHS Patient Backlog Map GIA Multi- Physical Contract Practice Name/Address List Tenure Functional Space Fire En Premises Yr 1-5 Comments No. m² site Conditio Quality Code Size Suitability Utilisation H&S v Assessment Maint'nce n incl H&S The County Practice, • 2007 purpose built premises Syston Health Centre, • Leased premises which may have been developed through 3rd party developer 16 C82042 12,751 1000* Lease Single BA FABC 7.0 £40,000 Melton Road, Syston, and subject to long lease periods with limited break clause opportunities LE7 2EQ • Below GIA space maxima and assessed as fully utilised

Jubilee Medical Practice, • 2007 purpose built premises Syston Health Centre, • Leased premises which may have been developed through 3rd party developer 17 C82078 12,109 1000* Lease Single BA FABC 7.0 £40,000 Melton Road, Syston LE7 and subject to long lease periods with limited break clause opportunities 2EQ • Below GIA space maxima and assessed as fully utilised

• Condition B/C • 1990s purpose-built branch premises Asfordby Surgery, • Ongoing investment to ensure that all areas meet infection control standards by Latham House, Regency 14 122 Free Branch B/C B UBB D* 10.5 £30,130 replacing high pressure laminate vanity units Road, Asfordby, LE17 • Requires investment to address internal/external backlog and routine maintenance 3YL issues • Assessed as under-utilised with limited opening hours and GP presence C82038 35,752 • Building Condition B/C • 1970s purpose-built building Latham House, Sage • Ongoing investment to ensure that all areas meet infection control standards by 15 Cross Street, Melton 1,786 Free Main B/C B FBB D* 9.5 £333,640 replacing kitchen units Mowbray, LE13 1NX • Requires investment to address internal/external backlog and routine maintenance issues and cyclical redecorations • Assessed as fully utilised and below GIA space maxima

• 1700s converted cottages with later extensions Long Clawson Medical • Functional suitability C as clinical rooms not sufficient for function Practice, The Sands, • Requires investment to address internal/external backlog and routine maintenance 13 C82016 6,995 341 Free Single BC FBBE 10.0 £36,285 Long Clawson, Melton issues, ensure all areas meet infection control standards and H&S compliance Mowbray, LE14 4PA • FRA recommended owing to physical elements noted during survey • Assessed as fully utilised and below space maxima

180 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Syston Vale & Melton: Building Age/Type Syston Vale & Melton: 6 Facet Assessment 3

2 2

1 3

0 1700s 1970s 1980s 1990s 2000s

Purpose built Converted Village Hall R A G

Syston Vale & Melton: Syston Vale & Melton: Practice GIAs Surgery Opening hours 600 Long Clawson Medical Practice 341

2250 Asfordby Surgery 1908 1

969 Jubilee Medical Practice 1000

1020 The County Practice 1000 4

0 500 1000 1500 2000 2500

Calculated Current GIA Core Core+ Core -

181 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.20.2. Key Issues from Appraisal and Mapping • Long Clawson Medical practice, Asfordby Surgery Latham Following the review and assessment, key issues for consideration House, and Ashfordby Surgery (Map no 13, 14, 15), have across the Syston, Vale and Melton PCN include the following: reported GIAs below the advised maxima for their patient • Four of the buildings were purpose built for healthcare with one population. a converted residential property dating from the 1700s • The County Practice and Jubilee Medical practices (Map no’s 16 • Latham House with reported GIA of 1,786m² has a backlog risk & 17) have GIA’s in line with their advised space maxima for their cost of £333,640. patient numbers. • The PCN has one leased building in Syston (Map no’s 16 & 17) built in 2007. The GIA of the entire building is approximately 9.20.3. Risks & Implications for Syston, Vale & Melton PCN 2600m² with Jubilee Medical Practice and the County Practice Based on the surveys, GIA assessment and mapping, the practices each occupying approximately 1000m². The remaining area of will not be able to accommodate, within the existing estate profile, the the building is occupied by Secondary Care Services. This likely growth in patient numbers from the planned housing building is owned by NHS PS and may be subject to long lease developments therefore it is likely that increased estate capacity will periods with limited break clause opportunities. be required. • Four premises are reported by the 6 Facet survey to be fully utilised (Map no’s 13, 15, 16 & 17). The proposed housing developments across the Syston, Vale & • Ashfordby Surgery branch premises (Map No 14) is reported to Melton PCN of just under 2,687 units could add over 6,019 people to be under-utilised as there is often no doctor provision at the the local GP registered lists. The topography and rural nature of the surgery and the hours could be extended by remaining open area means there are a number of very small housing developments over lunch and for full days on Thursday and Friday (currently spread across the PCN area. The practice premises are spread closes at 11.30 am both days). across the PCN and more shared agency approaches in isolated

182 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE communities, across the public sector services, may need to be within their current demise. considered in order to ensure sustainable service delivery. Thurmaston Medical Centre (Map no. 93), part of Watermead PCN, Larger housing developments are planned in Melton District Council is to the west of these extensive developments and has registered area at Barkby Thorpe (3,402 units), Melton Mowbray (827 units), patients in these areas and there is also a large housing Barkby (801 units), Bottesford (357 units) and Asfordby (225 units). development at Thurmaston. However, that practice is fully utilised, In addition, the impact of developments at Syston (1808 units) and with a reported GIA below the advised space maxima so is unlikely Queniborough (324 units) as part of the Charnwood Borough to be able to absorb any new patients from Barkby, Syston or Council housing development plan will also need to be absorbed Thurmaston without further development. locally. This may add circa 12,683 new patients to the local GP registered lists which will impact on Syston, Vale & Melton PCN and Consideration of a space utilisation survey followed by exploration Watermead PCN practices. of expanding the current demise of the two Syston practices through discussions with the landlord may offer an on-site solution. If there The housing developments at Barkby Thorpe and Barkby may add is no possibility of this, a feasibility study should be considered, circa 9,400 new patients locally. These, and depending on patient working with both Market Harborough & Bosworth, Cross Counties flow, the large developments at Syston and Queniborough are likely and Watermead PCNs, to jointly assess reconfiguration and space to also impact on the County Practice and Jubilee Medical Practice expansion, including a possible new build for the practices affected (Map no’s 16 & 17). Both practices are in modern premises and have to manage the impact of increasing patient numbers resulting from reported GIA’s at the level expected against the advised space the housing developments in the communities within the triangle of maxima for their current patient numbers. As they are reported to be Syston, Bushby and Thurmaston. fully utilised and operate full/extended opening hours the practices may be compromised to absorb the increased patient numbers

183 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE For the main and branch surgeries at Latham House in Melton Bottesford with a branch surgery in Waltham, so the 1,845 additional Mowbray and nearby Asfordby Surgery (Map Nos 14 & 15) the main patients are likely to be dispersed across these four practice sites. housing impact of circa 2,590 additional patients is likely to come The Long Clawson Medical practice (Map no. 13) operates full from the development of 1,146 housing units in Melton Mowbray, opening hours, is reported as having a GIA significantly below the Asfordby, Asfordby Mill and Frisby on the Wreake. In addition, advised space maxima and is fully utilised making provision of although sites are not confirmed, longer term planning in the Melton additional services difficult due to limited space. If the practice were Urban area to the 2036 timescale is likely to add a further circa 4,000 to increase their list by circa 500 people to circa 7,500 patients the patients to local lists. advised GIA space maxima would rise to circa 600m² which is 260m² more than the current size of the reported demise. A desktop condition and capacity assessment including the condition surveys, health needs, population and geographical data relating to Consideration of a utilisation study to identify the current level of these two premises does not present an obvious option at this stage, space efficiency and determine the shortfall to inform a revised therefore, a feasibility study should be considered to determine long schedule of accommodation would inform further planning. A desktop term estates options for the primary care estate in the Melton review suggests there may be the potential for expanding the current Mowbray area for a practice list that will potentially rise to over 38,000 building subject to checking ownership and legal boundaries which patients. might offer an option for further consideration. The reality is that the impact might not be resolvable without considering other sites. Long Clawson Medical practice (Map no. 13) may feel the impact of a number of housing developments at Long Clawson (130 units), Harby (141 units), Bottesford (357 units), Stathern (120 units) and Hose (76 units), adding around 1,845 new patients. However, there are two South Lincolnshire practices in Croxton Kerrial and

184 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The summarised issues for Syston, Vale & Melton PCN are listed in the table below: Premises Issue Action Syston Health Will be under pressure from new housing, Centre but increased building efficiency might be achieved with the potential to identify options for potentially expanding demise. Syston, Bushby & Will be under pressure from new housing Thurmaston triangle between East Goscote, Thurmaston and Beeby including Syston, Barkby, Barkby Thorpe and Queniborough (See Hot Spot No 5 working with Watermead and Cross Counties PCNs) Long Clawson Undertake space utilisation study of whole building to determine actual use and identify options for potentially expanding GMS space. Melton Mowbray and Consider an optimisation study to assess Asfordby options across both Melton Mowbray and Asfordby to determine scope to increase capacity.

185 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.21. Harborough District Council Area Market Harborough, the main town, is located on the East Midlands 9.21.1. Socio-economic Profile Trains rail route and the East Midlands Airport and Birmingham Harborough is predominately rural with relatively low population Airport are within 50 miles of much of the District. density, covering 230 square miles. The District borders Warwickshire to the west, Northamptonshire to the south, with the 9.21.2. Demographic Profile Rivers Well and Avon forming much of the District’s southern Harborough has a current population of 92,499 (2018 Public Health boundary, and Rutland to the east. Harborough adjoins five other Profile). It is a growing and ageing population, with almost a quarter Leicestershire planning authorities, namely Charnwood, Melton, of the population of the District (24.3%) expected to be within the over Oadby and Wigston, Blaby, and Leicester City. 65 group by 2024.

186 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The District has a very low ethnic mix, with white-British the largest 9.21.4. Housing ethnic group (92.8% in 2011 Census). There is an objectively assessed housing need (OAN) for Harborough District of 557 dwellings per annum, which amounts to a 9.21.3. Health Needs total housing requirement between 2011 to 2031 of 12,800 dwellings. Harborough is one of the 20% least deprived Districts/unitary Market Harborough is the focus of growth with housing plans for authorities in England, however about 7% (1,000) of children live in about 1,500 new homes to the north-west of the town. in addition to low income families. plans for about 8,792 dwellings around Lutterworth and Broughton Astley. The health of people in Harborough is generally better than the England average, with life expectancy mostly higher than the Affordability is a particular issue with an estimated need for 179 new England average, and life expectancy is not significantly different for affordable homes per annum from 2017 to 2031. In addition, the people in the most deprived areas of Harborough than in the least District's need for specialist housing for older people to 2031 has deprived areas. been estimated to be 63 dwellings per annum or 1,267 dwellings. Leicester City Council has indicated that there may be a requirement The number of people with qualifications is generally higher than the for the Harborough District to support unmet housing need in UK average. In Year 6, 11.5% (109) of children are classified as Leicester City. obese, better than the average for England. Levels of teenage pregnancy, GCSE attainment, smoking, TB, early deaths from cardiovascular diseases and early deaths from cancer are all better than the England average.

187 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE The SHLAA (2015/16) and Local Plan (2011-31) identifies the Claybrooke 122 275 62 60 0 0 following developments over a 16-20 year period. Magna Dunton 47 106 5 42 0 0 No of Projected Deliverable Bassett Settlement added Additional Foxton 31 70 31 0 0 0 units Pts (2.25) 0-5 6-10 11-15 16+ years years years years Gilmorton 138 311 45 93 0 0 Great Glen 1,739 3,913 599 444 259 437 Great 569 1,280 119 351 18 81 Fleckney 956 2,151 633 166 157 0 Bowden Houghton Great 388 873 79 259 50 0 287 646 34 253 0 0 on Hill Easton Billesdon 394 887 200 150 0 44 Hallaton 104 234 0 104 0 0 Ullesthorpe 186 419 12 92 29 53 Lubenham 124 279 0 89 0 35 Husbands 66 149 0 26 40 0 Medbourne 149 335 40 48 61 0 Bosworth North 272 612 98 13 0 161 Kibworth 4,633 10,424 337 1,745 1,739 812 Kilworth Scraptoft 1,325 2,981 0 687 484 154 Swinford 79 178 0 41 38 0 Broughton Tilton on 1,901 4,259 801 364 648 88 32 72 0 32 0 0 Astley the Hill Lutterworth 3,000 6,750 0 521 881 1,598 Tugby 10 23 10 0 0 0 Market 2,380 5,355 352 732 887 409 Total: 20,363 45,799 3,457 6,592 5,557 4,760 Harborough Thurnby 655 1,474 0 175 211 269 and Bushby Edge of 619 1,393 0 0 0 619 Oadby Stoughton 0 0 0 0 0 0 Bitteswell 143 322 0 88 55 0 Church 14 32 0 14 0 0 Langton

188 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.21.5. Map of Practices & Housing Developments

189 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.22. Market Harborough & Bosworth PCN Review of Estate

190 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.22.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Patient Map GIA Multi- Backlog Contract Practice Name/Address List Tenure Physical Comments No. m² site Functional Space Fire En Premises Yr 1-5 Code Size Conditio Quality Suitability Utilisation H&S v Assessment Maint'nce n incl H&S Husbands Bosworth • 2010s purpose built primary care facility Surgery, 1 Marsh Drive, 31 471 Free Main AA UAB A* 7.0 £18,840 • Assessed as under-utilised with typically 4 out of the 8 clinical spaces being Husbands Bosworth, utilised LE17 6PU C82109 3,874 • GP sessions held one afternoon per week held which are providing a local service Husbands Bosworth for patients 32 Surgery, Village Hall, n/a Lease Outreach Not Surveyed - VH 0.0 £29,650 • Unlikely that the environment will be compliant for any consultation requiring Welford, NN6 7HT invasive clinical procedures

• 1990s purpose built primary care facility Market Harborough • Some investment required for backlog and routine maintenance Medical Centre, 67 issues/replacements, cyclical redecorations and ensure all areas meet 29 650* Free Main BA FAB F* 7.0 £49,300 Coventry Road, Market infection control Harborough, LE16 9BX • Premises assessed as fully utilised and practice overall is below the GIA space maxima C82009 25,000

Market Harborough • 2010s purpose built GP surgery forming part of St Lukes Hospital premises Medical Centre, St Lukes • Leasehold premises from NHSPS and may be subject to long lease periods with 30 Branch Surgery, 33 400* Lease Branch AA FAA B* 5.0 £17,000 limited break clause opportunities Leicester Road, Market • Premises assessed as fully utilised Harborough, LE16 7BN

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9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Market Harborough: Building Age/Type Market Harborough: 6-Facet Assesment 2

1

4 0 N/K 1930s 1990s 2000s 2010s

Purpose built Converted Village Hall R A G

Market Harborough: Practice GIAs Market Harborough: Surgery Opening Hours

Market Harborough 1050 Medical Centre 1600

2 2 471 Husbands Bosworth Surgery 300

0 200 400 600 800 1000 1200 1400 1600 1800

Current Calculated Core Core+ Core -

192 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.22.2. Key Issues from Appraisal and Mapping • The Husbands Bosworth Surgery practice offers booked Following the review and assessment, key issues for consideration appointments in the Village Hall at Welford (Map No 32) which is across the Harborough PCN area include the following: providing a local service for patients however, it is unlikely that • The overall condition of buildings is excellent condition and the environment will be compliant for any consultation requiring functionality. invasive clinical procedures. • The Market Harborough branch practice (Map no.30) is a part of • Space appears to be an issue for both the Market Harborough St Luke's Hospital which is purpose built as a medical centre with practice premises (Map no’s 29 & 30); these operate full hours, facilities of excellent quality. with three of the four premises reported by the 6FS to be fully • The Husbands Bosworth Surgery (Map no. 31) is a 2017 purpose utilised and have reported GIAs estimated to be below the built primary care facility where the condition and quality of advised space maxima for their list sizes. facilities are both excellent. • Based on the surveys, GIA assessment and mapping, the • Both the PCN’s branch practices are leased, though one, Harborough PCN may be able within the existing estate profile to Husbands Bosworth Surgery branch (Map no. 32), is a room in a accommodate some but not all the likely growth in patient Village Hall used by appointment only. numbers from the planned housing developments across the • St Luke’s Hospital is owned by NHSPS and may be subject to PCN area. long lease periods with limited break clause opportunities however there may be flexibility to secure additional space if 9.22.3. Risks & Implications for Market Harborough & Bosworth required within the multi-functional provider building. PCN • The main Husbands Bosworth Surgery (Map no.31) has a GIA The majority of proposed housing developments across the above the advised space maxima for the list size and is reported Harborough PCN area are clustered mainly around Market by the 6 Facet survey to be under-utilised. Harborough (2,380 units), with smaller housing developments at North Kilworth (272 units) and nearby Husbands Bosworth (66 units),

193 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE collectively adding circa 6,115 new patients to be absorbed by the The key issues for Market Harborough and Bosworth PCN are listed PCN practice lists. The impact of new patients is likely to fall on in the table below with an estimated cost for improvement/investment Market Harborough Medical Centre and their branch practice (Map where identified: no. 29, 30) together with the Two Shires Surgery branch premises Premises / Action (Map no. 22) which is a Cross Counties PCN practice located at Issue Market Harborough. All these practices are reported to be operating Market Will be under pressure from new housing (See to capacity. Harborough Hot Spot No 15 working with Leicester Health Focus PCN. Husbands Bosworth Surgery (Map no 31) may feel the impact of small developments at North Kilworth and nearby Husbands Bosworth will add potentially 762 new patients. Given the practice is in excellent condition and reported as under-utilised, with a GIA reported to be above the advised space maxima for the patient list size, it should be able to accommodate the additional new patients and is therefore not a priority.

194 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.23. Cross Counties PCN Review of Estate

195 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.23.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary NHS Patient Map GIA Multi- Backlog Contract Practice Name/Address List Tenure Physical Comments No. m² site Functional Space Fire En Premises Yr 1-5 Code Size Conditio Quality Suitability Utilisation H&S v Assessment Maint'nce n incl H&S

• 2000s purpose built premises The Croft Medical • Requires investment to address internal/external backlog and routine maintenance 28 C82067 Centre, 2 Glen Road, 9,268 600* Lease Main BA OBB C* 10.0 £51,100 issues and cyclical redecorations Oadby, LE2 4PE • Assessed as overcrowded and below GIA space maxima

• Building Conditon and Functional Suitability C Billesdon Surgery, 4 • 1900's Grade II listed converted residential property with later extensions 26 Market Place, Billesdon 359 Free Main CC FBBF 11.0 £71,875 • Investment required to address backlog maintenance issues and prevent the need LE7 9AJ for major repairs • Major change is required to improve space relationships within the building C82022 7,014

• Purpose built facility ccupying ground floor of a residential sheltered housing Billesdon Surgery, Main complex 27 200* Lease Branch BA UABD 8.0 £10,120 Street, Bushby LE7 9NY • Restricted opening hours means that the space is generally under used and this could be significantly increased

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Six Facet Survey Summary NHS Patient Map GIA Multi- Backlog Contract Practice Name/Address List Tenure Physical Comments No. m² site Functional Space Fire En Premises Yr 1-5 Code Size Conditio Quality Suitability Utilisation H&S v Assessment Maint'nce n incl H&S South Leicestershire • GP sessions held one afternoon per week held which are providing a local service Medical Group (Hallaton for patients 18 Outreach Clinic) n/a Lease Outreach Not Surveyed - VH 0.0 £61,530 • unlikely that the environment will be compliant for any consultation requiring Stenning Hall, Horn invasive clinical procedures Lane, Hallaton South Leicestershire • GP sessions held one afternoon per week held which are providing a local service Medical Group for patients 19 (Medbourne Outreach n/a Lease Outreach Not Surveyed - VH 0.0 £0 • unlikely that the environment will be compliant for any consultation requiring Clinic) Village Hall, Main invasive clinical procedures Street Medbourne • Building Condition B/C and Quality C • 1800s converted school with 1990s extension South Leicestershire • Requires investment to address internal/external backlog and routine maintenance Medical Group (The Old issues, cyclical redecorations and ensure all areas meet infection control standards 20 School Surgery), 2a 411 Free Branch B/C B F B C E* 10.5 £69,890 and H&S Station Road, Kibworth, • Functional suitability is generally satisfactory, although clinical spaces were slightly LE8 0LN undersized • FRA recommended owing to physical elements noted during survey • Asbestos survey and access audit recommended • Building Condition B/C and Quality C • 1970s former residential property South Leicestershire • Requires capital investment to improve facilities Medical Group (Fleckney 21 123 Free Branch B/C B F C C E* 11.5 £31,265 • Requires investment to address internal/external backlog and routine maintenance Surgery), 6A High Street, issues, ensure all areas meet infection control standards and H&S compliance C82001 Fleckney, LE8 8AJ 26,497 • Access audit, FRA review and asbestos survey recommended

• Purpose built 2000s primary care facility South Leicestershire • Leased premises which may have been developed through 3rd party developer Medical Group (Two and subject to long lease periods with limited break clause opportunities 22 Shires Surgery), Torch 667* Lease Branch BA FABC 7.0 £53,830 • Requires investment to address routine maintenance issues and ensure all areas Way, Market Harborough meet infection control standards and H&S compliant LE16 9HL

South Leicestershire • Building Condition B/C, Functional Suitability and Quality C Medical Group Great • Requires capital investment to improve facilities 23 Glen Surgery, 24 Main 80* Free Branch B/C C FCC F* 12.5 £14,600 • Requires investment to address backlog and routine maintenance issuesensure all Street, Great Glen LE8 areas meet infection control standards and H&S compliance 9GG • Building Condition B/C, Functional Suitability and Quality C • 1990s purpose built premises South Leicestershire • Requires investment to address internal/external backlog and routine maintenance Medical Group, Fleckney 24 85* Free Branch B/C B U C B E* 11.5 £36,700 issues, cyclical redecorations and ensure all areas meet infection control standards Medical Centre, High and H&S Street, Fleckney LE8 8AJ • Assessed as under utilised with restricted opening hours

South Leicestershire • 2010s purpose built premises Medical Group Kibworth • Leased premises which may have been developed through 3rd party developer 25 871 Lease Branch AA UAA C* 6.0 £34,840 Medical Centre, Smeeton (Assura) and subject to long lease periods with limited break clause opportunities Road, Kibworth LE8 0LG • Assessed as underutilised

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9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Cross Counties: Building Age/Type Cross Counties: 6 Facet Assessment* 2

