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Appendix 3

ILP, Cluster and Practice Programme

Framework Library image

1 1 Overview

A full breakdown of plans and supporting evidence is attached at appendix 6 an the follow section provides a summary for each ILP ICS

Cheltenham ILP* ILP* ILP* ILP* ILP* ILP*

PCN PCN PCN PCN PCN PCN North Aspen Berkeley Vale St Paul's Cotswolds Stroud Forest of Dean HQR TWNS Central South Cotswold Inner City Peripheral Cotswolds Severn Health North South Gloucester (NSG)

* Integrated Locality Partnerships (ILPs) are Gloucestershire’s localised version of NHS ’s ‘Place’ level; The ILPs will help to deliver ICS, Health & Wellbeing and local priorities; ILPs will also support PCNs to deliver; Each ILP will collectively develop an ILP plan for their place. 1.1 ILP

3 1.2i Cheltenham summary

• Population projections - 175,000 patients PCN Practices by 2031 Corinthian Surgery • New Cleevelands Medical Centre Portland Practice completed and open St Paul's Royal Well Surgery St Catherine's Surgery • Stoke Road refurbished and extended St George's Surgery • Winchombe extended Berkeley Place Surgery • Delivery of Prestbury Road Primary Care Crescent Bakery Surgery Centre due to be open end of 2020 Overton Park Surgery Central Royal Crescent Surgery • Delivery and procurement approach for a Underwood Surgery surgery at North West Elms housing Yorkleigh Surgery development Cleevelands Medical • Condition of remaining estate relatively Centre The Leckhampton Surgery acceptable but some surgeries undersized Peripheral Sixways Clinic • Overton Park and Yorkleigh – 2021 to 2026 Stoke Road Surgery priority Medical • Reviewing options around Leckhampton Centre and Sixways 4

1.2ii Cheltenham housing by practice

Cheltenham Practice District North West West of Wider Wider Total housing capacity Cheltenham cheltenham Bishops Winchombe Cleeve Berkeley Place 275 0 0 0 0 275 Cleevelands 0 0 0 314 0 314 Corinthian Surgery 263 0 0 0 0 263 Crescent Bakery 175 0 0 0 0 175 Leckhampton Surgery 418 0 0 0 0 418 Overton Park Surgery 382 0 0 0 0 382 Portland Practice 418 0 0 0 0 418 Royal Crescent Surgery 259 0 0 0 0 259 Royal Well Surgery 215 0 0 0 0 215 Sixways clinic 342 0 0 0 0 342 St Catherine’s Surgery 299 0 0 0 0 299 St George’s Surgery 319 0 0 0 0 319 Stoke Road Surgery 0 0 0 314 0 314 Underwood Surgery 338 0 0 0 0 338 West Cheltenham(proxy) 0 4,285 1,100 0 0 5,385 Winchcombe 0 0 0 0 224 224 Yorkleigh Surgery 279 0 0 0 0 279 Total 3,982 4,285 1,100 628 224 10,219 5 1.2iii Cheltenham ILP list size growth

Registered list Registered list Projected list size Practice size April 2015 size Jan 2019 April 2031 Berkeley Place Surgery 7,495 8,605 9,050 Cleevelands Medical Centre 9,972 10,503 11,012 Corinthian Surgery 8,651 8,324 8,750 Crescent Bakery Surgery 6,069 5,408 5,692 Leckhampton Surgery 12,738 13,284 13,961 Overton Park Surgery 11,546 12,122 12,741 Royal Crescent Surgery 6,916 7,722 8,141 Royal Well Surgery 6,755 6,846 7,194 Sixways Clinic 10,864 10,838 11,393 St Catherine's Surgery 9,793 9,485 9,969 St George's Surgery 10,127 10,145 10,661 Stoke Road Surgery 9,718 10,692 11,201 Portland Practice 13,750 13,331 14,008 Underwood Surgery 9,866 11,395 11,943 West Cheltenham (proxy) 1,596 3,339 12,063 Winchcombe Medical Practice 6,787 7,532 7,895 Yorkleigh Surgery 8,835 8,912 9,364 151,478 158,483 175,038