3 1

6

0 N/K 1800s 1970s 1980s 1990s 2000s 2010s

Purpose built Converted Village Hall R A G

Cross Counties: Practice GIAs Cross Counties: Surgery Opening Hours

559 Billesdon Surgery 561 2

2237 South Leicestershire Medical Group 1750 2 7 600 The Croft Medical Centre, 700

0 500 1000 1500 2000 2500

Current Calculated Core Core+ Core -

198 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE 9.23.2. Key Issues from Appraisal and Mapping located within a sheltered housing facility. Following the review and assessment, key issues for consideration • The PCN offers two GP one hour sessions once per week across the Cross Counties PCN area include the following: held in local community centres/village halls at Hallaton and • Five of the nine are purpose built premises for health care, Medbourne (Map no’s 18 & 19) which are providing a local two are converted residential properties service for patients; however, it is unlikely that the • Six leased buildings two of which are in village halls. The four environment will be compliant for any consultation requiring which are standard venues (Map no’s 22, 25, 27 & 28) may invasive clinical procedures. have been developed through a 3rd party developer and be • South Leicestershire Medical Group, Fleckney Surgery (Map subject to long lease periods with limited break clause no. 21) is a fully utilised small single storey 1970s opportunities. construction in a challenged condition and requires capital • It is noted that Two Shires Medical Practice is a group investment. practice with a single list of registered patients. Their eight • Two branch premises on the High Street serving Fleckney premises (Map no’s 25, 18, 19, 20, 21, 22, 23 & 24), form the are both small according to their reported GIAs of 123m² and major geographical coverage and premises capacity the 85m² and operating less than full core opening hours. Full Cross Counties PCN. time opening across both buildings would offer 7 hours of • Kibworth Medical Centre, a large new in purpose built in 2018 additional capacity Monday to Friday. (Map No 25) is not yet fully utilised • Functional suitability at Great Glen Surgery (Map no. 23) and • Notable levels of backlog risk cost exist particularly for the Billesdon Surgery (Map no. 26) is compromised reported GIA sizes e.g. Fleckney Medical Centre and • Over half of premises (Map no’s 20, 21, 22, 23, 26 & 28), Fleckney Surgery for the Two Shires Medical Practice and reported being fully, or with the Croft Medical Centre (Map no. Billesdon Surgery. (Map No’s 21,24 & 26) 28), over utilised. However, three of the premises reported to • Bushby Branch Surgery at Thurnby (Map No 27) is co-

199 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE be full should have scope to offer additional capacity if they with the Two Shires Surgery branch premises (Map no. 22) which is operated full core opening hours (Map no’s 21, 22, 23 & 24). a Cross Counties PCN practice located at Market Harborough. All these practices are reported to be operating to capacity. 9.23.3. Risks & Implications for Cross Counties PCN Consideration could be given to working with NHS Nene CCG to The largest proposed housing developments across the Cross explore the potential some of the impact of new patients to be Counties PCN area are around Kibworth (4,633 units), Great Glen absorbed by Rothwell Surgery in Kettering who have a branch (1,739 units), Fleckney (956 units) and Scraptoft (1,325 units), on the surgery at Desborough, to the south of Market Harborough. border of the Harborough and Leicester City, which could impact local Cross Counties PCN practices to the south of the proposed In addition, a number of smaller but significant housing developments development area. These developments may collectively add circa spread across the area including Houghton on the Hill (388 units), 19,500 new patients to be absorbed by local practice lists. The impact Billesdon (394 units), Thurnby and Bushby (655 units), Hallaton (104 of new patients is likely to fall on Two Shires Centre and their branch units) and Medbourne (149 units) may add the potential of circa 3,800 practice (Map no. 21, 22) together with Fleckney and Kibworth new patients requiring a further GIA capacity of citca 304m² to be Medical Centres (Map nos. 24, 25), Great Glen Surgery (Map no. 23) absorbed by PCN practice lists, primarily Billesdon Surgery (Map no. and The Old School Surgery (Map no. 20). All these practices are 27). Current capacity might be able to absorb this impact if reported to be operating to capacity, though there is a possible individually they were the only pressure however, several e.g. extension option for practice no. 25. Thurnby and Bushby impact on the same practice area which indicates that incremental actions and solutions would not address Market Harborough has a large planned housing expansion (2,380 the pressure. units), amplified by smaller developments nearby with the impact of possibly 5,355 new patients likely to fall on Market Harborough Billesdon practice (Map No 26) whilst not an immediate priority needs Medical Centre and their branch practice (Map no. 29, 30) together to be monitored as it is the only practice in the area and has some

200 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

9. LEICESTERSHIRE COUNTY COUNCIL AREA PRIMARY CARE ESTATE challenging estate maintenance issues to be addressed within a The key issues for Cross Counties PCN are listed in the table below Grade 2 listed building. with an estimated cost for improvement/investment where identified: Premises / Issue Action Hallaton and Medbourne are served by outreach clinics of Two Kibworth, Great Glen Will be under pressure from new Shires Medical practice delivered as GP led one hour sessions once and Fleckney housing (See Hot Spot No 16. per week held in local community centres (Map Nos 29 & 30). Market Harborough Will be under pressure from new Although these venues would not be suitable for any consultation housing (See Hot Spot No 15. working requiring invasive procedures, they are the only physical primary care with Harborough PCN and NHS Nene facilities provided and will need to continue to be reviewed for the CCG) longer term. The smaller housing developments at Great Bowdon, Scraptoft, Thurnby Will be under pressure from new Lubenham and Foxton are likely to be served by a combination of and Billesdon housing (See Hot Spot No 17). practices from Market Harborough, Uppingham and Lakeside Fleckney Surgery Undertake a utilisation assessment Healthcare (Corby CCG) depending on patient flow dispersing the Hallaton and Review existing provision and identify impact. Medbourne options, working with Rutland PCN

201 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

202 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE

203 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.1. Socio-economic Profile Rutland has a higher than average proportion of its population within Forming the “smallest county in England” and covering 147 square the Armed Forces Community of serving, dependant and retired miles, Rutland sits to the east of Leicestershire and is a Unitary personnel. Authority. Being predominantly rural it has two major settlements of Oakham and Uppingham and one of the largest man-made bodies of Rutland has plans to expand its population through residential water in the United Kingdom in Rutland Water. development in the period to 2036, including potential major developments on sites that may become vacant through changes in land use. An increasing population and proximity to other major settlements including Leicester, Peterborough, Nottingham and Corby will affect the services provided for the population and impact on their location and use.

Though the profile shows an affluent and rural area, the high cost of housing and difficulties in access to services due to the dispersed pattern of settlement and lack of public transport are issues facing Rutland. The service sector provides the most jobs in Rutland, with agriculture, the traditional employer, now a minority employer and still declining.

10.2. Demographic Profile Rutland has a current population of 36,997 (2018 Public Health

Profile). It is an older and growing population with almost a quarter

204 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE (23.9%) of the population aged over 65 years, compared to 17.9% 10.3. Health Needs nationally. The 85 and over population is predicted to grow at a faster The health of people in Rutland is generally better than the England rate than nationally, by 142.9%. The rise in Rutland’s population is average and Rutland is one of the least economically deprived areas projected to gradually increase due to inward migration. in the country. There are low levels of unemployment and above average levels of educational attainment. In spite of the relative affluence of Rutland, there are concealed pockets of deprivation and housing affordability problems given the high house prices, with about 7% (400) of children living in low income families.

Rutland has lower levels of limiting long-term illness and the lowest levels of premature death (under the age of 75) in the East Midlands. Life expectancy for both men and women is higher than the England average.

Estimated levels of adult smoking, early deaths from cardiovascular diseases and cancer are all better than the England average.

10.4. Housing The Updated Strategic Housing Assessment (2015) identified a

The proportion of non-white ethnic groups is low, with 97% White and requirement for about 170 new dwellings per annum with a total of 3% other BME groups. around 4,250 additional new dwellings in Rutland in the period to 2036, with an affordability adjustment of 160 dwellings per annum.

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10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Oakham and Uppingham are likely to be the most sustainable Ryhall 196 419 0 172 24

locations for new development, with much of the expected population St Georges 1,765 3,777 0 0 growth accommodated in the Oakham area. Garden 1,765 Community Uppingham 528 1,130 9 519 0 Rutland has a high proportion of larger housing and some of the Whissendine 306 655 0 306 0 highest house prices in the country with the high ratio of house prices Total 5,488 11,744 56 3,005 2,227

to household income creating a need for a significant increase in affordable housing.

No of Projected Deliverable Settlement added Additional 1-5 6-10 11-15 units Pts (2.14) years years years+ Barleythorpe 8 17 8 0 0 Cottesmore 95 203 18 77 0 Edith Weston 70 150 0 70 0 Empingham 29 62 5 18 6 Great Casterton 54 116 0 54 0 Greetham 58 124 0 58 0 Ketton 336 719 0 336 0 Langham 119 255 16 103 0 Little Casterton (figs from South Kersteven DC Not Not Not SHLAA 2011-2036 650 1,391 available available available Rutland element of a site that straddles DC boundary) Market Overton 71 152 0 71 0 Oakham 1,203 2,574 0 771 432

206 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.5. Map of Practices

207 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.6. Rutland Healthcare PCN Review of Estate

208 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.6.1. Premises Assessment This is based on local estates knowledge including reviewed 6FS data from 2019 where this was available and our assessment of the potential to develop, extend or rationalise estates to support proposed new services and the CCGs commissioning objectives.

Six Facet Survey Summary Multi- Map Practice Patient GIA Practice Name/Address site Tenure Property Comments No code list size m² Physical Functional Space Fire Risk Quality Env Assessment Condition Suitability Utilisation H&S Cost

• Converted office building shared with NFU and Ashdale Pharmacy • Requires investment to address backlog maintenance issues The Uppingham Surgery, 835 Main Free B A FA BC 7 £58,000 • Below GIA space maxima for patient population and extended operating 38 North Gate Uppingham hours • Full utilisation reported with greater pressure on Mondays/Fridays • Leasehold premises (Burghley House Preservation Trust Ltd) may be subject to long lease term The Uppingham Surgery, • Break opportunities may be limited • Limited opening hours with only 2 hours on Monday pm and 2 hours on 39 C82077 Kings Lane, Barrowden 11,364 55 Branch Lease B A U AB E* 8.0 £11,300 LE15 8EF Thursday/Friday am • Requires investment to address backlog maintenance issues • Practice overall below GIA space maxima for patient population

• Leasehold premises (Corby Borough Property) may be subject to long lease The Uppingham Surgery, term and limited break options Kirby Road, Gretton, 40 60 Branch Lease B A U AB D* 8.0 £16,000 • Limited opening hours with only 2 1/2 hours on Monday/Tuesday am and 2 Northamptonshire NN17 hours on Thursday pm 3BD • Practice overall below GIA space maxima for patient population

• Consulting rooms considered too small for function Empingham Medical • Requires investment to address backlog and routine maintenance issues Centre, Main Street, 34 C82044 7,001 311 Single Free B B OBB F* 11.0 £54,618 • Below GIA space maxima for patient population and full operating hours Empingham, Oakham LE15 • Reported as overcrowded 8PR

• Offers a one hour prescription service once a week Market Overton & Somerby • Unlikely that environment is will be compliant for any consultation requiring Surgeries, The Surgery, n/a Outreach Lease Not Surveyed - VH 0.0 £0 invasive clinical procedures 35 Church Lane, Wymondahm • Overall the practice is above the GIA space maxima for the patient LE14 2AB population • Slightly above the GIA m2 space maxima for the size of the patient Market Overton & Somerby population 36 C82649 Surgery, Thistleton Road, 4,539 150 Main Free B A FA B D* 7.0 £11,822 • Reported as full with core operating hours although some less busy on Oakham LE15 7PP Wednesday afternoons • Access from the car park requires review for people with mobility issues • Overall the practice is slightly over the GIA space maxima for the combined The Surgery, Oakham population 231 Branch Free B A F AB B* 7.0 £45,750 37 Road, Somerby LE14 2QF • Full utilisation reported although less busy on Wednesday mornings • Investment required to address H&S, backlog and routine maintenance issues • Below GIA m2 space maxima for patient population Oakham Medical Practice, • Full utilisation and extended hours in operation 33 C82010 Cold Overton Road, 16,063 790 Single Free B A FBCF 9.0 £54,350 • Requires investment to address H&S, backlog and routine maintenance Oakham LE15 6NT issues Additi l t d ti id d i d l b ildi

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10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE

Rutland: Building Age/Type Rutland: 6-facet assessment 4

1 3

2

1

7 0 N/K 1970s 1980s 1990s 2000s

Purpose built Converted Village Hall R A G

Rutland: Practice GIAs Rutland: Practice Opening Hours

1,285 Oakham Medical Practice 790

3 363 Market Overton & Somerby Surgeries 381

560 Empingham Medical Centre 311 4

909 The Uppingham Surgery 950 1

0 200 400 600 800 1,000 1,200 1,400

Calculated Current GIA Core Core + Core -

210 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE 10.6.2. Key Issues from Appraisal and Mapping • The Market Overton & Somerby Surgery offers a one hour Following the review and assessment, key issues for consideration prescription collection service once per week held in the Village across the Rutland Healthcare PCN area include the following: Hall at Wymondham (Map No 35) which provides a valued local • Five of the eight premises are purpose built for healthcare, two service for patients; however, it is unlikely that the environment are converted residential properties and one a village hall. will be compliant for any consultation requiring invasive clinical • The PCN has three leased buildings (Map no’s 35, 39 & 40) which procedures. may have been developed through a 3rd party developer and may • Based on the surveys, GIA assessment and mapping, the be subject to long lease periods with limited break clause Rutland Healthcare PCN is likely to be able to accommodate opportunities. increased patient numbers from the smaller developments but is • Five premises are reported by the 6 Facet survey to be fully unlikely to be able to cater for the potential growth in patient utilised (Map no’s 33, 35, 36, 37 & 38), with one, Empingham numbers from the major planned housing developments within Medical Centre (Map no. 34), reported as overcrowded. the existing estate profile. • Both the Uppingham Surgery (Map no 38) and Empingham Medical Centre have reported GIA’s estimated below the advised 10.6.3. Risks & Implications for Rutland Healthcare PCN maxima for their patient population. The proposed housing developments across the Rutland of just • The GIAs for Map no’s 36, 37, 39 & 40, though joint across main under 5,488 units could add over 11,744 people to the local GP and branch practices, are above the expected advised space registered lists. A key challenge for estate planning and premises maxima for their patient numbers. The 6 Facet survey results utilisation across the Rutland Healthcare PCN is the topography and suggest that Map no’s 36 & 37 may also have some under- rural nature of the area. There are a number of very small housing utilisation on Wednesdays. The two Uppingham Surgery branch developments spread across the PCN area (including Wymondham, practices (Map no’s 39 & 40) are reported by the survey as under- Market Overton, Somerby, Langham, Cottesmore, Greetham, utilised. Empingham and Exton). Solutions, including increasing utilisation of

211 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

10. RUTLAND COUNTY COUNCIL AREA PRIMARY CARE ESTATE buildings, may require more joint agency approaches across the extensions/new buildings or significant consolidations, in addition to public sector services to support sustainable service delivery in an optimisation programme (See Hotspot 18). isolated communities. The key issues for Rutland Healthcare PCN are listed in the table Though the PCN will need to consider sustainable service delivery in below with an estimated cost for improvement/investment where dispersed communities, the practices are likely to be able to absorb identified: the impact of new patients from these smaller sites. Improving and Premises / Issue Action optimising existing premises by more efficient utilisation of space Oakham Undertake a feasibility study to assess including extending opening times may suffice in some areas. (Map Nos 33, 37) local options in Oakham to manage the impact of increasing patient Consideration should be given to developing a more detailed numbers. See Hotspot 18 understanding of capacity across Uppingham, Barrowden and South and East Rutland Undertake a feasibility study to assess Gretton. Solutions may be available within current buildings e.g. covering Uppingham, options to manage the impact of other tenants with offices in the same location as Uppingham Surgery Barrowden, Gretton increasing patient numbers. See might offer opportunities to increase the demise of the surgery within Empingham Ketton & Hotspot 19 the existing building. Little Casterton Liaise with South Lincolnshire CCG to understand the impact of Ketton and Based on the 6 Facet utilisation data and the scale of planned Little Casterton housing developments housing development particularly impacting Oakham and on the Stamford practice & determine Uppingham, it is unlikely there will be adequate capacity within the if additional action is required. existing estate to meet the growth requirement. Increased estate capacity will be required. Consideration should be given to additional

212 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

213 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

11. LLR HOTSPOTS As part of the housing and primary care estate analysis, the risks and implications for each PCN or HNN are described with priority areas highlighted. Based on these highlighted areas, ‘Hot Spots’ have been identified where there is a significant housing or estate impact of major significance across multiple primary care premises, or where that impact needs to be considered across more than one PCN/HNN. This section summarises the Hot Spots which have been identified for each PCN and HNN area. Both the analysis and Hotspot detail provide a basis for action planning to inform an Implementation Plan.

The Hot Spots are outlined in the tables below: Hot Spot No: 1 Markfield, Groby, Ratby and Anstey PCNs involved Villages/Towns Impacted Premises NHS No Map Potential Impact Potential No Impact NWL Hub 2, Markfield, Groby, Markfield Surgery C82028 56 Planned dwellings 8,589 Bosworth Ratby, Anstey Groby Surgery C82628 70 Additional potential new patients 19,669 Ratby Surgery C82634 71 Additional GIA (m2) 1,574 Anstey Surgery C82032 82 Index cost (new build) £4,641,884 Comments: Area also adjacent to Hotspot 11.

Hot Spot No: 2 Barlestone, Newbold Verdon, Market Bosworth and Desford PCNs involved Villages/Towns Impacted Premises NHS Map Potential Impact Potential No No Impact NWL (Hub1), Barlestone, Market Westfield Surgery branch, C82012 49 Planned dwellings 5,968 Bosworth Bosworth, Nailstone, Barlestone Newbold Verdon, Newbold Verdon Medical Practice C82051 67 Additional potential new 13,309 Twycross, Desford patients Market Bosworth practice C82051 68 Estimated GIA (m2) Impact 1,065 Desford Medical Centre C82650 72 Index cost (new build) £3,141,750 Comments: Opportunity to address premises improvement issues, with four premises requiring investment to improve quality and physical condition, with two having high backlog risk cost for size.

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11. LLR HOTSPOTS

Hot Spot No: 3 Earl Shilton and Barwell

PCNs involved Villages/Towns Impacted Premises NHS Map Potential Impact Potential No No Impact Bosworth, Earl Shilton and Heath Lane Surgery C82121 69 Planned dwellings 6,890 Fossway Barwell Barwell & Hollycroft Medical Centre C82061 78 Additional potential new patients 15,365 Estimated GIA (m2) Impact 1,229 Index cost (new build) £3,625,550 Comments: The Earl Shilton practice catchment area extends towards but not into Barwell in the Fossway PCN and vice versa giving an overlap with the Barwell practice, making both practices potentially under pressure.

Hot Spot No: 4 Hinckley and Burbage

PCNs involved Villages/Towns Impacted Premises NHS Map Potential Impact Potential No No Impact Hinckley Central, Hinckley, Burbage Station View Health Centre C82043 62 Planned dwellings 15,442 Fosseway Castle Mead Medical Centre C82075 63 Additional potential new 34,436 patients The Centre Surgery C82082 65 Estimated GIA (m2) Impact 2,755 Maples Family Medical Practice 66 Index cost (new build) £8,126,896 C82047 Burbage Surgery C82054 74 Hollycroft Medical Centre C82061 79 Comments: Links to wider development e.g. community hospital.

215 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

11. LLR HOTSPOTS Hot Spot No: 5 East Goscote, Beeby, Thurmaston ‘triangle’

PCNs involved Villages/Towns Impacted Premises NHS No Map Potential Impact Potential No Impact Watermead, East Goscote, Silverdale Medical Centre C82627 93 Planned dwellings 8,283 Syston, Vale and Thrussington, Thurmaston Medical Centre C82003 95 Additional potential new 18,968 Melton Rearsby, patients Queniborough, Birstall Medical Centre C82091 91 Estimated GIA (m2) Impact 1,517 Syston, Barkby, The County Practice C82078 16 Index cost (new build) £4,476,448 Barkby Thorpe, Jubilee Medical Practice C82627 17 Beeby, Thurmaston, Comments: A46 Expressway development to 2050 will add further impact on this area as more land is released for housing development along the proposed route.

Hot Spot No: 6 Loughborough

PCNs involved Villages/Town Impacted Premises NHS Map Potential Impact Potential s No No Impact Carillion, Loughborough Pinfold Medical Practice C82011 96 Planned dwellings 6,061 Beacon Bridge Street Medical Practice C82026 97 Additional potential new patients 13,880 Park View Surgery C82035 98 Estimated GIA (m2) Impact 1,110 Student Medical Centre, Loughborough C82111 100* Index cost (new build) £3,275,68 University 0 Woodbrook Medical Centre C82070 99 Roseberry Medical Centre C82041 101 Outwoods Medical Centre C82041 102 Forrest Edge Medical Centre C82041 103 Dishley Grange Medical Practice C82103 105 Comments: Opportunity to address premises improvement issues, consolidation and increased co location. May require a separate approach for the premises at Loughborough University that caters for the student population.

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11. LLR HOTSPOTS Hot Spot No: 7 Shepshed PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Beacon Shepshed Forest House Surgery C82064 104 Planned dwellings 3,715 Field Street Surgery C82656 107 Additional potential new 8,507 patients Estimated GIA (m2) Impact 665 Index cost (new build) £1,960,452 Comments: Nearest practices are fully utilised with GIAs below the advised level - limited scope for support from neighbouring practices due to Loughborough development (Hot Spot 6)

Hot Spot No: 8 Quorn and Barrow Upon Soar

PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Soar Valley Barrow on Soar, Quorn Medical Practice C82034 83 Planned dwellings 2660 Quorn Barrow Health Centre C82062 84 Additional potential new 6,091 patients Estimated GIA (m2) Impact 487 Index cost (new build) £1,437,476 Comments: Significant under-provision at Quorn not included in additional GIA figure.

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11. LLR HOTSPOTS Hot Spot No: 9 Ibstock, Coalville and Whitwick PCNs involved Villages/Towns Impacted Premises NHS No Map Potential Impact Potential No Impact NWL (Hub 1), Ibstock, Heather, The Surgery, Coalville C82045 58 Planned dwellings 11,717 NWL (Hub 2), Coalville, Whitwick Health Centre (Pavel) C82052 59 Additional potential new 26,989 NWL (Hub 3) Swannington, patients Whitwick, Whitwick Health Centre (Virmani) C82120 61 Estimated GIA (m2) Impact 2,159 Ravenstone, Ibstock House C82072 48 Index cost (new build) £6,369,404 Donington le Broom Leys Surgery C82096 53 Heath, Ellistown, Hugglescote Surgery C82050 54 Bardon Hill Long Lane Surgery C82045 55 Hugglescote Comments: There may be opportunity to increase estate co location around Ibstock, Coalville and Whitwick.

Hot Spot No:10 Castle Donnington, Isley Walton, Breedon on the Hill and Belton PCNs involved Villages/Towns Impacted Premises NHS Map Potential Impact Potential No No Impact NWL (Hub 3) Castle Donnington, Castle Donnington Surgery C82007 57 Planned dwellings 8,311 Isley Walton, Manor House Surgery C82102 60 Additional potential new patients 19,115 Langley Priory, Estimated GIA (m2) Impact 1,529 Disworth, Index cost (new build) £4,511,140 Breedon on the Hill Belton Comments: Not many registered patients below A42 corridor from Castle Donington Surgery. Belton practice has registered patients above the A42.

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11. LLR HOTSPOTS Hot Spot No:11 M1 Corridor PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact North Blaby, Glenfield, Kirby Glenfield Surgery C82056 8 Planned dwellings 12,316 Leicester Health Muxloe, Leicester Kings Way Surgery, Thorpe Astley C82039 7 Additional potential new 29,312 Focus Forest East, Enderby, patients Narborough, Warren Lane Surgery C82631 12 Additional GIA (m²) 2,345 Huncote, Littlethorpe Forrest House Medical Centre 10 Index cost additional GIA (new £6,917,750 C82066 & Lubbersthorpe Enderby Medical Centre 11 build) The Limes Medical Centre C82055 9 Comments: The Limes Medical Centre catchment includes Huncote, Thurlaston and Croft in West Leicestershire Glenfield Surgery is on the border of Leicester City and West Leicester so adjacent to Hotspot 1

Hot Spot No: 12 Countesthorpe and Blaby PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact South Blaby and Blaby, Whetston and Countesthorpe Health Centre C82002 1 Planned dwellings 7,807 Lutterworth Countesthorpe, Glen Northfield Medical Centre 3 Additional potential new patients 18,581 C82068 Parva & South Hazelmere Medical Centre 4 Additional GIA (m²) 1,486 Wigston Kings Way Surgery, Kingsway C82039 6 Index cost additional GIA (new £4,385,116 South Wigston Health Centre C82079 46 build) Dr Singh C82019 124 Dr SA Bailey & Partners C82100 126 Pasley Road Health Centre C82626 131 Comments: From current patient catchment information, South Wigston Health Centre does not appear to take many patients from the west and south of the practice, reducing the potential impact

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11. LLR HOTSPOTS Hot Spot No: 13 Lutterworth and Bitteswell PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Imp act South Blaby and Lutterworth and Wycliffe Medical Practice C82025 2 Planned dwellings 3,143 Lutterworth, Bitteswell Fosseway PCNs The Masharani Practice 5 Additional potential new patients 7,072 C82611 Additional GIA (m2) 566 Old School Surgery C82027 73 Index cost additional GIA (new build) £1,669,700 Comments: Two practices sharing same building in good condition, next to Feilding Palmer Hospital

Hot Spot No:14 Oadby PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Oadby, Oadby The Central Surgery 42 Planned dwellings 358 C82021 Cross Counties Rosemead Drive Surgery 43 Additional potential new patients 874 PCNs C82048 Harborough Road Surgery 44 Additional GIA (m2) 70 Severn Surgery C82112 47 Index cost additional GIA (new £206,264 build) Comments: Estates driven issue associated with age, residential style and condition of buildings with compromised functional suitability. Opportunity to explore options to consolidate and achieve capacity for additional patients.

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11. LLR HOTSPOTS

Hot Spot No: 15 Market Harborough PCNs involved Villages/Towns Impacted Premises NHS No Map Potential Impact Potential Imp No act Harborough and Market Harborough, Market Harborough Medical Centre 29 Planned dwellings 2,609 Cross Counties Great Bowdon, Market Harborough Medical Centre, St C82009 30 Additional potential new patients 5,870 Lubenham, Foxton Luke's practice Two Shires Surgery, Market Harborough 22 Additional GIA (m2) 470 C82001 Index cost additional GIA (new build) £1,385,320 Comments: Optimise capacity across the three buildings; all buildings are in good condition and may have potential capacity to provide for impact from future housing developments

Hot Spot No:16 Kibworth, Great Glen and Fleckney PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Cross Counties Kibworth, Great Glen Two Shires Medical practice, Fleckney 21 Planned dwellings 7,328 and Fleckney Two Shires Medical practice, Market Additional potential new patients 16,488 22 Harborough Fleckney Medical Centre, Kibworth HC C82001 24 Additional GIA (m2) 1,319 Kibworth Medical Centre 25 Index cost additional GIA (new £3,891,168 The Old School Surgery 20 build) Great Glen Surgery premises 23 Comments: All practices are reported to be operating to capacity, though there is a possible extension option for practice no. 25.

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11. LLR HOTSPOTS Hot Spot No:17 Scraptoft, Thurnby and Billesdon Triangle PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Cross Counties, Scraptoft, Thurnby, Dr J G Astles & Partners C82029 132 Planned dwellings 2,981 Harborough, Oadby Bushby, Stoughton, Dr Roshan Y00137 137 Additional potential new patients 6,712 & Wigston & N&EL Houghton on the Hill Dr AJJ Bentley & Partners C82030 145 Additional GIA (m²) 537 HNN, PCNs and Billesdon Johnson Medical Practice, C82676 147 Index cost additional GIA (new £1,582,852 Maidenwell Avenue build) Dr J A Wood C82676 148 Dr J A Wood, The Common 149 Humberstone Medical Centre C82033 150 Billesdon Surgery C82022 26 Billesdon Surgery, Main Street 27 Comments: Some existing potential capacity might be able to absorb the impact if individually they were the only pressure; however, several housing development impacts on the same practice area indicates incremental actions and solutions would not address the pressure.

Hot Spot No: 18 Oakham PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Rutland Oakham Oakham Medical Practice C82010 33 Planned dwellings 1,203 Market Overton Surgery, Somerby C82649 37 Additional potential new patients 2,574 Additional GIA (m²) 206 Index cost additional GIA (new build) £607,464 Comments: Oakham Practice already using clinical space at the Community Hospital for GMS consultations

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11. LLR HOTSPOTS Hot Spot No:19 South East Rutland area PCNs involved Villages/Towns Impacted Premises NHS No Map No Potential Impact Potential Impact Rutland Little Casterton, The Uppingham Surgery, North Gate 38 Planned dwellings 2,904 Empingham, The Uppingham Surgery, Kings Lane 39 Additional potential new patients 6,214 Uppingham, C82077 40 Additional GIA (m²) 497 Barrowden and The Uppingham Surgery, Kirby Road Ketton C82044 34 Index cost additional GIA (new build) £1,466,740 Empingham Medical Centre Comments: Topography and rural nature of the area may require more joint agency approaches across the public sector services to support sustainable service delivery in isolated communities.

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11. LLR HOTSPOTS Hot Spot No: 20 Beaumont Leys, Abbey and Fosse PCNs involved Ward Impacted Premises NHS No Map No Potential Impact Potential Impact Millenium, Beaumont Leys, Baxter’s Close Surgery C82094 117 Planned dwellings 4,377 City Care Alliance, Abbey, Heatherbrook Surgery C82623 136 Additional potential new patients 10,943 Leicester Health Focus Fosse Beaumont Lodge Medical Practice C82094 116 Additional GIA (m2) 875 Leicester City South Narborough Road Surgery C82119 164 Index cost additional GIA (new build) £2,582,548 The Practice -Beaumont Leys C82624 174 Fosse Family Practice C82114 170 Fosse Medical Centre C82086 111 Groby Road Medical Centre C82005 108 Westcotes 1 C82059 121 Westcotes 2 C82653 122 Colwell Road C82639 119 Charles Berry House C82670 128 Leicester City Assist Y00344 130 Fosse Family Practice C82114 170 Fosse Medical Centre C82086 111 Comments: Most practices are fully utilised with GIAs below the advised level.

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11. LLR HOTSPOTS Hot Spot No: 21 Castle PCNs involved Ward Impacted Premises NHS No Map Potential Impact Potential No Impact Leicester City South, Castle Bowling Green Street Surgery Y02686 156 Planned dwellings 3,407 Leicester Central, Belgrave Health Centre C82671 169 Additional potential new patients 8,517 Leicester City & De Montfort Surgery C82020 176 Additional GIA (m2) 681 University and Inclusion Healthcare C82670 128 Index cost additional GIA (new build) £2,010,048 Fox’s PCNs St Matthews Health and Community Centre Y02469 155

Comments: Though there is potential capacity across some practices, patient flow is variable, making it difficult to predict the impact on individual practices geographically near the planned developments.

Hot Spot 22 Rushey Mead PCNs involved Ward Impacted Premises NHS No Map No Potential Impact Potential Impact Aegis Healthcare Rushey Heatherbrook Surgery C82623 136 Planned dwellings 334 Millenium, Mead Beaumont Lodge Branch Surgery C82094 117 Additional new patients 835 City Care Alliance Leicester Central PCNs Manor Medical Centre C82018 113 Additional GIA (m2) 67 Spirit Rushey Mead practice C82680 175 Index cost additional GIA (new £197,060 build) Canon Street Surgery C82084 142 Spinney Hill Medical Centre C82024 139 Broadhurst Street Surgery C82651 143 Comments: No practices are geographically near the developments with impact potentially on other HNN practices, so a joint approach is advised

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226 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

12. FINANCIAL SUMMARY Whilst it is beyond the scope of this commission to specifically detail Leicester City Council the individual capital cost implications for the recommended actions, Health Need Backlog we have summarised the likely financial implications for each County Neighbourhood Risk Cost Maintenance Leicester Central £814,419 £346,180 area in terms of their current backlog and risk costs i.e. the likely cost Leicester South £324,631 £23,850 of improvements to the existing estate; the likely cost of meeting the Leicester North & West £803,320 £223,880 projected future GIA shortfall by extension works or new build Leicester North & East £377,670 £43,820 premises; and a likely cost of the planning work that would be Leicester City Total £2,320,040 £637,730

required to provide rationale and evidence to enable and implement Leicestershire County Council any required capital spending e.g. feasibility studies, utilisation Backlog studies, and capacity studies. PCN Area Risk Cost Maintenance North West Leicestershire Hub 1 £420,710 £243,710 These costs will then be consolidated to provide an overall indicative North West Leicestershire total cost implication for LLR. Hub 2 £238,855 £56,860 North West Leicestershire Hub 3 £204,037 £24,300 12.1 Risk Cost and Backlog R&M Costs i.e. Current and Backlog Hinkley Central £204,037 £41,725 Improvement Costs Bosworth £244,240 £48,750 Fosseway £342,765 £132,700 Backlog costs identified in 6FS exclude VAT, any associated fees, Soar Valley £254,992 £81,650 preliminary costs, planning application fees and any required Watermead £206,780 £14,800 associated investigative works. These have first been identified by Carillon £396,805 £180,295 Council Area. Beacon £324,959 £53,053 North Blaby £285,895 £134,575 South Blaby & Lutterworth £174,520 £31,750 Oadby and Wigston £337,689 £92,650

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12. FINANCIAL SUMMARY Syston, Vale & Melton £480,055 £43,430 housing units over the next 20 years, a total additional GIA Market Harborough & requirement of 23,209m² has been calculated (based on a Bosworth £114,790 £31,850 requirement of 0.08 m² per person). Cross Counties £435,750 £174,245 Leicestershire CC Total £4,666,879 £1,386,343 Development costs are based upon an assumption that a new build Rutland County Council Area will incur a construction cost of £2,950 per m² (this includes 10% for Backlog fees but excludes VAT and inflation). This generates an indicative PCN Area Risk Cost Maintenance development cost of £68,446,550. Rutland £208,690 £29,650 Rutland Council Total £208,690 £29,650 It should be noted that this cost is an estimated figure for new build accommodation only – we have assumed that all future development The total Risk Cost for the Leicester City, Leicestershire, and Rutland will be new build and subject to further feasibility and planning work. area is £7,195,609, of which £2,053,723 is the current backlog We have not considered the cost of refurbishment or extension of maintenance cost relating to the current estate across the three existing premises at this stage, which would vary the cost per square County areas. metre for development. In addition, these costs are high level and indicative, and would be subject to change in terms of proposed 12.2 Anticipated GIA shortfall and future build costs design, market price fluctuations, inflation, VAT, and other factors In order to provide an indicative capital cost for future development which could impact on cost as the development of any scheme and expansion of the current estate, the projected likely additional progresses. GIA across the estate has been calculated based on the projected increased population that would be realised by the proposed new housing unit numbers. Based on the number of proposed additional

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12. FINANCIAL SUMMARY 12.3 Anticipated Planning work costs The table indicates that the total indicative cost outlay required over The estimated cost of planning works has been calculated with the next 20 years to effectively plan for and develop the primary care reference to the recommended actions for each area of the County estate across the LLR region in order to accommodate the projected that have been suggested throughout this document. Where ‘hot future population within the primary care estate is £76,087,159. spots’ and any specific recommendations have been identified, these have been consolidated and added to provide a total for the LLR Council area.

These are high level and indicative, and actual figures would be subject to the nature, scope and extent of the output required. Whilst some work would likely be done as business as usual, for example through existing commissioning teams and routine Primary Care Contract monitoring processes, a budget of circa £425k may be needed to progress space utilisation, PIDs and feasibility studies to further explore the issues that have been identified through this commission over the next five years.

12.4 Total Costs for LLR Total Risk & Backlog Maintenance Cost £7,195,609 Total Development Cost £68,466,550 Total Planning Cost £425,000 £76,087,159

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230 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

13. IMPLEMENTATION PLANNING FRAMEWORK Following completion and adoption of the Leicester, Leicestershire are long term. As such, this Plan could form the basis of a and Rutland Clinical Commissioning Groups Primary Care Estate programme-based approach. This will include a mechanism to Strategy (PCES), which has identified the general estates profile of monitor delivery of individual projects for the LLR Estates Group the Leicester, Leicestershire and Rutland area, the CCGs are together with performance criteria for delivery of actions focused on committed to implementing action to deliver the ambitions of the improvements in the quality of the operational estate over time, the Strategy. The PCES identifies actions and recommendations that quality of the environment for patients, the utilisation of space in the support the improvement in primary care services and the delivery of buildings and revenue costs. solutions in the right place to support future needs, population growth and demographic changes. Implementation of the PCES is underpinned by key technical and survey data for individual practice premises, collated in an estates To develop an Implementation Plan, key actions and data capture spreadsheet which has been developed as part of the recommendations from the PCES will be reviewed to understand the Primary Care Estates Strategy project. This spreadsheet will action required, ensuring these are in line with the CCGs’ clinical continue to be updated by the CCG during implementation to ensure strategies and wider estates strategies as well as any further the data is current and forms the basis of a full database of primary changes to national policy guidance. It is the CCGs intention to care estates information across the CCG area. determine their priorities across LLR using the findings in the document and additional raw data. 13.1 Estates Capability and Capacity The CCG recognises that key to successfully implementing the Any Implementation Plan will need to translate strategic priorities into PCES is ensuring there is sufficient internal estates capacity and clear actions, ideally outlining success measures outlined, and capability, supported by an appropriate organisational governance timescales against which progress of the Plan implementation can infrastructure, and further developing their relationships with be monitored - particularly salient as some of the estate’s outcomes individual lead officers from other organisations as well as through

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13. IMPLEMENTATION PLANNING FRAMEWORK the key estates working groups associated the integrated care improvement and development programme, closer system (ICS). This is not only so the organisation is able to deliver collaboration with the NHSE/I primary care estates team the PCES outcomes, but to make sure these continue to be aligned together with systems and programmes to prioritise, manage strategically with wider estates strategies and are also in line with the and review planned and proposed premises developments. aspirations of the NHS Long Term Plan. • Developing a Housing Programme reflecting population/ demographic changes: develop more structured Therefore, to support implementation of this PCES, the CCGs will approaches and systems to work with Local Authority need to consider the appropriate governance structure and partners to confirm and review local authority housing plans framework to support the management and development of the and the impact on the local population, together with primary care estate. understanding the impact of wider demographic changes and local health needs on premises capacity. 13.2 Approach to Implementation • Working with NHS Property Services, Community Health It is recommended that the CCGs identifies key areas of focus for Partnerships and Leicester LIFT Company: working implementation of the PCES; these could include: together to manage, maintain and develop the estate in line with service delivery and transformation, including estates • Developing a new Estates Management Model: ensuring compliance and facilities management services, resolution of the CCGs have detailed knowledge of the GP contract, any tenant debt issues, establishing clarity on baseline specifically the premises directions, ready access to an estates cost data and estates remodelling and development estates’ professional (individual or service) with knowledge of with an agreed development plan to support service primary care premises and premises management, capacity transformation. to support both ‘business as usual’, together with the project management and development of the primary care premises

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13. IMPLEMENTATION PLANNING FRAMEWORK • Effective utilisation and void space: develop systems to • Primary Care Estates Baseline Data: develop and maintain identify and improve utilisation and reduce void space across the planning database for the primary care estate using the primary care estate appropriate tools, such as the Shape management tool, • Premises and Land Disposal Opportunities: including building on the development of the PCES. potential opportunities resulting both from the CCG’s primary • Financing Estates Schemes: consider procurement options care estates changes and developments and from the and potential funding sources for capital investment and emergence of the integrated care system and services development to implement estates improvement action, changes. particularly in the context of the Health and Social Care • NHS Digitisation: delivering local and national priorities funding environment where approvals systems and including, for example, interoperability between systems and procurement options/rules are constantly changing. There the Integrated Shared Care Record are a number of different opportunities for estates funding • Place based care and Primary Care Networks: ensure within the Health and Social Care system. Current capital estates and premises plans reflect the evolving requirements funding sources to be considered include Business as Usual, of Place Based care and Primary Care Networks, in addition the Estates Transformation and Technology Fund (ETTF), to the requirements of locality, neighbourhood and individual STP Capital, NHS Property Services/Community Health GP Practice Primary Care services. Partnerships (Landlord capital), Local Authorities, Third party • The STP and One Public Estate: work with One Public developer funding (3PD), the Local Improvement Finance Estate partners through the STP Local Estates Forum, OPE Trust (LIFT) and the Section 106 and Community Programme Manager and Strategic Estates Advisor to Infrastructure Levy. The CCG should also consider how to maximise estate opportunities to better utilise and potentially ensure its approach is in line with wider strategic rationalise joint estate. transformation enabling submissions for ICS capital monies.

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14. RECOMMENDATIONS & NEXT STEPS The development and implementation of the Leicester, • Undertake key locality/neighbourhood projects to address Leicestershire and Rutland PCES provides clarity to stakeholders needs and meet bid timescales e.g. ETTF and next wave STP about the CCG estates priorities and how they will be progressed. It funding also acts as a base on which more detailed project plans can be • Further proactive work to understand the detail of each capital developed for individual projects and a mechanism for monitoring funding source, including the suitability, criteria, application their progress and delivery. process, timescales and contact/s

The following recommendations and next steps are advised to Development of the PCES and the CCG’s subsequent implement the PCES: implementation plan, in combination, will offer a solid platform on • Approval of the PCES through the CCG/ICS governance which the CCG can build its approach to managing and improving framework the primary care estate across Leicester, Leicestershire and Rutland, • Engagement with the wider CCG and Primary Care as one element of public sector funded estate. It also ensures that community the primary care estate data and priorities can be fed into wider • Develop clear priorities from the issues identified in the PCES strategic plans and opportunities across the STP area to achieve and share the agreed CCG’s estates priorities with Partners wider transformational change in line with the NHS Long Term Plan through the Local Estates Forum and the One Public Estate approach across Leicester, Leicestershire • Identify project leads and any Project Management Office and Rutland. (PMO) infrastructure, including operational or working groups reporting to the LLR Estates Group, to take forward the issues identified in the PCES • Set up an internal mechanism to monitor delivery of the projects, risks and outcomes

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BIBLIOGRAPHY 1. Blaby Strategic Housing Land Availability Assessment (SHLAA) 21. Next steps on the NHS Five Year Forward View (NHSE - 31 (2017) March 2017) 2. Charnwood Appendix 1 2018 SHLAA sites 22. Next steps to better care in LLR (STP update - 2018) 3. Charnwood Strategic Housing Land Availability Assessment 23. NHS Digital Data and Information Strategy (NHS Digital – (SHLAA) (2018) November 2016) 4. ECV 6 Facet Surveys (2019) 24. NHS Five Year Forward View (NHSE - October 2014) 5. General Practice Forward View (NHSE – April 2016) 25. North West Leicestershire SHELAA Part 1 – Assessment of 6. Harborough District Council Strategic Housing Land Availability Potential Housing Sites (2019) Assessment (2015 Update) - Site Assessment Companion 26. Oadby & Wigston Local Plan April (2019) Guide 27. Oadby & Wigston Strategic Housing Land Availability 7. Harborough District Council Strategic Housing Land Availability Assessment (SHLAA) (2018) Assessment 2015 Update (May 2016) 28. Official Journal of the European Community (OJEC) (The 8. Harborough Local Plan 2011- 31 Publications Office of the European Union) 9. Health and Social Care Act 2012 29. Planning Act (2008): Section 106, Community Infrastructure 10. Hinckley and Bosworth Strategic Housing Land Availability Levy (CIL) Assessment (SHLAA) (2018 Update) 30. Public Health England Local Authority Health Profiles (2018) 11. Joint Strategic Needs Assessments (JSNA) 31. Rutland SHELAA Report (2019) 12. Leicester & Leicestershire Housing and Economic Development 32. Rutland: Five Year Land Supply Report 2019/20 – 2023/24 Needs Assessment (2017) (June 2019) 13. Leicester City SHELAA Summary of Sites (2017) 33. South Kesteven Local Plan 2011 - 36 14. Leicester City Strategic Housing & Economic Land Availability 34. The NHS Long Term Plan (NHSE – January 2019) Assessment & Five Year Land Supply Update (2017) 15. Leicester, Leicestershire and Rutland 2019/20-2023/24 Primary Care Strategy (June 2019) 16. Leicestershire 2018-2021 Joint Needs Assessment (JSNA) 17. LLR Sustainability and Transformation Plan (2016) 18. Local Strategic Partnering Agreement (SPA) 19. Melton Local Plan (2018) 20. Melton Strategic Housing Land Availability Assessment (SHLAA) (2016)

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APPENDIX Six Facet Classifications and Worked Example

A Six facet Survey assesses a building for its current condition and function only and is purely an estate tool. It makes no reference to other elements such as if it is the appropriate size for the registered patient list, future service needs, including housing developments, or changes in the service and delivery model of primary care services. The table below explains the classifications referred to in the 6FS Report of each building.