6 1.2ivCheltenham ILP surgery sizes Projected Gap for Registered list size allowance 2019 Allowance Gap for list size Jan April for 2019 popn for 2031 2031 % diff Practice 2019 2031 m2 popn m2 m2 % diff popn2 popn m2 West Cheltenham (Proxy) 3,339 12,063 273 290 -17 -5.9% 919 -646 -70.3% Berkeley Place Surgery 8,605 9,050 240 717 -477 -66.5% 754 -514 -68.2% Crescent Bakery Surgery 5,408 5,692 193 450 -257 -57.1% 474 -281 -59.3% Royal Crescent Surgery 7,722 8,141 308 643 -335 -52.1% 678 -370 -54.6% Overton Park Surgery 12,122 12,741 448 921 -473 -51.4% 947 -499 -52.7% Yorkleigh Surgery 8,912 9,364 418 743 -325 -43.7% 780 -362 -46.4% Sixways Clinic 10,838 11,393 529 868 -339 -39.1% 891 -362 -40.6% St George's Surgery 10,145 10,661 538 839 -301 -35.9% 861 -323 -37.5% Leckhampton Surgery 13,284 13,961 635 970 -335 -34.5% 998 -363 -36.4% St Catherine's Surgery 9,485 9,969 542 790 -248 -31.4% 831 -289 -34.8% Underwood Surgery 11,395 11,943 663 891 -228 -25.6% 914 -251 -27.5% Corinthian Surgery 8,324 8,750 537 687 -150 -21.8% 729 -192 -26.3% Royal Well Surgery 6,846 7,194 492 571 -79 -13.8% 600 -108 -18.0% Stoke Road 10,692 11,201 729 862 -133 -15.4% 883 -154 -17.4% Portland Practice 13,331 14,008 912 972 -60 -6.2% 1000 -88 -8.8% Winchcombe Medical Practice 7,532 7,895 686 628 58 9.2% 658 28 4.3% Cleevelands 10,503 11,012 950 854 96 11.2% 875 75 8.6%

7 1.2vCentral Primary Care Network (Cheltenham) – Premises Overview to 2026

• 6 Practices in PCN • Registered population in January 2019 of 54,161 • Population projections - 56,931 patients by 2031 • Total current space equates to around 2,270 GIA m2 Berkeley Place Surgery versus expected of 4,865 GIA m2 for 2031 population Crescent Bakery Surgery • Services have been provided over 7 buildings Overton Park Surgery • Key priority to complete the Prestbury Road Primary Royal Crescent Surgery Care Centre development. Expected to be open by the Underwood Surgery Yorkleigh Surgery end of 2020 – facilitates colocation of Berkeley Place, Crescent Bakery and Royal Crescent surgeries • Remaining priority to develop business case for Overton Park and Yorkleigh surgeries, ideally a single centre for period 2021 to 2026 • Plan to reduce number of buildings from 7 to at least 5, possibly 4

8 1.2viPeripheral Primary Care Network (Cheltenham) – Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 52,849 • Population projections - 55,462 patients by 2031 Cleevelands Medical Centre • Services have been provided over 7 different buildings The Leckhampton Surgery • Number of buildings has reduced to 5 Sixways Clinic • Total current space equates to around 3,529 GIA m2 Stoke Road Surgery versus expected of 4,305 GIA m2 for 2031 population Winchcombe Medical • Winchombe surgery extension completed Centre • Stoke Road substantially refurbished and extended • New Cleevelands medical centre completed and opened • Review requirements and the needs of Leckhampton surgery and Sixways clinic over the long term

9 1.2viiSt Pauls Primary Care Network (Cheltenham) – Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 48,131 Corinthian Surgery • Population projections - 50,582 patients by 2031 Portland Practice • Services have been provided over 3 different buildings Royal Well Surgery • Services now provided over 2 sites St Catherine's Surgery • Total current space equates to around 3,021 GIA m2 St Georges surgery versus expected of 4,021 GIA m2 for 2031 population • Key priority is the continued long term use of St Pauls medical centre which supports all 5 practices in the PCN.

10 1.3 Cotswolds ILP

11 1.3i Cotswolds summary

• Population projections - 98,554 patients by 2031 North Cotswold Medical Practice • Cotswolds Mann Cottage Surgery Completion of Cotswold Medical Practice Stow Surgery refurbishment White House Surgery • Completion and opening of Stow surgery Health Group • Completion of new surgery in ; Hilary Cottage Surgery • Completion of new surgery at Chesterton, South Phoenix Health Group Cirencester; Cotswolds Rendcomb Surgery • New surgery to replace Avenue and St. Upper Thames Medical Peter’s Road buildings Group • Business case for a new Campden surgery

12 1.3ii Cotswolds housing by practice

Bourton Campden, and Mickleton North and Cirence Down South Upper Total Blockley leach ster Chesterton Apney Kemble Moreton Cerney Stow Tetbury Rissington Windfall Campden Surgery 55 370 81 451

Cotswold Medical Practice 130 27 81 238 Mann Cottage 246 80 326 Stow Surgery 181 80 261 White House 245 80 325 Cirencester Health Group 52 481 80 613 Hilary Cottage 25 131 80 236 Upper Thames Medical group 51 239 20 28 80 418 Phoenix Surgery 52 720 30 37 115 80 1034 Rendcomb 80 80 Romney Surgery 608 81 689 Unallocated 360 360 Total 55 130 370 155 1,800 75 131 37 28 491 115 181 608 27 883 5,030 13 1.3iiiCotswolds list size growth