CLASSIFICATION INDEX

Physical Condition Quality A As new (built within last 2 years) and can be expected to perform A A facility of excellent quality adequately over its design life. (No Cost within the next 5 years). B A facility requiring general maintenance investment only B Sound, operationally safe and exhibits only minor deteriorations (Costs C A less than acceptable facility requiring capital investment to sustain condition B sub-elements in condition B during the D A very poor facility requiring significant capital investment or forthcoming financial year). replacement B/C Currently in B but may fall to C within 5 years (The cost to bring B(C) X Supplementary rating added to C or D to indicate that nothing but a tota sub-elements up to condition B at the future point during the next 5 rebuild or relocation will suffice (that is, improvements are either years). impractical or too expensive to be tenable) C Operational but major repair or replacement may be needed soon D Runs a serious risk of imminent breakdown Fire Health& Safety and DDA X Applied to "C" or "D" ratings (i.e.. Cx or Dx) indicating that nothing other A Building complies with all relevant standards and guidance; equal to a than a total rebuild or relocation will suffice (improvements are either new building impractical or too expensive). B Action will be required within the current period to comply with Functional Suitability relevant guidance and statutory requirements A Very satisfactory, no change needed C Known contravention of one or more standards - which falls short of "B" B Satisfactory, minor change needed D Dangerously below "B", e.g.: " that have been subject to adverse C Not satisfactory, major change needed external inspections D Unacceptable in present condition X Supplementary to "C" or "D", indicating that nothing but a total rebuild o X Supplementary rating to "C" or "D", to indicate that nothing but a total relocation will suffice (too impractical or expensive to remedy) rebuild or relocation will suffice, i.e. improvements are either impractical or too expensive. Space Utilisation Environmental E EMPTY - empty or grossly-under used at all times (excluding temp A Energy Performance Operational Rating: 0 > 25 closure) B Energy Performance Operational Rating: 26 > 50 U UNDER-USED - generally underused; utilisation could be significantly C Energy Performance Operational Rating: 51 > 75 increased D Energy Performance Operational Rating: 76 > 100 F FULLY USED - a satisfactory level of utilisation E Energy Performance Operational Rating: 101 > 125 O OVERCROWDED - overcrowded, over loaded and facilities generally F Energy Performance Operational Rating: 126 > 150 over stretched. G Energy Performance Operational Rating: 150

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237 Leicester, Leicestershire & Rutland Primary Care Estates Strategy – April 2020

LLR PCES NEXT STEPS HOUSING AND POPULATION GROWTH UPDATE BACKGROUND

Leicester LIFT Company Limited (LEL)has been requested by Leicester City CCG (LCCCG) to support the ‘Next Steps’ following completion of the Leicester, Leicestershire & Rutland (LLR) Primary Care Estates Strategy (PCES). This Report captures the outputs of that appointment, namely:

 A Housing/Population Growth Schedule capturing:

o Projected growth by PCN/HNN and District/LPA areas, with PCN/HNN details aggregated into the relevant District/LPA details o Projected growth over time periods of 1‐5 years, 6+ years, and the combined projected growth across those combined periods

 A series of maps identifying the impact of the projected housing/population growth on PCNs/HNNs, with cross‐boundary growth allocated across the relevant PCNs/HNNs

INFORMATION SOURCES The starting point for the review was the Local Plans adopted by the various Local Authorities so as to identify future housing developments. A trawl of these documents highlighted the fact that there is no consistent dataset nor standard method of reporting, which has created a challenge when projecting growth forward. However, in some instances, Local Plans are under review in order to provide a longer planning horizon, and where this is the case an examination of the annual Authority Monitoring Report has provided information on housing trajectories which set out the sites or areas included within the 5 year housing land supply, and the rate at which they are anticipated to be developed. Local Planning Authorities are required to identify a 5‐year supply of deliverable sites. Paragraph 73 of the NPPF sets out the responsibility of those authorities’ to: ‘Identify and update annually a supply of specific deliverable sites sufficient to provide a minimum of five years’ worth of housing against their housing requirement set out in adopted strategic policies, or against their local housing need where strategic policies are more than five years old’. In addition, information has been obtained from the relevant Strategic Housing and Economic Land Availability Assessment (SHELAA). However, it should be noted that whilst the SHELAA is an important evidence base to inform plan‐making, it does not in itself determine whether or not a site should be granted planning permission or allocated for development; it is for the Local Plans to select the sites that would best meet the needs in a particular area.

1

Given the above, the following sources have been used to obtain information relevant to individual Local Authority areas:

 Leicester City Council: draft Local Plan including draft Housing Trajectories  North West Leicestershire District Council: 5 Year Land Supply Housing Trajectory ‐ 2019  Hinckley & Bosworth Borough Council: April 2020 Authority Monitoring Statement Projected Annual Completions  Charnwood: 5 Year Land Supply Report 2020‐2026  Blaby District Council: 2019 SHELAA  Oadby & Wigston Borough Council: Housing from Local Plan 2019  Melton Mowbray District Council: 2019/20 Housing Trajectory Spreadsheet  Harborough District Council: updated 5 Year Housing Land Supply Report March 2018  Rutland County Council: Local Plan 2019 LEICESTER CITY COUNCIL Leicester City Council (LCiC) is in the process of reviewing the Local Plan and whilst a draft Housing Trajectory has been produced as part of a Consultation Draft, there is little detail about the location and scale of any projected housing developments. An extract of the projected housing developments from the Draft Housing Trajectory is in Table 1 below. LCiC: Draft Housing Trajectory Projected Housing Developments

Dwellings Additional Patients (2.5)1

0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Central Development Area 2,271 913 1,192 4,376 5,678 2,283 2,980 10,941

Non‐Central Development Area 587 2,212 1,281 4,080 1,468 5,530 3,203 10,201

Commitments 5,129 3,644 ‐ 8,773 12,823 9,110 ‐ 21,933

Windfall 750 750 900 2,400 1,875 1,875 2,250 6,000

Totals 8,737 7,519 3,373 19,629 21,844 18,798 8,433 49,075 Table 1 In summary, the Draft Housing Trajectory proposes delivery of the following dwellings out to 11+ years:

 4,376 dwellings in the Central Development Area (CDA) which covers elements of the Abbey, Castle, Saffron, and Westcotes Wards, with the Castle Ward appearing to cover a greater part of the proposed CDA  4,080 dwellings on non‐CDA sites (see Table 3 below for further details)

1 ONS Table 427: Change in average household size, local authority districts and England, 2014‐2039.England, 2014- 2039 2

 The dwellings in the CDA and non‐CDA areas are in addition to ‘Commitments’ of 8,733 dwellings, although no details are provided on the location or scale of the developments which are intended to deliver these dwellings  Finally, a ‘Windfall’ of 2,400 dwellings is also identified; the basis of this is not made clear Table 2 below identifies the City’s Health Needs Network (HNN), PCNs and Practices (by Code) potentially affected by the CDA dwellings, although the scale of development cannot be quantified by area. LCiC: Wards Covered by CDA

Health Needs Ward PCN Code Map Ref Network C82005 108 Leicester Health Focus, Abbey Leicester Central C82018 112 Millennium, C82639 119

156 Leicester Central Y0686 123 Millennium C82107 169 Leicester Foxes C82671 118 Castle Leicester Central C82660, 119 C82020 176 Leics City & Uni C82124 177 C82029 133 Aegis C82122 135 127 Leicester City South C82662 115 Saffron Leicester South Millennium C82092 135 Aegis C82122 C82639 118

C82059 121 Millennium C82653 122 Westcotes N&WL C82114 170

Leicester Foxes Y05387 120

Leicester City & Uni C82020 176 Table 2 It should be emphasised that the details in the Draft Housing Trajectory do not represent a confirmed strategy, rather they provide an indication of the direction of travel on the delivery of dwellings. 3

LCiC’s Draft Local Plan provides a list of Strategic and Non‐Strategic Development Sites able to deliver a total of 4,170 dwellings. These sites are identified in Table 3 below, and have been used to estimate and map future developments (see Map 1). LCiC: Draft Local Plan Strategic and Non‐Strategic Sites

Practice Dwellings Additional Patients Health Needs Ward Network Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Leicester Health Focus C82005 108 Abbey N&WL C82018 112 ‐ 277 ‐ 277 ‐ 693 ‐ 693 Millennium C82639 119 Leicester City South C82046 125 Aylestone Leicester South Millennium, C82092 115 ‐ 46 ‐ 46 ‐ 115 ‐ 115 Leicester Foxes C82669 167 C82018 112 N&WL, Leicester Millennium, City Care, Beaumont Leys C82094 116 206 684 784 1,674 515 1,710 1,960 4,185 Central, N&EL Leicester Health Focus C82624 174 C82024 139 C82037 141 C82084 142 Belgrave Leicester Central No major impact ‐ ‐ 16 16 ‐ ‐ 40 40 C82088 162 C82642 159 C82651 143 N&WL, Leicester City Care Alliance, C82073 171 Braunstone Park ‐ 26 45 71 ‐ 65 113 178 Central, N&EL Leicester Health Focus C82053 110 Y00137 137 Aegis Healthcare Evington N&EL C82030 145 177 317 176 670 443 793 440 1,676 Salutem C82676 149

Aegis Healthcare, C82626 131 Eyres Monsall Leicester South 18 39 78 135 45 98 195 338 Leicester City South C82019 124 C82100 126 4

Practice Dwellings Additional Patients Health Needs Ward Network Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref C82031 150 Humberstone N&EL Salutem C82033 147 ‐ 114 19 133 ‐ 285 48 333 C82626 148 City Care Alliance, C82614 173 Knighton N&EL 100 13 ‐ 113 250 33 ‐ 283 Leicester Foxes C82660 166 Salutem, C82642 158 Y02469 154 North Evington Leicester Central ‐ 23 19 42 ‐ 58 48 106 Belgrave &Spinney Hill C82667 144 Aegis C82063 134 City Care, Belgrave & Spinney Hill, Aegis N&EL/Leicester Rushey Mead 44 54 ‐ 98 110 135 ‐ 245 Central

Leicester City South, C82046 125 Saffron Leicester South Aegis C82662 127 32 46 41 119 80 115 103 198 C82122 135 No major impact C82024 138 C82037 140 Spinney Hills Leicester Central ‐ ‐ 71 71 ‐ ‐ 178 178 C82031 146 C82643 157 Thurncourt N&EL Aegis C82029 132 11 28 ‐ 39 28 70 ‐ 98 Troon N&EL City Care Alliance C82680 135 ‐ ‐ 11 11 ‐ ‐ 28 28 Millennium, Leicester C82639 118/119 Foxes, C82653 121/122 C82114 170 Westcotes N&EL and N&WL 7 44 15 66 18 110 38 166 C28059 121 C82020 176 Y03587 120 5

Practice Dwellings Additional Patients Health Needs Ward Network Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Leicester Health Focus, C82008 109 Western N&WL City Care Alliance C82053 110 ‐ 348 233 581 ‐ 870 583 1,453 C82610 172 Wycliffe Leicester Central No major impact ‐ 8 ‐ 8 ‐ 20 ‐ 20 Totals 595 2,067 1,508 4,170 1,489 5,170 3,774 10,333 Table 3

6

LCiC: Projected Developments Based upon Strategic and Non‐Strategic Sites

Map 1

7

NORTH WEST LEICESTERSHIRE DISTRICT COUNCIL North West Leicestershire District Council (NWLDC) issued a 5 Year Land Supply Housing Trajectory in 2019, and this document has been used to inform Table 4 and Map 2 below. NWLDC: 5 Year Supply Land Supply Housing Trajectory 2019

Practice Dwellings Additional patients (2.38) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total ref Ashby Hub 1 C82014 50 1,000 750 477 2,227 2,380 1,785 1,135 5,300

Castle Donington Hub 3 C82007 57 483 250 109 842 1,150 595 259 2,004 C82072 53 Coalville urban Area Hub 2/Hub 3 C82050 55 1,247 1,445 1,512 4,204 2,968 3,439 3,599 10,006 C82045 58 Ibstock Hub 1 C82012 48 80 ‐ ‐ 80 190 ‐ ‐ 190

Kegworth Hub 3 (Nottingham & Nottinghamshire CCG) C82007 57 191 85 ‐ 276 455 202 ‐ 657

Measham Hub 1 C82017 51 62 240 170 472 148 571 405 1,124

Blackfordby Hub 1 C82017 51 134 11 ‐ 145 319 26 ‐ 340

Diseworth Hub 3 C82007 51 13 ‐ ‐ 13 31 ‐ ‐ 31 C82014 50 Moira Hub 1 (Derby & Derbyshire CCG) 26 ‐ ‐ 26 62 ‐ ‐ 62 C82017 51 Oakthorpe Hub 1 C82017 51 44 ‐ ‐ 44 105 ‐ ‐ 105

Ravenstone Hub 2 C82072 53 10 ‐ ‐ 10 24 ‐ ‐ 24

Worthington Hub 1 C82014 50 15 22 ‐ 37 36 52 ‐ 88

8

Practice Dwellings Additional patients (2.38) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total ref Totals 3,305 2,803 2,268 8,376 7,868 6,670 5,398 19,931 Table 4

9

NWLDC: Projected Developments Based upon 5 Year Land Supply Housing Trajectory 2019

Map 2

10

HINCKLEY & BOSWORTH BOROUGH COUNCIL Hinckley & Bosworth Borough Council (H&BBC) issued an Authority Monitoring Statement Projected Annual Completions in April 2020, and this document has been used to inform Table 5 and Map 3 below. H&BBC: Authority Monitoring Statement Projected Annual Completions – April 2020

Practice Dwellings Additional Patients (2.23) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Bagworth NWL Hub 2 C82028 56 12 ‐ 12 27 ‐ 27

Barlestone NWL Hub 1 C82012 49 64 ‐ 64 ‐ ‐ ‐

Barwell Fosseway C82121 78 99 ‐ 99 221 ‐ 221

Burbage Fosseway C82054 74 46 ‐ 46 103 ‐ 103

Desford Bosworth C82650 72 160 ‐ 160 357 ‐ 357

Earl Shilton Bosworth C82121 69 374 ‐ 374 834 ‐ 834 Hinckley Fenny Drayton C82075 64 11 ‐ 11 25 ‐ 25 Central Groby Bosworth C82628 70 28 ‐ 28 62 ‐ 62 C82043 62 Hinckley C82075 63 Hinckley 665 640 1,305 1,483 1,427 2,910 Central C82082 65 C82047 66 Market Bosworth Bosworth C82051 68 180 ‐ 180 401 ‐ 401

Markfield Bosworth C82028 56 15 ‐ 15 33 ‐ 33

Newbold Verdon Bosworth C82051 67 116 ‐ 116 259 ‐ 259

11

Practice Dwellings Additional Patients (2.23) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Ratby Bosworth C82634 71 141 27 168 314 60 374

Twycross ? 40 ‐ 40 89 ‐ 89

Wellingborough ? 38 ‐ 38 85 ‐ 85

Totals 1,989 667 2,656 4,293 1,487 5,780 Table 5

12

H&BBC: Authority Monitoring Statement Projected Annual Completions April 2020

Map 3

13

CHARNWOOD BOROUGH COUNCIL Charnwood Borough Council (CBC) has issued a 5 Year Land Supply Report (2020‐2026), and Appendix 7 (Housing Numbers by Parish) of that document has been used to inform Table 6 and Map 4 below. CBC: 5 Year Land Supply Report (2020‐26) – Appendix 7

Additional patients Practice Dwellings (2.29) Settlement PCN Code Map 0 ‐ 5 6‐10 11+ Total 0 ‐5 6‐10 11+ Total Ref Anstey Soar Valley C82032 82 138 No data 138 316 No data 316 C82627 93 Watermead/ C82678 95 Barkby 23 No data 23 53 No data 53 Syston Vale & Melton C82042 16 C82078 17 Barrow on Soar Soar Valley C82062 84 200 No data 200 458 No data 458 C82003 90 Birstall Watermead 494 No data 494 1,131 No data 1,131 C82091 91 C82011 96 C82026 97 Loughborough Carillon C82035 98 1,411 No data 1,411 3,231 No data 3,231 C82070 99 C82111 100 C82095 85 Mountsorrel Soar Valley 154 No data 154 353 No data 353 C82097 86 C82042 16 Queninborough Syston Vale & Melton 47 No data 47 108 No data 108 C82078 17 Quorn Soar Valley C82034 83 44 No data 44 101 No data 101

Rearsby Watermead C82657 94 21 No data 21 48 No data 48

14

Additional patients Practice Dwellings (2.29) Settlement PCN Code Map 0 ‐ 5 6‐10 11+ Total 0 ‐5 6‐10 11+ Total Ref C82095 85 Rothley Soar Valley 146 No data 146 334 No data 334 C82097 86 C82064 104 Shepshed Beacon 665 No data 665 1,523 No data 1,523 C82656 107 C82600 87 Sileby Soar Valley 467 No data 467 1,069 No data 1,069 C82644 88 C8204 16 Syston Syston Vale & Melton 24 No data 24 55 No data 55 C82078 17 C82627 93 Thurmaston Watermead 796 No data 796 1,823 No data 1,823 C82678 95 Woodhouse/Woodhouse Soar Valley Y020252 89 20 No data 20 46 No data 46 Eaves Totals 4,650 ‐ 4,650 10,649 ‐ 10,649 Table 6

15

CBC: 5 Year Land Supply Report (2020‐26) – Appendix 7

Map 4

16

BLABY DISTRICT COUNCIL It was not possible to locate any local housing information which had been made publicly available by Blaby District Council (BDC); as a result, the 2019 SHELAA has been used to inform Table 7 and Map 5 below. BDC: SHELAA 2019

Practice Dwellings Additional patients Settlement Map Deliverable Developable Developable PCN Code Total 0‐5 6‐10 11+ Total Ref 0‐5 6‐10 11+ C82068 3 Blaby South Blaby & Lutterworth 80 182 1,624 1,886 190 433 3,865 4,488 C82098 4 Cosby South Blaby C82631 12 152 336 751 1,239 362 800 1,787 2,949 Countesthorpe South Blaby C82002 1 18 700 394 1,112 43 1,666 938 2,647 Croft North Blaby C82631 12 14 123 56 193 33 293 133 459 Bosworth (see Hinckley& Elmesthorpe C82121 69 7 ‐ 1,458 1,465 17 ‐ 3,470 3,487 Bosworth map) C82055 9 Enderby North Blaby ‐ 84 136 220 ‐ 200 324 524 C82631 12 Huncote North Blaby C82631 12 24 348 ‐ 372 57 828 ‐ 885 Glenfield North Blaby C82056 8 45 ‐ 1,384 1,429 107 ‐ 3,294 3,401 C82068 3 Glen Parva South Blaby & Lutterworth 70 124 65 259 167 295 155 617 C82098 4 Kilby South Blaby C82002 1 ‐ 24 30 54 ‐ 57 71 128

Kirby Muxloe North Blaby C82066 11 319 394 2,423 3,136 759 938 5,767 7,464

North Blaby/ Littlethorpe C82055 9 86 392 11 489 205 933 26 1164 South Blaby & Lutterworth

17

Practice Dwellings Additional patients Settlement Map Deliverable Developable Developable PCN Code Total 0‐5 6‐10 11+ Total Ref 0‐5 6‐10 11+

Leicester Forest North Blaby C82066 11 ‐ 275 1,206 1,481 ‐ 655 2,870 3,525 East

Lubbesthorpe North Blaby C82039 12 1,395 1,575 1,809 4,779 3,320 3,749 4,305 11,374

Narborough Soar Valley C82055 9 ‐ 543 381 924 ‐ 1,292 907 2,199

Sapcote Fosseway C82054 76 177 574 ‐ 751 421 1,366 ‐ 1,787 Sharnford Fosseway C82054 77 ‐ 21 ‐ 21 ‐ 50 ‐ 50 Stoney Stanton Fosseway C82054 73 6 461 5,000 5,467 14 1,097 11,900 13,011 C82631 Thurlaston North Blaby/Bosworth 12 ‐ 66 ‐ 66 ‐ 157 ‐ 157 C82121 North Blaby/ 3 10,803 Whetstone C82055 178 42 4,319 4,539 424 100 10,279 South Blaby & Lutterworth 4

Totals 2,571 6,264 21,047 29,882 6,119 14,909 50,091 71,119

Table 7

18

BDC: SHELAA 2019

Map 5

19

OADBY & WIGSTON BOROUGH COUNCIL Oadby & Wigston Borough Council (O&WBC) issued a Local Plan In 2019, and this document has been used to inform Table 8 and Map 6 below. O&WBC: Local Plan 2019

Additional patients Practice Dwellings (2.44) Settlement Practice PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref C82048 43 C82021 44 Oadby & Oadby & Wigston C82013 41/45 1,651 704 No data 2,355 4,028 1,718 No data 5,746 Wigston C82071 46 C82079 47 Cross C82067 28 ‐ ‐ ‐ ‐ ‐ ‐ Counties C82112 Totals 1,651 704 ‐ 2,355 4,028 1,718 ‐ 5,746 Table 8

20

O&WBC: Local Plan 2019

Map 6

21

MELTON MOWBRAY DISTRICT COUNCIL Melton Mowbray District Council (MMDC) issued a Housing Trajectory Spreadsheet for 2019/20, and this document has been used to inform Table 9 and Map 7 below. MMDC: Housing Trajectory Spreadsheet 2019‐20

Practice Dwellings Additional patients (2.24) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Syston Vale & Ab Kettleby C82038 15 14 ‐ ‐ 14 31 ‐ ‐ 31 Melton Syston Vale & Asfordby Hill C82038 14 72 14 ‐ 86 161 31 ‐ 192 Melton Syston Vale & Asfordby C82038 14 174 ‐ ‐ 174 390 ‐ ‐ 390 Melton Bottesford Grantham &Rural 260 103 23 386 582 231 52 865 Syston Vale & Brooksby C82038 16 70 ‐ ‐ 70 157 ‐ ‐ 157 Melton Syston Vale & C82038 13 Croxton Kerrial Melton/Grantham 44 20 ‐ 64 99 45 ‐ 144 C82016 15 & Rural Syston Vale & Easthorpe C82016 13 44 ‐ ‐ 44 99 ‐ ‐ 99 Melton Syston Vale & Frisby on the Wreake C82038001 15? 80 11 ‐ 91 179 25 ‐ 204 Melton Syston Vale & 16 Gaddesby C82038 53 ‐ ‐ 53 119 ‐ ‐ 119 Melton 17 Syston Vale & Great Dalby C82038 15 15 27 ‐ 42 34 60 ‐ 94 Melton Syston Vale & Harby C82016 13 125 11 ‐ 136 280 25 ‐ 305 Melton 22

Practice Dwellings Additional patients (2.24) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref Syston Vale & Hose C82016 13 60 18 ‐ 78 134 40 ‐ 174 Melton Syston Vale & Long Clawson C82016 13 63 41 ‐ 104 141 92 ‐ 233 Melton Syston Vale & Melton Mowbray C82038 15 1,432 2,010 1,123 4,565 3,208 4,502 2,516 10,226 Melton Syston Vale & Nether Broughton C82016 13 55 ‐ ‐ 55 123 ‐ ‐ 123 Melton Syston Vale & C82016 13 Old Dalby 103 72 ‐ 175 231 161 ‐ 392 Melton C82038 14 Syston Vale & Queensway C82038 15 39 ‐ ‐ 39 87 ‐ ‐ 87 Melton Syston Vale & C82016 13 Scalford 10 ‐ ‐ 10 22 ‐ ‐ 22 Melton C82038 14 Somerby Rutland C82649001 91 2 ‐ 93 204 4 ‐ 208 Syston Vale & Stathern C82016 13 81 ‐ ‐ 81 181 ‐ ‐ 181 Melton Syston Vale & Thorpe Arnold C82038 14 ‐ 24 ‐ 24 ‐ 54 ‐ 54 Melton Syston Vale & Waltham/W on the C82016 13 Melton/Grantham 96 ‐ ‐ 96 215 ‐ ‐ 215 Wolds C82038 14 & Rural Syston Vale & Wymondam C82038 14 28 34 ‐ 62 63 76 ‐ 139 Melton Sites less than 10 89 ‐ ‐ 89 199 ‐ ‐ 199 Totals 3,098 2,387 1,146 6,631 6,939 5,346 2,568 14,853 Table 9

23

MMDC: Housing Trajectory Spreadsheet 2019‐20

Map 7 24

HARBOROUGH DISTRICT COUNCIL Harborough District Council (HDC) issued an updated 5 Year Housing Land Supply Report in March 2018, and this document has been used to inform Table 10 and Map 8 below. HDC: Updated 5 Year Housing Land Supply Report March 2018

Practice Dwellings Additional patients (2.38) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref

Billesdon Cross Counties C82022 26 49 ‐ ‐ 49 110 ‐ ‐ 110 Broughton Astley Fosseway C82109 80 217 ‐ ‐ 217 488 ‐ ‐ 488 Church Langton Cross Counties C82001 20 17 ‐ ‐ 17 38 ‐ ‐ 38 Cross C82001 21 Fleckney 415 80 ‐ 495 934 190 ‐ 1,124 Counties/Harborough C82009 24 Cross Counties/ C82001 22 Foxton 15 ‐ ‐ 15 34 ‐ ‐ 34 Harborough C82009 29 31 Gilmorton Harborough C82109 143 ‐ ‐ 143 322 ‐ ‐ 322 32 Harborough/Cross C82009 29 Great Bowden 13 ‐ ‐ 13 29 ‐ ‐ 29 Counties C82001 22 Great Glen Cross Counties C82001 23 128 ‐ ‐ 128 288 ‐ ‐ 288 26 Houghton on the Hill Cross Counties C82022 67 ‐ ‐ 67 151 ‐ ‐ 151 27 Husbands Bosworth Harborough C82109 31 30 ‐ ‐ 30 68 ‐ ‐ 68 Harborough/Cross C82009 29 Lubbenham 20 ‐ ‐ 20 45 ‐ ‐ 45 Counties C82001 22? South Blaby & C82025 2 Lutterworth 212 835 400 1,447 477 1,987 952 3,416 Lutterworth C82611 5

25

Practice Dwellings Additional patients (2.38) Settlement Map PCN Code 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Ref

Cross Counties/ C82001 22 Market Harborough 1,237 2,055 516 3,808 2,783 4,891 1,228 8,902 Harborough C82009 29 31 Kilworth Harborough C82109 74 ‐ ‐‐ 74 167 ‐ ‐ 167 32? 26 Scraptoft Cross Counties C82022 373 ‐ ‐ 373 839 ‐ ‐ 839 27? Shangton Cross Counties C82001 22? 21 ‐ ‐ 21 47 ‐ ‐ 47 South Blaby & C82025 The Claybrooks 2/5 38 ‐ ‐ 38 86 ‐ ‐ 86 Lutterworth C82611 The Kibworths Cross Counties C82001 20 216 ‐ ‐ 216 486 ‐ ‐ 486 Thurnby/Bushby Cross Counties C82022 27 341 ‐‐ ‐ 341 767 ‐ ‐‐ 767 South Blaby & C82025 2 Ullesthorpe 45 ‐ ‐ 45 101 ‐ ‐ 101 Lutterworth C82611 5 Totals 3,671 2,970 916 7,557 8,260 7,068 2,180 17,508 Table 10

26

HDC: Updated 5 Year Housing Land Supply Report March 2018

Map 8

27

RUTLAND COUNTY COUNCIL Rutland County Council (RCoC) issued a Local Plan in 2019, and this document has been used to inform Table 11 and Map 9 below. RCoC: Local Plan 2019

Additional patients Practice Dwellings (2.14) Settlement Map PCN Code 0 ‐ 5 6‐10 11+ Total 0.5 6‐10 11+ Total Ref Oakham inc Barleythorpe Rutland C82010 33 382 No data No data 382 817 No data No data 817 Uppingham Rutland C82077 38 200 No data No data 200 428 No data No data 428 St George's Garden Rutland C82044 34 1,000 No data No data 1,000 2,140 No data No data 2,140 Cottesmore Rutland C82649 36 8 No data No data 8 17 No data No data 17 Edith Weston Rutland C82044 34 70 No data No data 70 150 No data No data 150 Empingham Rutland C82044 34 11 No data No data 11 24 No data No data 24 Adjacent Ketton 60 No data No data 60 128 No data No data 128 PCN Market Overton Rutland C82649 36 27 No data No data 27 58 No data No data 58 Adjacent Ryhall 36 No data No data 36 77 No data No data 77 PCN Whissendine Rutland C82649 36? 37 No data No data 37 79 No data No data 79 Totals 1,831 ‐ ‐ 1,831 3,918 ‐ ‐ 3,918 Table 11

28

RCoC: Local Plan 2019

Map 9

29

SUMMARY In summary, the growth figures for each Local Authority are identified in Table 12 below. Please note that the figures for both the ‘Draft Housing Trajectory Housing Developments’ and ‘Local Plan Strategic and Non‐Strategic Sites’ for LCiC have been included in the table.

Dwellings Additional Patients Council 0‐5 6‐10 11+ Total 0‐5 6‐10 11+ Total Leicester City (Draft Housing Trajectory 8,737 7,519 3,373 19,629 21,844 18,798 8,433 49,075 Housing Developments) Leicester City (Draft Local Plan Strategic & 595 2,067 1,508 4,170 1,489 5,170 3,774 10,333 Non‐Strategic Sites) North West 3,305 2,803 2,268 8,376 7,868 6,670 5,398 19,931 Leicestershire District Hinckley & Bosworth 1,989 667 2,656 4,293 1,487 5,780 Borough Charnwood 4,650 No data No data 4,650 10,649 No data No data 10,649

Blaby District 2,571 6,264 21,047 29,882 6,119 14,909 50,091 71,119 Oadby & Wigston 1,651 704 No data 2,355 4,028 1,718 No data 5,746 Borough Melton Mowbray District 3,098 2,387 1,146 6,631 6,939 5,346 2,568 14,853

Harborough District 3,671 2,970 916 7,557 8,260 7,068 2,180 17,508

Rutland County 1,831 No data No data 1,831 3,918 No data No data 3,918 Table 12 Predicted developments, certainly those beyond 5 years, are always difficult to ascertain with a sound degree of confidence, and this should be remembered when analysing dwellings and population growth beyond the 5‐year point. In addition, two other ongoing matters are likely to impact upon the certainty associated with growth figures:

 The Government’s intention to reform the planning system (currently out to consultation)  The Council for the Protection of Rural England’s (CPRE) proposed changes to the methodology for allocating growth across the City and County which, if implemented would not only see a significant increase in growth for Leicester and Leicestershire, but would also see that growth shift out of the City into surrounding Districts and Boroughs, the result of which could represent a 35% fall in the City and a potential increase of over 100% across the Districts/Boroughs. However, in the longer term, LCiC and LCoC intend to develop a Strategic Growth Plan which would project for each Local Authority the notional housing needs and supply between 2031 and 2050, a Plan which would help improve certainty and confidence in growth figures. 30

TABLES MAPS 1. LCiC: Draft Housing Trajectory Projected 1. LCiC: Projected Developments Based upon Housing Developments. Strategic and Non‐Strategic Sites. 2. LCiC: Wards Covered by CDA. 2. NWLDC: Projected Developments Based 3. LCiC: Draft Local Plan Strategic and Non‐ upon 5 Year Land Supply Housing Strategic Sites. Trajectory 2019. 4. NWLDC: 5 Year Supply Land Supply Housing 3. H&BBC: Authority Monitoring Statement Trajectory 2019. Projected Annual Completions April 2020. 5. H&BBC: Authority Monitoring Statement 4. CBC: 5 Year Land Supply Report (2020‐26) Projected Annual Completions – April 2020. – Appendix 7. 6. CBC: 5 Year Land Supply Report (2020‐26) – 5. BDC: SHELAA 2019. Appendix 7. 6. O&WBC: Local Plan 2019. 7. BDC: SHELAA 2019. 7. MMDC: Housing Trajectory Spreadsheet 8. O&WBC: Local Plan 2019. 2019‐20. 9. MMDC: Housing Trajectory Spreadsheet 8. HDC: Updated 5 Year Housing Land Supply 2019‐20. Report March 2018. 10. HDC: Updated 5 Year Housing Land Supply 9. RCoC: Local Plan 2019. Report March 2018. 11. RCoC: Local Plan 2019. 12. Growth Figures for Each Local Authority.

31

PRIORITISATION REVIEW - SCORE SHEET

SCORE SHEET TOTAL TOTAL Total score- Score- TOTAL score- TOTAL Score- CRITERIA CRITERIA Ref Criteria Critical Factors category Weighting MINIMUM MAXIMUM MINIMUM MAXIMUM score- score- Weighting MINIMUM MAXIMUM Demographic, health, 1a Deprivation indeces 1 5 5 5 25 and socio-economic 1b Population Projections 3 15 2 6 30 1 factors which impact on 20 29 145 services 1c Life Expectancy 2 10 5 10 50 1d Multimorbidity 1 5 8 8 40 Housing and Population Potential increase in net population due to housing growth. growth. Required 2a Years 1-5 years (based upon identified developments and 1 5 25 25 125 demand potential patient flows). 2 35 35 175 Potential increase in net population due to housing growth. 2b Years 6 + years (based upon identified developments and 1 5 10 10 50 potential patient flows). Suitability of Current Current space is less than needed for the practice's list size. 3a 0 5 15 0 75 Premises Issues where the physical condition of the premises affect 3b the delivery of services 1 5 8 8 40 Issues where the functional suitability of the premises affect 1 5 8 8 40 3c the delivery of services. Issues where the quality of the premises affect the delivery of 3 1 5 5 5 25 13 207 3d services. 43 Extent to which the building is utilised 3e 0 5 3 0 15 Identified Health and Safety issues requiring rectification. 3f 1 5 2 2 10 impact of COVID-19 that needs reconfiguration for cohorting 2 0 2 3g and flow 0 1 The impact of new commissioning decsions on the need for physical space to deliver priamry care services; specifically- 4 4a Additional roles funded through the PCN DES and leftshift of 2 1 5 2 2 10 2 10 activity from secondary care

TOTAL 100 100 89 537 79 537 NHS Housing and Notes (where the Practice appears in CCG Contract Practice Name PCN Area Population more than one of the thre priority Code Growth categories) Forest House Medical Note ELR C82066 North Blaby 165 Centre The initial 'top 20' scores are shown in green in column E. South Leicestershire ELR C82001 Medical Group (The Cross Counties 165 Old School Surgery) Empingham Medical ELR C82044 Rutland 155 Centre The Practice - City C82624 City Care Alliance 150 Beaumont Leys Beaumont Lodge C82094 Also in the top 20 for unsuitability of City Medical Practice (The Millenium 150 premises excluding GIA Surgery) North West WL C82014 Castle Medical Group Leicestershire (Hub 145 1)

C82623 Heatherbrook Surgery Also in the top 20 for unsuitability of City Aegis Healthcare 140 (Dr F Rizvi & Partner) premises including GIA

Market Harborough Market Harborough ELR C82009 140 Medical Centre & Bosworth Latham House Medical Syston, Vale and ELR C82038 135 Practice Melton North West Castle Donnington WL C82007 Leicestershire (Hub 120 Surgery 3) Appears as a top 20 in all three WL C82111 Student Medical Centre Carillon 115 categories WL C82064 Forest House Surgery Beacon 115 Woodbrook Medical WL C82070 Carillon 115 Centre Also in the top 20 for unsuitability of WL C82035 Park View Surgery Carillon 115 premises excluding GIA C82030 City Downing Drive Surgery Salutem 115 Bridge Street Medical WL C82026 Carillon 115 Practice Pinfold Medical WL C82011 Carillion 115 Practice St Elizabeth’s Medical City C82676 Salutem 115 Centre (Dr J A Wood) Greengate Medical Also in the top 20 for unsuitability of WL C82003 Watermead 115 Centre premises including GIA

City Y00137 Dr Roshan Aegis Healthcare 115

Also in the top 20 for unsuitability of WL C82628 Groby Surgery Bosworth 115 premises including GIA Silverdale Medical WL C82627 Watermead 115 Centre Also in the top 20 for unsuitability of WL C82656 Field Street Surgery Beacon 115 premises excluding GIA Thurmaston Health WL C82678 Watermead 115 Centre WL C82091 Birstall Medical Centre Watermead 115

Also in the top 20 for unsuitability of ELR C82022 Billesdon Surgery Cross Counties 115 premises excluding GIA

ELR C82056 Glenfield Surgery North Blaby 115 Long Clawson Medical Syston, Vale and ELR C82016 110 Practice Melton Newbold Verdon WL C82051 Bosworth 105 Medical Practice WL C82121 Heath Lane Surgery Bosworth 105 C82662 Leicester City City Walnut Street Surgery 105 South De Montfort Surgery C82020 Leicester City & City (University) 105 University C82124 Victoria Park Health Leicester City & City 105 Centre University Oakham Medical ELR C82010 Rutland 105 Practice The Orchard Medical WL C82093 Practice (Broughton Fosseway 105 Astley) Y02686 Bowling Green Street City Leicester Central 105 Surgery North West WL C82072 Broom Leys Surgery Leicestershire (Hub 95 2) North West The Whitwick Road WL C82045 Leicestershire (Hub 95 Surgery 3) North West WL C82017 Measham Medical Unit Leicestershire 95 (Hub 1) North West WL C82050 Long Lane Surgery Leicestershire (Hub 95 2) Highgate Medical WL C82644 Soar Valley 90 Centre WL C82095 Alpine House Surgery Soar Valley 90 WL C82097 Charnwood Surgery Soar Valley 90 The Wycliffe Medical South Blaby & ELR C82025 90 Practice Lutterworth WL C82032 Anstey Surgery Soar Valley 90 WL C82600 Banks Surgery Soar Valley 90 WL C82062 Barrow Health Centre Soar Valley 90 The Masharani South Blaby & ELR C82611 90 Practice Lutterworth Husbands Bosworth Market Harborough ELR C82109 90 Surgery & Bosworth WL C82082 The Centre Surgery Hinckley Central 80 Castle Mead Medical WL C82075 Hinckley Central 80 Centre C82008 Leicester Health City Oakmeadow Surgery 80 Focus C82610 The Parks Medical City City Care Alliance 80 Centre C82053 Hockley Farm Medical Leicester Health City 80 Practice Focus WL C82650 Desford Medical Centre Bosworth 80 Maples Family Medical WL C82047 Hinckley Central 80 Practice WL C82634 Ratby Surgery Bosworth 80 Market Overton & ELR C82649 Rutland 80 Somerby Surgery Station View Health WL C82043 Hinckley Central 80 Centre The Uppingham ELR C82077 Rutland 80 Surgery Hazelmere Medical South Blaby & ELR C82098 70 Centre Lutterworth ELR C82021 The Central Surgery Oadby & Wigston 70 The Limes Medical ELR C82055 North Blaby 70 Centre Northfield Medical South Blaby & ELR C82068 70 Centre Lutterworth The Old School WL C82027 Fosseway 70 Surgery Enderby Medical ELR C82631 North Blaby 70 Centre South Wigston Health ELR C82079 Oadby & Wigston 70 Centre Rosemead Drive ELR C82048 Oadby & Wigston 70 Surgery The Croft Medical ELR C82067 Cross Counties 70 Centre ELR C82112 Severn Surgery Oadby & Wigston 70 Two Steeples Medical ELR C82071 Centre - Wigston Oadby & Wigston 70 Central Surgery Two Steeples Medical ELR C82013 Centre - Bushloe Oadby & Wigston 70 Surgery WL C82034 Quorn Medical Centre Soar Valley 65 WL Y00252 Cottage Surgery Soar Valley 65 Dishley Grange WL C82103 Medical Practice Beacon 65 (Maxwell drive) Jubilee Medical Syston, Vale and ELR C82078 65 Practice Melton Syston, Vale and ELR C82042 The County Practice 65 Melton Charnwood Medical WL C82041 Group (Rosebery Beacon 65 Medical Centre) Dr TLH Sperry & C82033 City Partners Salutem 60

Barwell & Hollycroft WL C82061 Medical Centre Fosseway 55 (Barwell) Ibstock & Barlestone North West WL C82012 Surgery Leicestershire (Hub 45 1) ELR C82039 Kings Way Surgery North Blaby 45 North West Markfield Medical WL C82028 Leicestershire (Hub 45 Centre 2) North West WL C82102 Manor House Surgery Leicestershire (Hub 45 3) North West WL C82096 Hugglescote Surgery Leicestershire (Hub 45 2) Countesthorpe Health South Blaby & ELR C82002 45 Centre Lutterworth North West Whitwick Health Centre WL C82120 Leicestershire (Hub 45 (Drs Vermani & Bedi) 3) North West Whitwick Health Centre WL C82052 Leicestershire (Hub 45 (Drs Patel & Tailor) 3) C82046 Saffron Health Leicester City City 35 South C82651 Dr KS Morjaria & Belgrave & Spinney City 35 Partner Hill C82086 Leicester Health City Fosse Medical Centre 35 Focus C82116 City Highfields Surgery Leicester Central 35 Spinney Hill Medical C82024 Belgrave & Spinney City Centre (Dr Pancholi & 35 Hill Partners) Evington Medical C82088 City Centre (Halsbury The Fox's 35 street) C82084 Dr B Modi Belgrave & Spinney City 35 Hill Brandon Street Surgery C82107 City (Belgrave Health Millenium 35 Centre) Willowbrook Medical C82029 Centre (Dr J G Astles City Aegis Healthcare 35 & Partners)

C82122 Clarendon Park City Aegis Healthcare 35 Surgery Narborough Road City C82119 The Fox's 35 Surgery C82614 City Spirit Asquith Surgery City Care Alliance 35 Pasley Road Health C82626 City Centre Aegis Healthcare 35

C82114 City Dr UK Roy City Care Alliance 35 Groby Road Medical Leicester Health City C82005 Centre 35 Focus C82080 Shefa Medical Practice City Leicester Central 35 (Dr F Docrat) Manor Park Medical C82018 City Practice (Manor Millenium 35 Medical Centre) Highfields Medical C82642 Centre (Belgrave City Leicester Central 35 Health Centre)

The Community Health C82643 Centre (Dr ZS Osama City Leicester Central 35 & Partners)

Al-Waqas Medical C82099 City Centre (Dr KA The Fox's 35 Choudhry) C82019 Sturdee Road Health & Leicester City City 35 Wellbeing Centre South C82671 City Dr R Kapur The Fox's 35 Dr R P Pandya & C82037 Partners (East Park Belgrave & Spinney City 35 Medical Centre (Dr Hill Pandya) Inclusion Healthcare C82670 Leicester City City (Charles Berry House) 35 South

St Peter's Health C82660 City Centre (Dr S D'Souza The Fox's 35 & Partner) Heron GP Practice City Y02469 (Merlyn Vaz Health Leicester Central 35 Centre) C82063 East Leicester Medical City Aegis Healthcare 35 Practice Westcotes Health C82639 City Centre (Dr RL Millenium 35 Hazeldine & Partner) C82100 The Hedges Medical Leicester City City 35 Centre South Y03587 Westcotes Medical City Millenium 35 Practice C82659 City Dr R Kapur & Partners The Fox's 35 C82653 Dr S Shafi (Westcotes City Millenium 35 GP Surgery- 2) C82680 Spirit Rushey Mead City City Care Alliance 35 Practice C82620 City Briton Street Surgery Millenium 35 C82059 Dr S Shafi (Westcotes City Millenium 35 GP Surgery-1) C82667 The Charnwood Belgrave & Spinney City 35 Practice Hill Johnson Medical C82031 Practice (Hilltop City Salutem 35 surgery)

C82073 Merridale Medical City City Care Alliance 35 Centre Leicester Medical C82092 City Group (Aylestone Millenium 35 Medical Centre) C82669 City Dr R Sahdev The Fox's 35 C82060 City Sayeed Medical Centre Leicester Central 35 C82105 City Dr AK Vania Leicester Central 35 (Un)Suitability NHS Notes (where the Practice of Current CCG Contract Practice Name PCN Area appears in more than one of the Premises Inc. Code thre priority categories) GIA Score Appears as a top 20 in all three Note WL C82111 Student Medical Centre Carillon 165 categories The initial 'top 20' scores are shown in Also in the top 20 for unsuitability of green. ELR C82021 The Central Surgery Oadby & Wigston 158 premises excluding GIA C82651 Dr KS Morjaria & Belgrave & Also in the top 20 for unsuitability of City 155 Partner Spinney Hill premises excluding GIA Also in the top 20 for unsuitability of WL C82034 Quorn Medical Centre Soar Valley 151 premises excluding GIA C82614 Also in the top 20 for unsuitability of City Spirit Asquith Surgery City Care Alliance 151 premises excluding GIA Forest House Medical ELR C82066 North Blaby 146 Centre Highgate Medical WL C82644 Soar Valley 144 Centre

C82623 Heatherbrook Surgery Also in the top 20 for housing and City Aegis Healthcare 143 (Dr F Rizvi & Partner) population growth

Hazelmere Medical South Blaby & ELR C82098 143 Centre Lutterworth North West Also in the top 20 for unsuitability of WL C82017 Measham Medical Unit Leicestershire 142 premises excluding GIA (Hub 1) Spinney Hill Medical C82024 Belgrave & City Centre (Dr Pancholi & 140 Spinney Hill Partners)

WL Y00252 Cottage Surgery Soar Valley 140

The Limes Medical ELR C82055 North Blaby 138 Centre Also in the top 20 for unsuitability of City C82116 Highfields Surgery Leicester Central 137 premises excluding GIA North West The Whitwick Road WL C82045 Leicestershire 135 Surgery (Hub 3) Also in the top 20 for housing and WL C82628 Groby Surgery Bosworth 132 population growth C82046 Saffron Health Leicester City City 132 South C82662 Leicester City City Walnut Street Surgery 130 South Greengate Medical Also in the top 20 for housing and WL C82003 Watermead 130 Centre population growth WL C82082 The Centre Surgery Hinckley Central 130 C82086 Leicester Health City Fosse Medical Centre 130 Focus C82084 Dr B Modi Belgrave & City 130 Spinney Hill C82624 The Practice - City City Care Alliance 128 Beaumont Leys Newbold Verdon WL C82051 Bosworth 128 Medical Practice The Community Health C82643 Centre (Dr ZS Osama City Leicester Central 127 & Partners)

C82008 Leicester Health City Oakmeadow Surgery 126 Focus South Leicestershire ELR C82001 Medical Group (The Cross Counties 125 Old School Surgery) WL C82035 Park View Surgery Carillon 125 WL C82095 Alpine House Surgery Soar Valley 125 WL C82097 Charnwood Surgery Soar Valley 124 WL C82064 Forest House Surgery Beacon 123 Latham House Medical Syston, Vale and ELR C82038 123 Practice Melton Evington Medical C82088 City Centre (Halsbury The Fox's 123 street) Barwell & Hollycroft WL C82061 Medical Centre Fosseway 123 (Barwell) Al-Waqas Medical C82099 City Centre (Dr KA The Fox's 123 Choudhry) Rosemead Drive ELR C82048 Oadby & Wigston 123 Surgery C82114 City Dr UK Roy City Care Alliance 122 C82610 The Parks Medical City City Care Alliance 122 Centre Empingham Medical ELR C82044 Rutland 121 Centre C82122 Clarendon Park City Aegis Healthcare 121 Surgery Narborough Road City C82119 The Fox's 121 Surgery North West WL C82072 Broom Leys Surgery Leicestershire 119 (Hub 2) Ibstock & Barlestone North West WL C82012 Surgery Leicestershire 119 (Hub 1) Market Market Harborough ELR C82009 Harborough & 117 Medical Centre Bosworth The Orchard Medical WL C82093 Practice (Broughton Fosseway 117 Astley) The Wycliffe Medical South Blaby & ELR C82025 117 Practice Lutterworth Desford Medical WL C82650 Bosworth 117 Centre WL C82600 Banks Surgery Soar Valley 117 De Montfort Surgery C82020 Leicester City & City (University) 116 University Brandon Street C82107 City Surgery (Belgrave Millenium 116 Health Centre) C82080 Shefa Medical Practice City Leicester Central 116 (Dr F Docrat) Highfields Medical C82642 Centre (Belgrave City Leicester Central 116 Health Centre)

C82671 City Dr R Kapur The Fox's 116 Long Clawson Medical Syston, Vale and ELR C82016 115 Practice Melton Enderby Medical ELR C82631 North Blaby 115 Centre ELR C82039 Kings Way Surgery North Blaby 115 Groby Road Medical Leicester Health City C82005 Centre 115 Focus Beaumont Lodge C82094 City Medical Practice (The Millenium 114 Surgery) Woodbrook Medical WL C82070 Carillon 113 Centre Pasley Road Health C82626 City Centre Aegis Healthcare 113