Registered list size April Registered list size Projected list Practice 2015 Jan 2019 size April 2031 Cirencester practices unallocated 0 0 583 Campden Surgery 4,810 5,080 5,811 Phoenix Surgery 12,689 13,907 15,582 Romney House, Tetbury 7,955 7,951 9,066 Hilary Cottage Surgery 7,261 7,637 8,019 Rendcomb Surgery 3,808 4,301 4,431 Cirencester Health Group 13,360 13,278 14,271 Upper Thames Medical Group 12,170 12,608 13,285 White House Surgery 4,408 4,682 5,209 Mann Cottage Surgery 3,683 4,346 4,874 Cotswolds Medical practice 10,012 11,119 11,505 Stow Surgery 5,551 5,496 5,919 85,707 90,405 98,555

14 1.3iv Cotswolds ILP surgery sizes

Projected Gap for Registered list size GIA for Gap for GIA for 2031 list size April 2019 popn 2019 2031 popn Practice Jan 2019 2031 m2 m2 popn m2 % diff popn m2 m2 % diff - Cirencester practices unallocated 0 583 0 0 0 0.0% 24.2 -24.2 100.0% Campden Surgery 5,080 5,811 282 423 -141 -33.3% 484 -202 -41.7% Phoenix Surgery 13,907 15,582 671 996 -325 -32.6% 1,041 -370 -35.5% Romney House, Tetbury 7,951 9,066 501 667 -166 -24.9% 755 -254 -33.6% Hilary Cottage Surgery 7,637 8,019 510 637 -127 -19.9% 668 -158 -23.7% Rendcomb Surgery 4,301 4,431 278 358 -80 -22.3% 367 -89 -24.3% Cirencester Health Group 13,278 14,271 835 969 -134 -13.8% 1,011 -176 -17.4% Upper Thames Medical Group 12,608 13,285 733 942 -209 -22.2% 970 -237 -24.4% White House Surgery 4,682 5,209 459 390 69 17.7% 434 25 5.8% Mann Cottage Surgery 4,346 4,874 458 362 96 26.5% 406 52 12.8% Cotswolds Medical practice 11,119 11,505 1182 896 286 31.9% 909 273 30.0% Stow Surgery 5,496 5,919 677 457 220 48.1% 493 184 37.3%

15 1.3vNorth Cotswolds Primary Care Network Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 30,723 • Population projections - 33,317 patients by 2031 • Services have been provided over 6 different buildings Chipping Campden • Total current space equates to around 3,058 GIA m2 Cotswold Medical Practice versus expected of 2,750 GIA m2 for 2031 population Mann Cottage Surgery • Significant development completed and open at Stow Surgery Moreton in Marsh – Three Shires Medical Centre for White House Surgery Mann Cottage and White House surgeries • Main site of Cotswold Medical Centre refurbished • New Stow surgery due to be open in Autumn of 2019 • Remaining priority is to develop business case for development or replacement of Campden surgery between 2021 to 2026. Current properties significantly undersized to meet needs

16 9.3viSouth Cotswolds Primary Care Network Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 52,045 • Population projections - 57, 218 patients by 2031 • Services have been provided over 14 different buildings Cirencester Health Group • Total current space equates to around 3,018 GIA m2 versus Hilary Cottage Surgery expected of 4,168 GIA m2 for 2031 population Phoenix Health Group • Development of new main Surgery site at Chesterton in Rendcomb Surgery Cirencester for Phoenix Health Group with business case Upper Thames Medical expected in the Autumn of 2019 Group • Development of new surgery in Tetbury for around 10,000 patients . Led by Phoenix Group the business case expected Winter of 2019 • Following merger of two practices Cirencester Health Group progressing options for replacement of their two separate buildings into one new building

17 1.4 Forest of Dean ILP

18 1.4i Forest of Dean summary

Blakeney Surgery • Population projections - 71,937 patients The Brunston & Practice by 2031 Coleford Family Doctors • Completion of new Health Dockham Road Surgery Centre Surgery Forest of Dean • Complete of new single surgery building in Forest Health Centre Coleford The Practice • Development primary care facilities across Surgery the wider Lydney (South of the Forest) area Newham Surgery • Review of primary care facilities to support Severnbank Surgery operational working across the Drybrook & Bream Practice and Mitcheldean areas

19 1.4ii Forest of Dean housing by practice

Huntley, Bream, Cinderford Sling and & and / Total Alvington Coleford Drybrook Mitcheldean Lydbrook Lydney Newnham housing Blakeney Brunston 203 26 229 Coleford H/C 202 202 Dockham Road 328 328 Drybrook 124 124 Forest Healthcare 327 327 Lydney Health Centre 11 571 116 28 726 Mitcheldean 124 124 Newnham 115 115 Severnbank 570 115 27 712 Yorkley & Bream 87 87 Total 11 87 655 405 124 124 26 1141 115 231 55 2,974