The Old School WL C82027 Fosseway 112 Surgery Pinfold Medical WL C82011 Carillion 110 Practice WL C82121 Heath Lane Surgery Bosworth 110 ELR C82056 Glenfield Surgery North Blaby 110 ELR C82022 Billesdon Surgery Cross Counties 109 Oakham Medical ELR C82010 Rutland 109 Practice ELR C82112 Severn Surgery Oadby & Wigston 109 Castle Mead Medical WL C82075 Hinckley Central 108 Centre Manor Park Medical C82018 City Practice (Manor Millenium 108 Medical Centre) North West WL C82102 Manor House Surgery Leicestershire 108 (Hub 3) WL C82032 Anstey Surgery Soar Valley 107 Northfield Medical South Blaby & ELR C82068 102 Centre Lutterworth Willowbrook Medical C82029 Centre (Dr J G Astles & City Aegis Healthcare 102 Partners)

North West Markfield Medical WL C82028 Leicestershire 102 Centre (Hub 2) St Peter's Health C82660 City Centre (Dr S D'Souza The Fox's 101 & Partner) Heron GP Practice City Y02469 (Merlyn Vaz Health Leicester Central 101 Centre) C82659 City Dr R Kapur & Partners The Fox's 101 Bridge Street Medical WL C82026 Carillon 100 Practice North West Castle Donnington WL C82007 Leicestershire 100 Surgery (Hub 3) C82030 City Downing Drive Surgery Salutem 100 WL C82634 Ratby Surgery Bosworth 100 The Croft Medical ELR C82067 Cross Counties 98 Centre Maples Family Medical WL C82047 Hinckley Central 95 Practice North West WL C82014 Castle Medical Group Leicestershire 94 (Hub 1) Dr R P Pandya & C82037 Partners (East Park Belgrave & City 94 Medical Centre (Dr Spinney Hill Pandya) WL C82062 Barrow Health Centre Soar Valley 93 C82019 Sturdee Road Health & Leicester City City 92 Wellbeing Centre South C82063 East Leicester Medical City Aegis Healthcare 91 Practice C82124 Victoria Park Health Leicester City & City 90 Centre University Silverdale Medical WL C82627 Watermead 87 Centre The Masharani South Blaby & ELR C82611 87 Practice Lutterworth Countesthorpe Health South Blaby & ELR C82002 87 Centre Lutterworth Y03587 Westcotes Medical City Millenium 86 Practice C82620 City Briton Street Surgery Millenium 85 C82653 Dr S Shafi (Westcotes City Millenium 78 GP Surgery- 2) C82680 Spirit Rushey Mead City City Care Alliance 77 Practice Johnson Medical C82031 Practice (Hilltop City Salutem 77 surgery)

WL C82656 Field Street Surgery Beacon 76 North West WL C82096 Hugglescote Surgery Leicestershire 76 (Hub 2) St Elizabeth’s Medical City C82676 Salutem 74 Centre (Dr J A Wood) South Wigston Health ELR C82079 Oadby & Wigston 74 Centre North West WL C82050 Long Lane Surgery Leicestershire 72 (Hub 2) Syston, Vale and ELR C82042 The County Practice 72 Melton Westcotes Health C82639 City Centre (Dr RL Millenium 71 Hazeldine & Partner) Dishley Grange WL C82103 Medical Practice Beacon 70 (Maxwell drive) Inclusion Healthcare C82670 Leicester City City (Charles Berry House) 65 South C82053 Hockley Farm Medical Leicester Health City 65 Practice Focus C82105 City Dr AK Vania Leicester Central 63 Charnwood Medical WL C82041 Group (Rosebery Beacon 62 Medical Centre) Station View Health WL C82043 Hinckley Central 62 Centre WL C82091 Birstall Medical Centre Watermead 57 Jubilee Medical Syston, Vale and ELR C82078 57 Practice Melton Market Overton & ELR C82649 Rutland 57 Somerby Surgery Two Steeples Medical ELR C82071 Centre - Wigston Oadby & Wigston 57 Central Surgery North West Whitwick Health Centre WL C82120 Leicestershire 57 (Drs Vermani & Bedi) (Hub 3) The Uppingham ELR C82077 Rutland 57 Surgery Thurmaston Health WL C82678 Watermead 56 Centre C82073 Merridale Medical City City Care Alliance 56 Centre C82667 The Charnwood Belgrave & City 56 Practice Spinney Hill C82100 The Hedges Medical Leicester City City 55 Centre South Y02686 Bowling Green Street City Leicester Central 49 Surgery North West Whitwick Health Centre WL C82052 Leicestershire 49 (Drs Patel & Tailor) (Hub 3) Dr TLH Sperry & C82033 City Partners Salutem 43

C82060 City Sayeed Medical Centre Leicester Central 42 Two Steeples Medical ELR C82013 Centre - Bushloe Oadby & Wigston 42 Surgery C82669 City Dr R Sahdev The Fox's 41 Y00137 City Dr Roshan Aegis Healthcare 40 Leicester Medical C82092 City Group (Aylestone Millenium 36 Medical Centre) Market Husbands Bosworth ELR C82109 Harborough & 28 Surgery Bosworth (Un)Suitability NHS Notes (where the Practice appears of Current CCG Contract Practice Name PCN Area in more than one of the thre priority Premises Exc. Code categories) GIA Score Also in the top 20 for unsuitability of City C82116 Highfields Surgery Leicester Central 92 Note premises including GIA The initial 'top 20' scores are shown in Student Medical Appears as a top 20 in all three WL C82111 Carillon 90 green. Centre categories Forest House ELR C82066 North Blaby 86 Medical Centre Beaumont Lodge Also in the top 20 for housing and City C82094 Medical Practice Millenium 84 population growth (The Surgery) The Central Also in the top 20 for unsuitability of ELR C82021 Oadby & Wigston 83 Surgery premises including GIA North West Measham Medical Also in the top 20 for unsuitability of WL C82017 Leicestershire 82 Unit premises including GIA (Hub 1) Also in the top 20 for unsuitability of WL C82035 Park View Surgery Carillon 80 premises including GIA Dr KS Morjaria & Belgrave & Also in the top 20 for unsuitability of City C82651 80 Partner Spinney Hill premises including GIA Also in the top 20 for housing and ELR C82022 Billesdon Surgery Cross Counties 79 population growth Barwell & Hollycroft WL C82061 Medical Centre Fosseway 78 (Barwell) Evington Medical City C82088 Centre (Halsbury The Fox's 78 street) Al-Waqas Medical City C82099 Centre (Dr KA The Fox's 78 Choudhry) Dr S Shafi C82653 City (Westcotes GP Millenium 78 Surgery- 2)

City C82114 Dr UK Roy City Care Alliance 77

Field Street Also in the top 20 for housing and WL C82656 Beacon 76 Surgery population growth Quorn Medical Also in the top 20 for unsuitability of WL C82034 Soar Valley 76 Centre premises including GIA Clarendon Park City C82122 Aegis Healthcare 76 Surgery Narborough Road City C82119 The Fox's 76 Surgery Spirit Asquith Also in the top 20 for unsuitability of City C82614 City Care Alliance 76 Surgery premises including GIA East Leicester City C82063 Aegis Healthcare 76 Medical Practice South Wigston ELR C82079 Oadby & Wigston 74 Health Centre North West Broom Leys WL C82072 Leicestershire 74 Surgery (Hub 2) Ibstock & North West WL C82012 Barlestone Surgery Leicestershire 74 (Hub 1) C82620 Briton Street City Millenium 70 Surgery Highgate Medical WL C82644 Soar Valley 69 Centre Newbold Verdon WL C82051 Bosworth 68 Medical Practice Hazelmere Medical South Blaby & ELR C82098 68 Centre Lutterworth Woodbrook WL C82070 Carillon 68 Medical Centre C82624 The Practice - City City Care Alliance 68 Beaumont Leys Heatherbrook C82623 Surgery (Dr F Rizvi City Aegis Healthcare 68 & Partner)

Pasley Road C82626 City Health Centre Aegis Healthcare 68

The Old School WL C82027 Fosseway 67 Surgery South Leicestershire ELR C82001 Medical Group Cross Counties 65 (The Old School Surgery) Alpine House WL C82095 Soar Valley 65 Surgery WL Y00252 Cottage Surgery Soar Valley 65 Spinney Hill C82024 Medical Centre (Dr Belgrave & City 65 Pancholi & Spinney Hill Partners) Inclusion Healthcare C82670 Leicester City City (Charles Berry 65 South House)

Charnwood WL C82097 Soar Valley 64 Surgery Latham House Syston, Vale and ELR C82038 63 Medical Practice Melton Forest House WL C82064 Beacon 63 Surgery Castle Mead WL C82075 Hinckley Central 63 Medical Centre Barrow Health WL C82062 Soar Valley 63 Centre The Limes Medical ELR C82055 North Blaby 63 Centre C82105 City Dr AK Vania Leicester Central 63 Rosemead Drive ELR C82048 Oadby & Wigston 63 Surgery Manor Park C82018 Medical Practice City Millenium 63 (Manor Medical Centre) C82610 The Parks Medical City City Care Alliance 62 Centre North West Hugglescote WL C82096 Leicestershire 61 Surgery (Hub 2) Empingham ELR C82044 Rutland 61 Medical Centre North West The Whitwick WL C82045 Leicestershire 60 Road Surgery (Hub 3) WL C82628 Groby Surgery Bosworth 57 The Orchard WL C82093 Medical Practice Fosseway 57 (Broughton Astley) Desford Medical WL C82650 Bosworth 57 Centre Whitwick Health North West WL C82120 Centre (Drs Leicestershire 57 Vermani & Bedi) (Hub 3) C82046 Saffron Health Leicester City City 57 South Thurmaston Health WL C82678 Watermead 56 Centre Greengate Medical WL C82003 Watermead 55 Centre The Centre WL C82082 Hinckley Central 55 Surgery North West Castle Donnington WL C82007 Leicestershire 55 Surgery (Hub 3) Long Clawson Syston, Vale and ELR C82016 55 Medical Practice Melton WL C82634 Ratby Surgery Bosworth 55 Enderby Medical ELR C82631 North Blaby 55 Centre C82662 Walnut Street Leicester City City 55 Surgery South Dishley Grange WL C82103 Medical Practice Beacon 55 (Maxwell drive) C82030 Downing Drive City Salutem 55 Surgery ELR C82039 Kings Way Surgery North Blaby 55 C82086 Fosse Medical Leicester Health City 55 Centre Focus C82084 Dr B Modi Belgrave & City 55 Spinney Hill Groby Road Leicester Health City C82005 Medical Centre 55 Focus The Croft Medical ELR C82067 Cross Counties 53 Centre The Community Health Centre (Dr C82643 City ZS Osama & Leicester Central 52 Partners)

C82008 Oakmeadow Leicester Health City 51 Surgery Focus C82053 Hockley Farm Leicester Health City 50 Medical Practice Focus ELR C82056 Glenfield Surgery North Blaby 50 Pinfold Medical WL C82011 Carillion 50 Practice Heath Lane WL C82121 Bosworth 50 Surgery Maples Family WL C82047 Hinckley Central 50 Medical Practice Y02686 Bowling Green City Leicester Central 49 Street Surgery Dr R P Pandya & Partners (East C82037 Belgrave & City Park Medical 49 Spinney Hill Centre (Dr Pandya) Whitwick Health North West WL C82052 Centre (Drs Patel Leicestershire 49 & Tailor) (Hub 3) Oakham Medical ELR C82010 Rutland 49 Practice ELR C82112 Severn Surgery Oadby & Wigston 49 North West Manor House WL C82102 Leicestershire 48 Surgery (Hub 3) C82680 Spirit Rushey City City Care Alliance 47 Mead Practice Johnson Medical C82031 Practice (Hilltop City Salutem 47 surgery)

WL C82032 Anstey Surgery Soar Valley 47 Station View WL C82043 Hinckley Central 47 Health Centre C82124 Victoria Park Leicester City & City 45 Health Centre University St Elizabeth’s City C82676 Medical Centre (Dr Salutem 44 J A Wood) Dr TLH Sperry & C82033 City Partners Salutem 43

C82060 Sayeed Medical City Leicester Central 42 Centre Willowbrook Medical Centre (Dr C82029 City J G Astles & Aegis Healthcare 42 Partners)

Market Market ELR C82009 Harborough Harborough & 42 Medical Centre Bosworth Silverdale Medical WL C82627 Watermead 42 Centre North West WL C82050 Long Lane Surgery Leicestershire 42 (Hub 2) The Wycliffe South Blaby & ELR C82025 42 Medical Practice Lutterworth Birstall Medical WL C82091 Watermead 42 Centre Northfield Medical South Blaby & ELR C82068 42 Centre Lutterworth WL C82600 Banks Surgery Soar Valley 42 The Masharani South Blaby & ELR C82611 42 Practice Lutterworth Jubilee Medical Syston, Vale and ELR C82078 42 Practice Melton Market Overton & ELR C82649 Rutland 42 Somerby Surgery The County Syston, Vale and ELR C82042 42 Practice Melton North West Markfield Medical WL C82028 Leicestershire 42 Centre (Hub 2) Two Steeples Medical Centre - ELR C82071 Oadby & Wigston 42 Wigston Central Surgery Countesthorpe South Blaby & ELR C82002 42 Health Centre Lutterworth Two Steeples ELR C82013 Medical Centre - Oadby & Wigston 42 Bushloe Surgery The Uppingham ELR C82077 Rutland 42 Surgery De Montfort C82020 Surgery Leicester City & City 41 (University) University

C82073 Merridale Medical City City Care Alliance 41 Centre C82669 City Dr R Sahdev The Fox's 41 Brandon Street C82107 City Surgery (Belgrave Millenium 41 Health Centre) Shefa Medical C82080 City Practice (Dr F Leicester Central 41 Docrat) Highfields Medical C82642 Centre (Belgrave City Leicester Central 41 Health Centre)

C82671 City Dr R Kapur The Fox's 41

St Peter's Health C82660 City Centre (Dr S The Fox's 41 D'Souza & Partner)

Heron GP Practice City Y02469 (Merlyn Vaz Health Leicester Central 41 Centre) Westcotes Health C82639 Centre (Dr RL City Millenium 41 Hazeldine & Partner) Y03587 Westcotes Medical City Millenium 41 Practice C82659 Dr R Kapur & City The Fox's 41 Partners C82667 The Charnwood Belgrave & City 41 Practice Spinney Hill Bridge Street WL C82026 Carillon 40 Medical Practice Y00137 City Dr Roshan Aegis Healthcare 40 C82100 The Hedges Leicester City City 40 Medical Centre South Leicester Medical C82092 City Group (Aylestone Millenium 36 Medical Centre) North West Castle Medical WL C82014 Leicestershire 34 Group (Hub 1) Charnwood Medical Group WL C82041 Beacon 32 (Rosebery Medical Centre) Sturdee Road C82019 Leicester City City Health & Wellbeing 32 South Centre Market Husbands ELR C82109 Harborough & 28 Bosworth Surgery Bosworth

Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group

Name of meeting: LLR CCGs’ Primary Care Date: 1 June 2021 Paper: Commissioning Committee D meetings in common Public  Confidential Report title: National GMS and Contract Changes 2021/22

Presented by: Jamie Barrett – Senior Contracts Manager – Primary Care Report author: Priya Pandya – Contracts Manager Nicci Briggs, Executive Director of Finance, Contracting and Corporate Executive lead: Governance, LLR CCGs Action required: Receive for information  Progress update: only: For assurance: For approval / decision: Executive summary: Appendix 1 and 2 sets out the General Medical Services contract changes for financial year 2021/22.

The purpose of the report is to summarise the key changes for the committee and to note key implementation updates locally. Appendices: Appendix 1 – National contract changes Appendix 2 – 2021/22 QOF guidance.

Recommendations: The LLR CCGs’ Primary Care Commissioning Committees are asked to:

NOTE the contract changes for 2021/22.

Report history and prior review: None

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG

X X X

Implications a) Conflicts of All Board GPs are conflicted however for the purpose of the report there is no interest: requirement for a decision to be made.

b) Alignment to Board Assurance LLR BAF 05 - Quality of care provided by primary care Framework LLR BAF 12 - Impact on Primary Care Resilience – workforce, estates, IT and PPE

c) Resource and Included in the report. financial implications d) Quality and Not applicable patient safety

Page 1 of 5 implications e) Patient and Not applicable public involvement f) Equality analysis Not applicable and due regard

CCG Primary Care Delegated Functions Assurance Checklist:

CCG Primary Care Delegated Additional Related Evidence Functions Assurance Checklist

· The relevant section of the Policy Guidance Manual Section 7.3 Legislation / Regulatory Changes ·

· NHSE statutory duties listed within Not applicable for the purpose of this report as the Delegation Agreement and the changes described are nationally mandated. also in the Policy Guidance Manual have been addressed and action taken. This could include cross references to the Quality Impact Assessments (QIA) and the Equality Impact Assessments (EIA · Engagement with patients and Not applicable stakeholders · · That procurement rules have been Not applicable considered and action taken where applicable · · Any needs assessment relevant to Not applicable the decision.

National GMS and Contract changes 2021/22

Context

1. The purpose of the report is to set out for the Primary Care Commissioning Committee the key changes to the GMS contract announced in January 2021 (appendix 1). The report will update the committee on local developments. In addition following the publication in January 2021, further announcements have been made which will be included as part of the report.

2. The following changes have come into effect as of 1 April 2021:

o Funding commitments already made will be honoured, GP contract uplifts, IIF and ARRS uplifts etc. will continue o Arrangements will remain under review, depending on the progression of the pandemic and the progress of the Covid-19 vaccination programme, and further changes will be agreed between NHS England and GPC England in year (with reasonable notice provided to practices).

Directed Enhanced Services 2021/22

3. Directed Enhanced services will continue which include the learning disabilities health check and minor surgery services. Given the significant focus of the pandemic on obesity and weight management, the GPC has agreed to discuss the introduction of a new enhanced service. The aim is to introduce new measures to tackle obesity during 2021/22, supported by additional funding from government. Details are still to be agreed between GPC and NHSEI, no further update is available on this.

4. The Network Contract DES will continue for this financial year, all practices across Leicester, Leicestershire and Rutland have been automatically enrolled onto the service. The committee are note the following:

o National ARRS increase in funding (£430m in 2020/21 to £746m in 2021/22). o Expansion of ARRS roles (additional roles agreed in October 2020 to continue, and paramedics, AHPs and MHPs to commence from April 2021) o Additional four service specifications will not be introduced from April 2021, given reprioritisation necessitated by the pandemic. o More phased approach to the introduction of new IIF indicators for 21/22 (exact indicators and dates to be agreed). o Access offer to be developed over summer 2021, and implemented from April 22, no further update available nationally however locally LLR are working towards PCNs looking to deliver the service notably PCNs in Leicester City and West Leicestershire CCG o Clinical Pharmacists transfer from the Clinical Pharmacist in General Practice scheme allowed from 1 April to 30 September 21. o PCNs will be entitled to an embedded mental health practitioner, employed and provided as a service by the PCN’s local provider of community mental health services, funded under a local agreement; 50% of the funding will be provided from the mental health provider and 50% by the PCN.

Digital Offer

5. The five year deal included a commitment for a core digital offer that practices will be required to make to their patients. The following changes have been agreed:

o Online consultations that can be used by patients, carers and by practice staff on a patient’s behalf, to gather submitted structured information and to support triage, enabling the practice to allocate patients to the right service for their needs o The ability to hold a video consultation between patients, carers and clinicians o Two-way secure written communication between patients, carers and practice o An up to date accessible online presence, such as a website, that, amongst other key information, links to online consultation system and other online services prominently o Signposting to a validated symptom checker and self-care health information (e.g. nhs.uk) via the practice’s online presence and other communications o Shared record access, including patients being able to add to their record o Request and management of prescriptions online o Online appointment booking.

6. Practices will need to install online and video consultation tools and use them ordinarily; the tools and functionality will the responsibility of the CCG.

7. The current arrangement for practices who have implemented and operate a ‘total- triage’ / ‘triage-first’ model do not have to meet the 25% online booking contract requirement, will be extended. Practices will provide for patients to use an online method to inform their practice of a change of address, contact details or of their demographic information.

8. For QOF where clinically appropriate practices are able to perform patient reviews remotely. There are some areas where reviews should be done face to face for dementia patients. Practices are advised to follow clinical judgement for the management of the patients (appendix 2 for guidance).

9. As with other changes to GMS and PMS contracts, the exact requirements will come into effect upon amendment of the contract regulations, and practices will be notified when this happens.

Other

10. Whilst not directly linked to the nationally agreed contract changes, as per NHS England’s guidance practices are expected to continue adhere to the national GP standard operating procedure (GP SOP), in relation to the Covid-19 pandemic last update issued in May 2021. Commissioners continue to work with practices to implement the latest guidance.

Finance

11. There are limited changes with the finance arrangement but key areas to note include – QOF point value will increase by £6.33 (3.3%) to £201.16, global sum will increase by £3.32 (3.5%) to £96.78 and Out of hours adjustment will increase by £0.14 (3.0%) to £4.59.

12. Payments will continue as normal during quarter 1 as per 2020/21 funding arrangements apart from any specific adjustments such as QOF, Global Sum and OOH adjustments.

Recommendations

The LLR CCGs’ Primary Care Commissioning Committees are asked to:

NOTE the contract changes for 2021/22.

Classification: Official

Publication approval reference: 001559

To: • All GP practices in England • Primary Care Network Clinical Directors Cc: • CCG Clinical Leads and Accountable Officers • Regional Directors of Commissioning • Regional Directors of Primary Care and Public Health • Regional Heads of Primary Care

21 January 2021

Supporting General Practice in 2021/22

Dear colleagues

1. Thank you for all that you and your teams have done, and are continuing to do, for your patients and communities over the last incredibly difficult year. This year is like no other and it is not yet clear when the pandemic will end, with general practice:

(i) rising to the most important task in its history – rapidly administering the COVID vaccination programme to priority groups;

(ii) responding to the pandemic, which continues to call on practices to adapt, remaining fully and safely open, in order to offer accessible healthcare to all, with a particular focus on inequalities;

(iii) facing a backlog of care, e.g. QOF reviews for people with chronic conditions, with the added burden of additional population ill-health, e.g. long COVID, the extent of which is not yet fully known; and

(iv) needing to support the workforce who have worked incredibly hard for many months.

2. NHS England and the BMA GPC England have agreed that too much remains unclear to confirm contractual arrangements for the whole of 2021/22. But we can offer some reassurance and certainty now.

3. The Update to the GP contract agreement in February 2020 guaranteed that the available funding for the PCN Additional Roles Reimbursement Scheme (ARRS)

would increase from a maximum of £430m in 2020/21 to a maximum of £746m in 2021/22.

4. This was intended to support the introduction of new PCN services from April. We reconfirm the increase in ARRS funding from April as promised, but the additional four services will not be introduced at the beginning of the year from April 2021, given reprioritisation necessitated by the pandemic.

5. The NHS needs every GP it can attract. Last year’s Update to the GP contract agreement confirmed additional multi-year Government funding, in line with its published manifesto costings, for a programme of GP recruitment and retention initiatives and we will promote their fullest possible uptake during 2021/22.

6. To support the pandemic response and the COVID vaccination programme, NHS England is currently committing an additional £30m/month for capacity expansion for the last five months of 2020/21 and 100% funding support for PCN Clinical Directors for the last quarter (£10m/month) where PCNs are participating in the vaccination programme. The potential need for some continued COVID funding in the first months of 2021/22 will be kept under review.

7. To provide practice stability and support recovery, QOF for 2021/22 will be based upon the indicator set already agreed for 2020/21, with very limited changes only. The one main exception is vaccinations and immunisations, where we previously committed to improving payment arrangements for vaccinations and immunisations by replacing the Childhood Immunisation DES with item of service payments, and a new vaccination and immunisation domain within QOF. Four indicators have been agreed to comprise the new vaccination and immunisation domain, transferring almost £60m from the DES to QOF in 2021/22. This reform to the contract does not generate new workload but provides clearer support for the delivery of vaccinations and immunisations.

8. The pandemic has required a rethink to the timetable for introducing new QI modules. No new modules will be introduced in 2021/22. The Quality Improvement modules on Learning Disabilities and Supporting Early Cancer Diagnosis are subject to income protection arrangements for 2020/21. These modules are too important not to be completed in full. They will be repeated for 2021/22 in their original format, with some slight modifications to account for the impact of the pandemic upon care.

9. COVID has cast a harsh light on the inequalities in our society. The life expectancy of people with a serious mental illness (SMI) is 15-20 years lower than the general population. NHS England will invest a further £24m into QOF from April in order to strengthen the SMI physical health check indicator set and support uptake. Minor changes have been made to the cancer care domain, and also to specific existing indicators for asthma and heart failure diagnostics.

10. The ARRS will continue to expand and be more flexible. From April 2021 further ARRS roles will be added: (i) paramedics, as planned; (ii) advanced practitioners; and (iii) mental health practitioners, in a way that supports improved working with local mental health services.

11. A joint funding model will bring together additional community mental health service funding with PCN funding. From April 2021, every PCN will become entitled to a fully embedded FTE mental health practitioner, employed and provided by the PCN’s local provider of community mental health services, as locally agreed. 50% of the funding will be provided from the mental health provider, and 50% by the PCN (reimbursable via the ARRS), with the practitioner wholly deployed to the PCN. This entitlement will increase to 2 WTE in 2022/23 and 3 WTE by 2023/24, subject to a positive review of implementation. For PCNs with more than 100,000 patients the entitlements are double. Staff funded in this way will be additional to those mental health practitioners and co-located IAPT practitioners already embedded within general practice. The new obligation on mental health providers will be confirmed in the final version of the NHS Standard Contract.

12. PCNs in London have faced an additional recruitment challenge in not being able to offer the same inner and outer London weighting that is available to other NHS staff in London. NHS London may now offer this on top of maximum current ARRS reimbursement amounts. For 2021/22, this will be reinforced through the Network Contract DES. This will not mean an increase to ARRS funding for London (but offers more flexibility in its use) nor a reduction in ARRS allocations outside London.

13. There will be a further opportunity, from 1 April 2021 to 30 September 2021, for clinical pharmacists that remain on the Clinical Pharmacist in General Practice scheme to transfer to PCNs and be reimbursed under the ARRS, as per previous transfer arrangements. Limits on the number of pharmacy technicians and physiotherapists which can be reimbursed will be removed.

14. We encourage all PCNs to make full use of their ARRS entitlements as soon as possible. PCNs are a platform for general practice investment. The extent to which they deploy that investment is a measure of their success.

15. The Update to the GP contract guaranteed that at least £30m of the £150m IIF funding in 2021/22 will incentivise improvements in access for patients. Beyond this commitment, it would be premature to decide now how exactly the IIF will expand beyond the initial indicator set. In light of the ongoing pandemic, there will be a more phased approach to the introduction of new IIF indicators for 2021/22, just as new PCN service requirements will also be phased. Indicators on seasonal flu vaccination (including for over 65s, patients aged 18-64 in a clinical at- risk group, and children aged 2-3 years), annual Learning Disability Health Checks and Health Action Plans, and social prescribing referrals will continue for 2021/22.

Details of the points and thresholds associated with these indicators will be communicated prior to 1 April.

16. Extended access services have been used to support the general practice pandemic response, including the delivery of the COVID vaccination programme. The transfer of funding for the CCG commissioned Extended Access Service will now take place in April 2022. A nationally consistent enhanced access service specification will be developed by summer 2021, with the revised requirements and associated funding going live nationally from April 2022. Commissioners are strongly encouraged to make local arrangements for a transition of services and funding to PCNs before April 2022, where this has been agreed with the PCN, and the PCN can demonstrate its readiness. This has already happened in many parts of England.

17. NHS England and the BMA’s GPC England have also agreed to discuss, in early 2021/22, the introduction of an enhanced service on obesity and weight management with a view to introducing this as early as circumstances allow during 2021. This will be supported by additional funding from the Government.

The additional arrangements for 2021/22 will be developed and communicated as soon as the response to pandemic allows, providing as much notice to practices as possible.

Yours sincerely

Dr Nikita Kanani Dr Richard Vautrey Robert Kettell

Medical Director for Chair Interim Director of General Primary Care Practice Contract and British Medical Association’s Workforce NHS England and NHS General Practitioners Improvement Committee NHS England and NHS Improvement

Annex A – new QOF indicators for 2021/22

Table 1 - New vaccination and immunisation domain Indicator Indicator wording Points Payment Points at ID thresholds lower threshold NM197 The percentage of babies who reached 8 18 90-95% 3 (adapted) months old in the preceding 12 months, who have received at least 3 doses of a diphtheria, tetanus and pertussis containing vaccine before the age of 8 months. NM198 The percentage of children who reached 18 90-95% 7 18 months old in the preceding 12 months, who have received at least 1 dose of MMR between the ages of 12 and 18 months NM199 The percentage of children who reached 5 18 87-95% 7 years old in the preceding 12 months, who have received a reinforcing dose of DTaP/IPV and at least 2 doses of MMR between the ages of 1 and 5 years. NM201 The percentage of patients who reached 10 50-60% 0 80 years old in the preceding 12 months, who have received a shingles vaccine between the ages of 70 and 79 years.

Table 2 – Agreed serious mental health and cancer QOF indicators, points and thresholds Clinical Indicator Indicator wording Points Thresholds area ID MH007 The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of 4 50-90% alcohol consumption in the preceding 12 months SMI NEW The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of a lipid profile in the preceding 12 months (in those patients currently prescribed 8 50-90% antipsychotics, and/or have pre-existing cardiovascular conditions, and/or smoke, and/or are overweight) or preceding 24 months for all other patients NEW The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of 8 50-90% blood glucose or HbA1c in the preceding 12 months

NEW The percentage of patients with cancer, diagnosed within the preceding 12 months, who have had the opportunity for a 2 70-90% discussion and informed of the support Cancer available from primary care, within 3 months of diagnosis. CAN003 The percentage of patients with cancer, diagnosed within the preceding 24 months, who have a patient Cancer Care Review 6 50-90% using a structured template within 12 months of diagnosis.

Annex B – Expanding the Additional Roles Reimbursement Scheme – new roles requirements

Paramedic role requirements

Reimbursement level: Indicative Agenda for Change Band 7

Description of role

Paramedic practitioners work independently within their scope of practice in the community, using their enhanced clinical assessment and treatment skills, to assess and manage patients presenting with acute presentations which include minor illness or injury, abdominal pains, chest pains and headaches.

Training requirements

1. Where a PCN engages a paramedic to work in primary care under the Additional Roles Reimbursement Scheme, the PCN must ensure that the paramedic:

a. is educated to degree/diploma level in Paramedicine or equivalent experience

b. is registered with the Health and Care Professions Council (HCPC)

c. has completed their two-year ‘Consolidation of Learning’ period as a “newly qualified paramedic”

d. has a further three years’ experience as a band 6 (or equivalent) paramedic

e. is working towards developing Level 7 capability in paramedic areas of practice and, within six months of the commencement of reimbursement for that individual (or a longer time period as agreed with the commissioner), has completed and been signed off formally within the clinical pillar competencies of the Advanced Clinical Practice Framework.

Integrated working

2. Where a PCN employs a paramedic to work in primary care under the Additional Roles Reimbursement Scheme, if the paramedic cannot demonstrate working at Level 7 capability in paramedic areas of practice or equivalent (such as advanced assessment diagnosis and treatment) the PCN must ensure that each paramedic is working as part of a rotational model with an Ambulance Trust, in which they have access to regular supervision and support from clinicians signed off at clinical practice level 7.

Clinical responsibilities

3. The PCN must ensure that each paramedic has the following key responsibilities:

a. They will work as part of a multi-disciplinary team (MDT) within the PCN.

b. They will assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team.

c. They will advise patients on general healthcare and promote self- management where appropriate, including signposting patients to the PCN’s social prescribing service, and where appropriate, other community or voluntary services.

d. They will be able to: • perform specialist health checks and reviews within their scope of practice and in line with local and national guidance • perform and interpret ECGs • perform investigatory procedures as required, and • undertake the collection of pathological specimens including intravenous blood samples, swabs, and other samples within their scope of practice, and within line of local and national guidance.

e. They will support the delivery of ‘anticipatory care plans’ and lead certain services (e.g. monitoring blood pressure and diabetes risk of elderly patients).

f. They will provide an alternative model to urgent and same day GP home visit for the network.

g. They will communicate at all levels across organisations ensuring that an effective, person-centred service is delivered.

h. They will communicate proactively and effectively with all colleagues across the multi-disciplinary team, attending and contributing to meetings as required.

i. They will maintain accurate and contemporaneous health records appropriate to the consultation, ensuring accurate completion of all necessary documentation associated with patient health care and registration with the practice.

j. Communicate effectively with patients, and where appropriate family members and their carers, where applicable, complex and sensitive information regarding their physical health needs, results, findings, and treatment choices.

Advanced Practitioner: additional role requirements

Reimbursement level: Indicative Agenda for Change Band 8A

Description of role

An advanced practitioner reimbursement tier may apply to the following PCN roles: Clinical Pharmacist; Physiotherapist; Occupational Therapist; Dietician; Podiatrist; and Paramedic. To be reimbursable at band 8a, this role needs to have the following additional minimum training requirements, plus these extra responsibilities.

The number of advanced practitioners will initially be limited to 1 WTE per PCN under or at 99,999 registered population; and 2 WTE for PCNs larger than that, until the HEE advanced practitioner registration process has been established and implemented (expected by October 2021).

Training requirements

1. The PCN must ensure that the practitioner both:

a. is educated to master’s degree level in relevant area of expertise; and

b. has the capabilities of advanced clinical practice set out in section one of the Multi-professional Framework for Advanced Clinical Practice in England.

Clinical responsibilities

2. The PCN must ensure that each band 8a advanced practitioner has the following additional responsibilities:

a. They will assess and triage patients, including same day triage, and as appropriate provide definitive treatment (including prescribing medications following policy, patient group directives, NICE (national) and local clinical guidelines and local care pathways) or make necessary referrals to other members of the primary care team.

b. They will be able to manage undifferentiated undiagnosed condition and identify red flags and underlying serious pathology and take appropriate action.

c. They will use complex decision making to inform the diagnosis, investigation, complete management of episodes of care within a broad scope of practice.

d. They will actively take a personalised care approach and population centred care approach to enable shared decision making with the presenting person.

e. They will have completed the relevant training in order to provide multi- professional clinical practice and CPD supervision to other roles within primary care, for example first contact practitioners and the personalised care roles.

Mental Health Practitioner overview and requirements

Reimbursement level: Indicative Agenda for Change Band 5 / 6 / 7 / 8a (depending on the individual registered clinician providing the service). The maximum reimbursement rates will be set at 50% of the standard levels, reflecting the 50% PCN contribution to the salary and employer NI/pension costs of the individual(s) delivering the service.

Deployment arrangements

The mental health practitioner role will be employed and provided under a local service agreement by the PCN’s local provider of community mental health services, and embedded within the PCN. PCNs will be entitled to a service equivalent to one FTE practitioner for PCNs under or at 99,999 registered population; and two for PCNs larger than that. PCNs will contribute 50% of the salary and employers NI/pension costs associated with the individual(s) delivering the service. The remaining costs will be covered by the mental health provider.

The final NHS Standard Contract will include obligations on all community mental health providers to provide the mental health practitioner role on this basis. If needed, the CCG will broker agreement between the PCN and community mental health provider on the detail of deployment arrangements.

In addition to the adult and older adults’ role, PCNs may also choose to embed a children and young people practitioner with the agreement of the mental health provider. This would be funded on the same joint basis.

Requirements

1. The mental health practitioner may be any registered clinical role operating at Agenda for Change Band 5 or above including, but not limited to, a Community Psychiatric Nurse, Clinical Psychologist, Mental Health Occupational Therapist or other clinical registered role, as agreed between the PCN and community mental health service provider.

2. The mental health practitioner will:

• provide a combined consultation, advice, triage and liaison function, supported by the local community mental health provider;

• work with patients to: a. support shared decision-making about self-management; b. facilitate onward access to treatment services; c. provide brief psychological interventions, where qualified to do so and where appropriate.

• work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. This will include the PCN’s MDT, including, for example, PCN clinical

pharmacists for medication reviews, and social prescribing link workers for access to community-based support.

• operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider.

• be supported through the local community mental health services provider by robust clinical governance structures to maintain quality and safety, including supervision where appropriate.

Annex C: other changes agreed for 2021/22

1. NHS England and GPC England remain committed to reviewing and agreeing changes to the terms and conditions of practice staff within existing resources, as set out in the Update to the GP contract agreement, during 2021/22. In the interim we will: • undertake a data collection survey in general practice to get an accurate baseline of current terms and conditions of practice staff, in order to inform the development of good practice guidance on employment terms and conditions;

• explore how general practice gender pay gap information can be made more transparent in a way which respects individual privacy and does not result in undue additional burdens upon practices, with a view to agreement and implementation during 2021/22.

2. We confirm the definition of the core digital offer which all practices must provide to patients, including the offer and use of video and online consultations, ability to do online prescriptions, and online appointment booking. This is already the norm in the vast majority of practices. This is as follows: • Practices offering online consultations that can be used by patients, carers and by practice staff on a patient’s behalf, to gather submitted structured information and to support triage, enabling the practice to allocate patients to the right service for their needs • The ability to hold a video consultation between patients, carers and clinicians • Two-way secure written communication between patients, carers and practices • An up to date accessible online presence, such as a website, that, amongst other key information, links to online consultation system and other online services prominently • Signposting to a validated symptom checker and self-care health information (e.g. nhs.uk) via the practice’s online presence and other communications • Shared record access, including patients being able to add to their record • Request and management of prescriptions online • Online appointment booking

For online consultations and video consultations, practices will need to not only install online and video consultation tools but also use them ordinarily. Practices will be enabled with the tools and functionality, as part of CCG infrastructure responsibilities. 3. We will extend the arrangement from April 2021 that those practices which have implemented and operate a ‘total-triage’ / ‘triage-first’ model do not have to meet the 25% online booking contract requirement.

4. Practices will provide the functionality for patients to use an online method to inform their practice of a change of address, contact details or of their demographic information, including ethnicity.

5. The cervical screening additional service will become an essential service.

6. The removal of the requirement for patient consent in use of eRD made under the pandemic regulations will become a permanent change.

7. A contractual requirement for a more timely transfer of patient records when patients move between practices will be introduced.

8. Changes will clarify that digital services are allowed to be delivered by contractors through locations other than practice premises, in line with current practice.

9. Minor updates will be made to the existing Structured Medication Review and Early Cancer Diagnosis services within the Network Contract DES from April 2021.

Classification: Official Publications approval reference: PAR433

NHS England and NHS Improvement

Skipton House 80 London Road London SE1 6LH

To: GPs in England, regional directors of primary 10 March 2021 care and public health and CCGs

Dear colleagues,

Update on Quality Outcomes Framework changes for 2021/22 To provide practice stability and support recovery, QOF for 2021/22 will be based on the indicator set already agreed for 2020/21, with very limited changes only. The reinstating of QOF in full will support the recovery of long-term condition management. The updates for 2021/22 include: • A new vaccination and immunisation domain (as previously agreed in the update to the GP contract agreement) consisting of four indicators to replace the current Childhood Immunisation Directed Enhanced Service (DES). Three of these indicators focus on routine childhood vaccinations and one on incentivising the delivery of shingles vaccinations. • The reintroduction of three indicators focused on patients with a serious mental illness to promote improved uptake in all six elements of the SMI physical health check. • A new indicator focused on cancer care has been introduced and amendments made to the timeframe and requirements for the cancer care review indicator. • The four flu indicators have been retired with incentives relating to flu vaccination for target groups being introduced in the Investment and Impact Fund. • The date of diagnosis has been amended to ‘on or after April 2021’ for the asthma, heart failure and COPD diagnostic indicators. • To account for the impact of the COVID-19 pandemic on care, the Learning Disabilities and Supporting Early Cancer Diagnosis Quality Improvement modules are to be repeated in their intended format (prior to amendments for the refocusing of QOF in September 2020) with some slight modifications to account for the impact of the pandemic on care.

The size of QOF has increased from 567 to 635 points in 2021/22. The value of a QOF point in 2021/22 will be £201.16 and the national average practice population figure will be 9,085. There are no changes to payment thresholds for indicators carried forward from 2020/21.

For 2021/22, practices may deliver patient reviews remotely where clinically appropriate to do so, unless otherwise specified. Face-to-face reviews have been recommended for patients with dementia to allow primary care practitioners to fully assess the changing needs of the patient. Practices should continue to apply their clinical judgement to the appropriate management of affected patients and the decision to provide a virtual or face-to-face review should be made on a patient-by- patient basis.

Further detailed information on the data recording requirements and payment is included in the QOF guidance for 2021/22. Thank you for your continued dedication and hard work. Yours sincerely,

Rob Kettell Dr Richard Vautrey Dr Ursula Montgomery

Interim Director of Chair Senior Clinical Advisor Contract and Workforce British Medical Primary Care NHS England and NHS Association’s General NHS England and NHS Improvement Improvement Practitioners Committee

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Name of meeting: LLR CCGs’ Primary Care Date: 1st June 2021 Paper: Commissioning Committee E meetings in common Public  Confidential

Report title: GP International Recruitment

Presented by: Tine Juhlert, IGP Project Manager

Report author: Tine Juhlert, IGP Project Manager

Executive lead: Alice McGee, Executive Director of People and Innovation

Receive for information Action required:  Progress update:  only: For assurance:  For approval / decision: Executive The LLR Workforce Plan (Jan 2018) highlighted an urgent need to recruit GPs summary: across LLR, in the plan it is also established that international GP could be a way to permanently fill some of those vacancies.

As a result, a joint LLR CCG application was submitted to NHS England to enable the delivery of the NHSE IGPR offer. The bid was approved and LLR STP started delivering under the IGPR - Central Midlands Expansion Model (NHSE Responsible Officer; Prof Aly Rashid) in January 2019. Our allocation and accompanying funding covered salary, on-cost, relocation and training costs for 30 IGPRs, plus the full cost of the STP hosted project manager (8b), to be drawn down monthly from the national IGPR NHSE&I office

The LLR IGPR project was delivered by the LLR CCG hosted IGPR Project Manager; Tine Juhlert who was a member of the Workforce Workgroup. The workforce workgroup (chaired by Ian Potter) was in place to deliver the workforce related priorities, projects, programmes and objectives of the (previously named) LLR GP Resilience Board, later known as the Primary Care Delivery Group

The LLR IGP project deliverable and corporate objectives were: • To work in partnership with NHSE, HEE and local practices to recruit IGPR as per the LLR Workforce objectives, by applying the Central Mids. IGPR expansion model • Employ 30 international GP’s to LLR practices, in two cohorts o First cohort (14 GPs) to be in practices from July 2019 o Second cohort (16 GPs) to be in practices from July 2020 • Retain 90% of IGPR GP’s within NHS for at least 3 years • Ensure effective communication engagement with relevant stakeholders as outlined in the communication strategy • Establish effective delivery approach to ensure the Project is delivered within Project tolerances, i.e. on time and to budget • Give consideration and ensure alignment to all LLR retention initiatives • Improve practice life

Appendices: N/a

Recommendations: The LLR CCGs’ Primary Care Commissioning Committees are asked to:

• RECEIVE the LLR IGP update

Report history and • Last report was brought in Sep 2020 prior review:

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG   

Implications a) Conflicts of N/a interest: b) Alignment to Board Assurance Framework c) Resource and IGPs salaries (whilst practicing under supervision) and IGP Project Manager financial post, are fully funded by NHSE&I implications d) Quality and IGPs are practicing under educationally and clinically supervision patient safety implications e) Patient and public involvement f) Equality analysis and due regard

2

LLR GP International Recruitment

The LLR Workforce Plan (Jan 2018) highlighted an urgent need to recruit GPs across LLR, in the plan it is also established that international GP could be a way to permanently fill some of those vacancies.

As a result, a joint LLR CCG application was submitted to NHS England to enable the delivery of the NHSE IGPR offer. The bid was approved and LLR STP started delivering under the IGPR - Central Midlands Expansion Model (NHSE Responsible Officer; Prof Aly Rashid) in January 2019. Our allocation and accompanying funding covered salary, on-cost, relocation and training costs for 30 IGPRs, plus the full cost of the STP hosted project manager (8b), to be drawn down monthly from the national IGPR NHSE&I office

The LLR IGPR project was delivered by the LLR CCG hosted IGPR Project Manager; Tine Juhlert who was a member of the Workforce Workgroup. The workforce workgroup (chaired by Ian Potter) was in place to deliver the workforce related priorities, projects, programmes and objectives of the (previously named) LLR GP Resilience Board, later known as the Primary Care Delivery Group

The LLR IGP project deliverable and corporate objectives were: • To work in partnership with NHSE, HEE and local practices to recruit IGPR as per the LLR Workforce objectives, by applying the Central Mids. IGPR expansion model • Employ 30 international GP’s to LLR practices, in two cohorts o First cohort (14 GPs) to be in practices from July 2019 o Second cohort (16 GPs) to be in practices from July 2020 • Retain 90% of IGPR GP’s within NHS for at least 3 years • Ensure effective communication engagement with relevant stakeholders as outlined in the communication strategy • Establish effective delivery approach to ensure the Project is delivered within Project tolerances, i.e. on time and to budget • Give consideration and ensure alignment to all LLR retention initiatives • Improve practice life

Progress since January 2020

Cohort 1 distribution across LLR;

• 3 IGPs in East Leicestershire and Rutland practices • 3 IGPs in West Leicestershire practices • 8 IGPs in Leicester City practices This distribution has stayed stable, even if some IGPs have moved practices. 3

Cohort 1 1. 14 IGPs are now working in LLR practices 2. 6 have become independent practitioners and are practicing full time without conditions - and as such have been exited off the programme (national programme, but still supported at a local level, by the project manager) 3. A further 6 are making good progress and are expected to all be ready to practice independently from May – Dec 2021 4. The last 2 are on enhanced development plans, supported and developed by HEE 5. Funding to pay the IGPs salary until they can practice independently, has been guaranteed by the national team.

Cohort 2 1. The 16th – 19th Jan 2020 initial recruitment event – completed with 7 candidates attending. 5 were appointed 2. Covid-19 meant the second recruitment event was cancelled 3. 3 of the appointed candidates chose to not join the programme because of Covid-19 4. Cohort 2 – is therefore only 2 IGPs 5. These two are making good progress and are expected to be practicing independently by, respectively March and July 2022

Cohort 1 & 2 – status and completion dates

Potential end Initials MCQ SimSurg date Dr A Aug-20 Jan-21 Nov-21 Dr B Jan-20 n/a Jul-21 Dr C Aug-20 Jan-21 Oct-21 Dr D Nov-21 Dr E Nov-20 Jan-21 Sep-21 Dr F Mar-20 Aug-20 Aug-21 Dr G Sep-20 Jan-21 Sep-21 Dr H Aug-20 Mar-21 Dec-21 Dr I Jun-22 Dr J Mar-22

LLR IGP Project

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1. Funding has been drawn down to cover the IGP project lead part time until March 2022 2. The LLR hosted IGP project manager will carry on supporting the 10 remaining IGPs until March 2022

RAG rating to delivery objectives

Objective Progress RAG

To work in partnership with NHSE, On target and no slippage Green HEE and local practices to recruit IGPR as per the LLR Workforce objectives, by applying the Central Mids. IGPR expansion model Employ 30 international GP’s to Cohort 1 – slippage due to Covid- Amber LLR practices, in two cohorts 19 - First cohort (14 GPs) to be in Cohort 2 – slippage due to Covid- practices from July 2019 19 - Second cohort (16 GPs) to Still fully funded by NHSE&I – so be in practices from March little financial risk to LLR STP 2020 Retain 90% of IGPR GP’s within On target – since January 2019 Green LLR for at least 3 years only on IGP has left the programme Ensure effective communication A Communications Strategy is in Green engagement with relevant place, stakeholders as outlined in the communication strategy Establish effective delivery On target and no slippage Green approach to ensure the Project is Financial control is provided by delivered within Project tolerances, Andrew Roberts (WLCCG) i.e. on time and to budget Give consideration and ensure The IGPR project reports to the Green alignment to all LLR retention PCDG via the Workforce initiatives Workgroup. Improve practice life To date the project has placed 4 Green permanent GPs in LLR practices

Recommendations

The LLR CCGs’ Primary Care Commissioning Committees are asked to:

Receive the report

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Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group

Name of meeting: LLR CCGs’ Primary Care Date: 1 June 2021 Paper: Commissioning Committee F meetings in common Public  Confidential Report title: Risk Share and CQC inspections 2020/21

Presented by: Wendy Hope, Head of Quality and Safety Wendy Hope, Head of Quality & Safety Report author: Amy Walker, Primary Care Quality Manager

Caroline Trevithick, Executive Director of Nursing, Quality and Performance & Executive lead: Deputy Chief Executive

Receive for information Action required:  Progress update: only: For assurance: For approval / decision: Executive summary: This report provides information on key risks share group activity and CQC inspections undertaken in 2020/21.

• 13 general practices have been on the risk log from across LLR CCGs • 6 CQC inspection reports have been published

Key themes includes: • Infection prevention and control and safeguarding process and procedures • Management of MHRA and other alerts • Medicines optimisation • Vulnerable patients and application of Accessible Information Standards • Oversight and governance arrangements

Appendices: Recommendations: The LLR CCGs’ Primary Care Commissioning Committees are asked to:

• RECEIVE the report for information

Report history and - prior review:

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG

Implications a) Conflicts of Information is aggregated and no specific general practice is mentioned interest: b) Alignment to Yes Board Assurance

Page 1 of 7 Framework c) Resource and None financial implications d) Quality and Learning from themes patient safety implications e) Patient and Assurance that the CCG considers themes from CQC reports public involvement f) Equality analysis - and due regard

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General Practice Risk Share and Care Quality Commission inspections 200/21

Introduction

1. Clinical Commissioning Groups (CCG) have a statutory responsibility to develop and continually improve the quality of primary medical services. One of the mechanisms is by way of risk sharing arrangements. This report provides a summary of key work undertaken by the LLR Risk Sharing Groups (RSG) during 2020/21.

2. It needs to be read in the context of 2020/21 being an extraordinary year with staff within organisations needing to collectively work together to ensure patients receive care during the COVID-19 pandemic. The general practice teams have adapted and changed their way of working, CQC paused routine inspections and the CCG adjusted to how it could support and deliver on quality.

3. The information contained within this report is not intended to be comprehensive of all the work undertaken; what it attempts to do is provide key information around work undertaken within the RSGs and key theme from Care Quality Commission (CQC) published inspection reports.

Risk Sharing Group/s

4. During 2020/21 the three processes for risk share across the three CCG began to come together to provide a regular forum at which intelligence about general practices of concern are shared between directorates and core partner agencies. The RSG reports into the Primary Care Commissioning Committees.

5. The current arrangement is chaired by the Deputy Director of Nursing, Quality and Performance. The group shares intelligence in relation to moderate or above risks identified which could impact on the quality and/or safety of care being provided. Generally these are general practices where the issues are more widespread or more prolonged or diverse in their cause rather than issues that are easier to define or focus on a single area or are considered to be time limited in cause or scope is restricted.

6. It is important to have an appropriate level of challenge therefore the independent lay member chair of the three CCG Primary Care Commissioning Committees and an independent GP are a key part of the RSG.

7. From this group, monthly exception reports are received at Primary Care Commissioning Committee, both at the public meeting and in the confidential sections.

8. It is important to note that if a concern is of a specific individual practitioner performance this will be the responsibility of NHS England. However, where the CCG becomes aware of an issue that is related to an individual practitioner this may be escalated to NHS England.

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9. The RSG maintains a general practice risk log which is reviewed at each of its meetings. During the course of 2020/21 there have been a total of 13 general practices on the log across the three CCGs. This equates to 10% of the CCGs general practices. The issues are multifaceted and not generally a single concern. The main reasons why a general practices required enhanced monitoring and support were:

• CQC inspection report highlighted areas for improvement • Service delivery issues - usually coupled with patient experience concerns including access, failure to follow robust processes and staffing

10. There have been no breach notices issued by the CCG from the RSG to general practices during 1920/21 as the preference is to work with the practices own CQC action plan or their own improvement plan rather than create an additional layer of work.

11. The practices on the risk log will receive varying levels of enhanced support and monitoring. This monitoring & support is intended to be facilitative and supportive whilst ensuring improvement. More around support provision can be found further in the paper.

Summary of LLR General Practice CQC Inspections during 2020/21

Overall Rating

12. During 2020/21 six CQC reports were published for Leicester Leicestershire and Rutland general practices. One practice was inspected twice throughout the twelve months. Of the five general practices to receive an inspection all five are from different Primary Care Networks.

13. The current overall rating is indicated below alongside their previous rating. Each of the practices inspected had a previous rating of inadequate, and it is positive to see a change in rating for all 5 practices recognising improvements in the quality of services.

Current Overall Rating Date report Previous Overall Date report Change published Rating published 1 Good 20/01/2021 Inadequate 28/04/2020

2 Requires 25/02/2021 Inadequate 18/09/2019 Improvement 3 Good 17/03/2021 Inadequate 12/03/2020

4 Requires 05/02/2021 Inadequate 28/06/2018 Improvement 5 Requires 07/04/2020 Inadequate 16/09/2019 Improvement

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Five key domains

14. From the six CQC reports published the outcome in each of the domains is indicated below. General practices have performed better in the caring and responsive key questions than in the safe, effective and well led key questions. The safe and well led domains are connected in that the well led is around leadership and governance process and one of the reasons a practice will not do so well in the safe domain is around lack of robust process.

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5

4 Good 3 Requires Improvement

2 Inadquate

1

0 Safe Effective Caring Responsive Well-led

Key Themes

15. Recognising the low numbers, there are six clear areas where if there was evidence of good processes and procedures general practice obtained a good rating whereas if evidence was limited or non-existent a rating of requires improvement or inadequate was given. These areas, in no particular order, are:

• Infection prevention and control process and procedures • Safeguarding processes and procedures • Management of MHRA and other alerts - receiving, recording, implementing, auditing • Medicines Optimisation: Monitoring of patients on high risk drugs, emergency medicines storage, limited evidence of structured medicine reviews for patients on repeat medicines • Vulnerable patients and application of Accessible Information Standards – recording, documenting translation, language, easy read information • Oversight and governance arrangements - management and performance of the practice was ineffective, systems to learn and make improvements when things went wrong, oversight of locums, lack of robust process and procedures

16. Interestingly, for safeguarding processes those practices that had completed the Safeguarding markers toolkit no actions for improvement were highlighted in this area by CQC.

Page 5 of 7

Support

17. GP partners and staff within the general practices have put in a lot of work to attain the required improvements. All general practice teams have engaged with the CCG

18. The CCG provides reactive support in a number of ways and is given by a variety of teams from across all five CCG directorates. The primary care quality team may coordinate this but it is important to recognise the support given by all teams. Support may be specialised in the form of safeguarding, medicines optimisation, infection prevention and control, or more generalist in areas such as access, website, contracting and wellbeing emotional support.

19. Proactive support and sharing of learning has taken place with general practice. Examples of this include:

• Contact by Integration and Transformation managers, contracting managers, quality and safety team members where any emerging concerns become known • CCG Medicines Optimisation visits, education and searches • Increasingly PCN support is being utilised • Use of primary care sit rep, protected learning time and other meetings to promote and inform of areas of learning and good practice. • Safeguarding Lead GP Forums • Provision of patient experience graphs and other information to general practices • Sharing areas of good practice from one practice to another during quality and/or contract visits

20. The next year will see proposals for a reformed RSG and a general practice quality operational group reporting into the RSG. A development session has been planned in relation to the GP quality operational group for April 2021. This group will amalgamate the 3 existing CCG GP Quality Dashboards into one central LLR General Practice dashboard and this will be refreshed so they are consistent with the CQC insight reports.

Conclusion

21. The year has been an unusual year with organisations working in the times of a pandemic. There has been fewer CQC inspections taking place and their approach has been different. Work within general practice and the CCG has also had to change and adapt to the situation.

22. During the course of the year the 3 risk sharing processes have amalgamated to ensure they continue to provide a valuable role in developing and delivering assurance flows in relation to primary care risks. The membership is committed to ensuring safe and effective services to meet people’s need by adopting a supportive and facilitative approach to improvement. This can be evidenced by some practices moving from inadequate to good overall on CQC re- inspection.

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23. It is acknowledged that the GP partners and staff within the general practice have put in a lot of work to attain improvements however the RSG, through it philosophy of approach has promoted and ensured safe and effective services for patients.

24. As we move into 2021/21 and into an integrated care system, the risk share group will continue to evolve. Staff working across CCG directorates will continue to strengthen, robust relationships will continue with CQC inspection managers and general practice teams and PCN teams will all work to ensure patients receive the care they deserve and need.

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Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group

Name of meeting: Primary Care Date: 1 June 2021 Paper: Commissioning Committee G in Common Public  Confidential

Report title: General Practice Quality - High level report

Presented by: Wendy Hope, Head of Quality & Safety

Report author: Wendy Hope, Head of Quality & Safety

Executive lead(s): Caroline Trevithick, Executive Director of Nursing, Quality and Performance

Receive for information Action required:  Progress update: only: For assurance: For approval / decision: Executive summary: This report aims to provide the Primary Care Commissioning Committee with a high level report informing the committee of:

• Overview information on newly published CQC reports for LLR general practices. o At the time of writing there have been no CQC reports published since the last meeting in March 2021

• The number of practices who are receiving increased support and monitoring and/or additional monitoring and oversight from CCG teams. o Ten

Appendices: • None

Recommendations: The LLR CCGs’ PCCC are asked to:

• RECEIVE and note the information contained in the report.

Report history and • n/a prior review:

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG   

Implications a) Conflicts of General Practitioners could be conflicted if their General Practice or Primary interest: Care Network is mentioned within the report.

b) Alignment to Yes

Board Assurance Framework c) Resource and None financial implications d) Quality and As indicated within the report patient safety implications e) Patient and N/A for purpose of the report public involvement f) Equality analysis None and due regard

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General Practice Quality and Contract Highlight Report

Introduction

1. This report aims to provide the Primary Care Commissioning Committee (PCCC) with information on newly published Care Quality Commission (CQC) reports and high level aggregated information of general practice quality concerns as discussed at the CCGs Risk Sharing Groups.

2. The report for those practices receiving additional or enhanced support or increased monitoring represents a point in time as there may be changes in circumstances between and the writing of the report and the PCCC meeting.

3. General practices receiving additional or enhanced support or where intelligence suggests there may be a concern, are discussed at the Risk Sharing Groups and other forums. From a quality perspective the risk sharing group will monitor and follow up on agreed actions for practices it discusses.

4. Whilst this report is high level, specific practice information is discussed within confidential sections of Primary Care Commissioning Committee as required.

Care Quality Commission

5. At the time of writing no CQC inspection reports have been published since the last Primary Care Commissioning Committee in common meeting.

6. A total of 131 LLR General Practices have received a CQC inspection. This number represents the latest reports that are available on the CQC website. The number, which includes any changes to practice locations, is not static and does fluctuate as practices are re-inspected and/or reports are archived. The overall CQC rating is indicated below.

CCG Total number of Outstanding Good Requires Inadequate general practices Improvement inspected LCCG 55 2 46 7 0 % of general 98.2% (55 inspected practices from 56 practices) 3.6% 83.6% 12.7% 0% inspected EL&R CCG 29 0 29 0 0 % of general 100% (29 inspected practices from 29 practices) - 100% - - inspected WLCCG 46 1 43 2 0 % of general 100% (46 inspected practices from 46 practices) 2.2% 93.4% 4.3% 0 inspected LLR CCGs 130 3 118 9 0 LLR CCG % of 99.2% (130 general inspected from a 2.3% 90.7% 6.9% 0% practices total of 131 LLR inspected practices)

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7. The CCG teams will work with practices that require additional support to enable them to make the required improvement.

Aggregated General Practice Information

8. The tables below summarise the numbers of practices who are receiving additional/enhanced support and/or increased monitoring from the Clinical Commissioning Groups. This support can be long term as it covers a period of time to ensure any changes have been embedded into the practice.

9. There are currently ten general practices receiving specific enhanced monitoring and/or support or increased monitoring.

2020/21 March 2021 New this month 1 Closed this month 3 Total number of practices 10

10. The aggregated reason/s for the specific enhanced or additional support and monitoring for these practices are outlined below.

2020/21 Aggregated Reason Patient Experience 4 Service Delivery 10 Care Quality Commission (CQC inspection) 7 Contractual 4 Staffing (specific challenges) 3

11. The CCG continues to support and monitor practices with actions arising from CQC inspection reports and any other concerns identified.

12. The current risk log is undergoing review and as such the format of this report may change for future meetings.

13. Any concerns in these areas are reported to the Risk Sharing group and where required escalation to the Primary Care Commissioning Committee.

Recommendations

The Primary Care Commissioning Committee is asked to:

RECEIVE and NOTE the information contained in the paper.

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Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group

Name of meeting: LLR CCGs’ Primary Care Date: 1 June 2021 Paper: Commissioning Committee H meetings in common Public  Confidential Report title: GP IM&T Update

Presented by: Sharon Rose, Senior Digital Enablement Manager Report author: Sharon Rose, Senior Digital Enablement Manager Executive lead: Alice McGee, Executive Director of People and Innovation Receive for information Action required:  Progress update: only: For assurance: For approval / decision: Executive This paper provides an update on the IM&T Work Programme across LLR summary: which supports the delivery of the Local Digital Roadmap and implementation of GP 5YFV requirements. Appendices: IM&T Tracker appendix a Recommendations: The LLR CCGs’ Primary Care Commissioning Committees are asked to:

• RECEIVE the report for information

Report history and Update is sent to the PCCC meeting in common and monthly to the GP prior review: IM&T Steering Group.

Aligned to Strategic Objectives Leicester City CCG West Leicestershire CCG East Leicestershire and Rutland CCG x x x Implications a) Conflicts of GPs dependent on project interest: b) Alignment to Monthly reports to the GP IM&T Steering Group Board Assurance Framework c) Resource and Carried out as and when required by projects financial implications d) Quality and Carried out as and when required by projects patient safety implications e) Patient and Carried out as and when required by projects public involvement f) Equality analysis Carried out as and when required by projects and due regard

Page 1 of 3 LLR GP IM&T Work Programme update

Introduction

The aim of the GP IM&T work programme is to deliver the IM&T initiatives which support the GP Five Year Forward View (GP5FV) and the Leicester, Leicestershire and Rutland Local Digital Road Map, overseen by the GP IM&T Steering Group. The Steering Group are also the forum to discuss any emerging initiative or development that will impact on GP IT.

IM&T Work Programme

1. Within the programme there are 4 key initiatives which are being delivered in response to national NHS E GP IT framework mandates, GP5FV or those locally defined strategic objectives of the LDR (Record sharing, Supporting pathways, Digital self-care and BI& research). The IM&T tracker is available in appendix a.

a. eConsultations b. GP Clinical System Migration c. Electronic Record Sharing d. Clinical System Optimisation

Work Stream Update

2. eConsultations. 75% of practices are providing an online consultation solution. Progress has slowed due to the pandemic and continuity of practice operating models. We continue to promote and work with practices, where applicable. Alongside this all practices have access to offer video consultations with over 95% actively doing so.

3. In December 2020, NHS England (NHS E) announced a new framework which should be used for all video consultation and online consultation solutions. This Framework known as the OCVC Framework is expected to launch on 26th April 2021 and onboarding of suppliers will happen over a phased period.

4. In the absence of the appropriate framework, The CCGs have been able to commence an initial contract on a bridging agreement with AccuRx from 1st April 2021 for continuation of video consultation provision. This process was in conjunction with and facilitated by the NHS E Commercial Hub. The Local contract is for the enhanced module which includes surveys and patient triage functionality, which may support the outstanding 25% of practices to fully achieve the requirement of Total Remote Triage.

5. In line with NHS E requirements, we may be expected to complete a mid-year re procurement for Video consultation solutions in line with the publication of the new OCVC (online consultation and video consultation) framework.

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6. System Migration. The 20/21 system migration project has successfully completed with the last of the 3 planned migrations from EMIS Web to SystmOne (S1) enabled in December 2020. 91% of the LLR population is now registered with a S1 practice. Currently there are no further practices wishing to migrate systems, and national funding to support this activity has not yet been made available.

7. Electronic Record Sharing. The Summary Care Record into Adult Social Care is a Proof of Concept project with Local Authorities across LLR. Leicestershire County Council has identified 4 new teams to form part of this project and Leicester city are now enabling this across their teams, this roll out had been paused due to the pandemic.

8. In addition to SCR 2.1, as an ICS we are now looking at progressing with a Shared Care Record. This is in very early stages of development and further information will be made available as this evolves. This workstream is a system wide development and will be moving at pace.

9. System Optimisation. During 20/21 this work stream has paused due to the pandemic. We are reviewing this programme for 21/22. Training for Clinical Systems has remained in place.

Emerging Work streams

10. GP IT Futures – With the replacement of the GP System of Choice (GPSoC) framework with GP IT Futures, all CCGs will be required to complete re procurements of clinical systems over the next 18 month period. The re procurements will include any other solution previously funded through GPSoC which for us locally will include Eclipse and Doman as well as EMIS Web and SystmOne.

RECOMMENDATIONS

The LLR CCGs’ Primary Care Commissioning Committees are requested to:

RECEIVE the report for information

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Apr-21 Project Areas Project Summary Current Position April Key Actions and Outputs for next month Risks and key issues including mitigation plans Items for Escalation to LLR Current month rag GP IM&T Group status

Provision of online consultation (OLC) within General practice from Apr 2020. LLR All sites contacted are technically enabled for online consultations (Licences with practices who have declined • Engagement to continue with remaining •Practices implement non approved IT solutions. Risks of using LLR highlighted to national Amber eConsultations have a procured solution Engage consult. to proceed at present have been suspended until they are ready to proceed for patient safety) practices. non-approved systems to be fully defined as not meeting the 100% Total remote triage (TRT) model is a general practice requirement to support As part of the COVID actions all LLR practices are now offering telephone triage and video consultations. • Support the work undertaken to increase •The licences for all practice that have declined to implement have total remote triage ask. Covid working and OLC forms part of the TRT model. the usage. been suspended. OLC Position • Release a practice survey to ascertain VC 84 practices are now live with Engage Consult and OLC requirements 15 practices are live with another online consultation solution 10 practices have a confirmed go live dates for Engage Consult 6 practices do not have a confirmed go live date yet 17 practices have declined to proceed at present

Video Consultations Intial Local contract for AccuRx has been commenced from 1st April and 2 webinars have been delivered to support the additional functionality.

This project will support our aspiration to move to one single platform (one 3 practice migrations planned for 20/21 and these are all now complete. Funding lodged with LPT from WL LHIS to continue with the CCG migrations • National funding is not made available None Green System Migrations clinical system) across LLR and contribute towards key deliverables within the STP. CCG 19/20 capital underspend. when funding becomes available. • Practices do not engage with migrations • 2 x ELR CCG C82044 Empingham – (Live) -13th Oct 2020 C82112 Spectrum Health (Severn Surgery) - 1st December (Live) - 1st Dec 2020 • 1 x LC CCG C82676 Elizabeth Health Centre – (Live) 3rd Nov 2020

Summary Care Records v2.1 has been the record sharing tool of choice. SCR phase 1 and 2 position remains the same. Continue with the implementation to the • Provider low usage of SCR, until a large proportion of the patient Amber Electronic Record • Phase 1 relates to the Primary Care roll out of Summary Care Records teams identified by the local authorities and population has consented to SCR v2.1. Currently higher proportion Sharing & Flagging v2.1including the development of the ICP SCR phase 3 support Rutland Council to rectify technical due to Covid temporary arrangements and Notifications • Phase 2 will look at streamlining and improvement of the Special Patient Note issues. process, and the challenge of encouraging Provider organisations to use SCR more Following the agreement from the November IM&T Group to continue with the proof of concept a futher readily meeting was held with Leicestershire County Council. The technical issues due to VDI are largely resolved and • Phase 3 will facilitate the introduction of SCR across Adult Social Care in LLR. they are keen to reignite SCR viewing and have identified 4 extra teams to roll the project into who they This is a first of type project and as such we are working closely with NHS D. believe will benefit. Talks are underway with the RA team on how the cards will be issued remotely. Running in parallel is the task of promoting and gaining patients explicit consent to sharing their enhanced Summary Care Record (SCR v2.1), which will enable Rutland Council have been struggling with IT issues and resource to get this rectified due to COVID. They are health care professionals access SCR v2.1 and deliver the most appropriate care to pushing to get this resolved. patients. Leicester City continue to view the information and have recently implemented in the OT and Reablement teams. They also have other teams that they believe will benefit from access to SCR.

Additional training and support to all practices across LLR. This will be via a •LHIS continue to provide a half day site based training per practice as well as the class based training that is 21/22 programme to be reviewed for None Red System number of routes such as at individual available through the LMS website delivery Optimisation practices, groups of practices/locality training sessions, or LHIS workshops. •The newsletter reminder article is included as a standing article going forward - paused due to COVID Benefits include: • Reduction in practice workload and pressures Paused due to COVID but will resume when return to business as usual. Clinical System training is still • Enable practices to work at scale available remotely. • Support whole systems efficiency The content of the training that is offered from LHIS through LMS was reviewed and the 3 CCG IM&T Leads agreed that the content was still current and should remain the same. One half day practice based training on system optimisation will be offered to all LLR practices.