The Forest of Dean housing plans are until 2026 only. A further adjustment to list sizes is provide from 2026 to 2031 based on average annual housing growth 20 9.4iii Forest of Dean list size growth

Projected list Registered list size April Registered list size size April Practice 2015 Jan 2019 2031 Dockham Road Surgery 6,115 6,389 7,268 Coleford Health Centre 7,175 7,098 7,798 Yorkley Health Centre 7,551 7,878 8,422 The Surgery (Newnham) 3,256 3,296 3,657 Forest Health Care 7,735 7,834 8,784 Mitcheldean Surgery 6,025 6,188 6,710 The Health Centre (Lydney) 6,981 7,307 8,909 Brunston Practice 5,730 6,083 6,778 The Surgery (Drybrook) 4,436 4,342 4,771 Severnbank Surgery 4,199 3,878 5,284 The Surgery (Blakeney) 3,292 3,385 3,556 Total 62,495 63,678 71,937

21 1.4iv Forest of Dean ILP surgery sizes

GIA allowance Gap for Registered Projected for 2019 Gap for GIA for 2031 list size Jan list size population 2019 2031 popn Practice 2019 April 2031 m2 m2 popn m2 % diff popn m2 m2 % diff Dockham Road Surgery 6,389 7,268 163 532 -369 -69.4% 605 -442 -73.1% Coleford Health Centre 7,098 7,798 342 591 -249 -42.1% 650 -308 -47.4% Yorkley Health Centre 7,878 8,422 422 656 -234 -35.7% 703 -281 -40.0% The Surgery (Newnham) 3,296 3,657 223 275 -52 -18.9% 305 -82 -26.9% Forest Health Care 7,834 8,784 467 685 -218 -31.8% 732 -265 -36.2% Mitcheldean Surgery 6,188 6,710 524 516 8 1.6% 558 -34 -6.1% The Health Centre (Lydney) 7,307 8,909 541 609 -68 -11.2% 741 -200 -27% Brunston Practice 6,083 6,778 428 507 -79 -15.6% 565 -137 -24.2% The Surgery (Drybrook) 4,342 4,771 380 362 18 5.0% 397 -17 -4.3% Severnbank Surgery 3,878 5,284 407 323 84 26.0% 440 -33 -7.5% The Surgery (Blakeney) 3,385 3,556 323 283 40 14.1% 296 27 14.1%

22 9.4vForest of Dean Primary Care Network - Premises Overview to 2026

• 11 Practices in PCN • Registered population in January 2019 of 63,678 Blakeney Surgery • Population projections - 71, 937 patients by 2031 The Brunston & Lydbrook Practice • Services provided over 14 different buildings • Total current space equates to 4,220m2 GIA versus Coleford Family Doctors Dockham Road Surgery expected of 5,992 m2 GIA for 2031 population Drybrook Surgery • Plan to reduce number of buildings to 11 through Forest Health Centre colocation/ merger into new Centres The Lydney Practice • New Cinderford Health Centre due to open in Mitcheldean Surgery Summer of 2020 • Development of new single building in Coleford Newham Surgery • Development of primary care facilities across the Severnbank Surgery wider Lydney (South of the Forest) area Yorkley & Bream Practice • Review of primary care facilities to support operational working across the Drybrook and Mitcheldean areas • Watching brief of Yorkley & Bream • Disposal of three NHS Propco owned sites 23 1.5 Gloucester ILP

24 1.5i Gloucester City summary

Rosebank Health The Hadwen Medical HQR Practice • Population projections - 196,406 patients Medical Centre by 2031 Bartongate Surgery Gloucester City Health • Completion of new Gloucester City Centre Centre Gloucester Health Access Primary Care Hub to replace Gloucester Inner City Centre Health Access Centre and Gloucester City Kingsholm Surgery Partners in Health Health buildings • Development of extension at Highnam The Alney Practice Brockworth Surgery surgery North South Gloucester Churchdown Surgery • Development of options for Bartongate (NSG) Surgery Longlevens Surgery surgery • Development of options for Cheltenham Aspen Aspen Medical Practice Road surgery building

25 1.5ii Gloucester ILP housing by practice

Gloucester South Fringe Highnam, urban Winney Churchdown North Innsworth & (Huntsgrove Shurdington & Maismore and total capacity Croft urban Brockworth extension) Brockworth housing Alney Practice 279 320 599 Aspen Group 522 522 Bartongate 172 172 Brockworth 0 1,500 594 2,094 Churchdown 0 1,100 1,385 2,485 Gloucester City Health 1,079 1,079 GHAC & Matson Lane 1,079 620 1,699 Hadwen Medical 407 146 553 Hucclecote Surgery 206 206 Kingsholm 79 79 Longlevens 0 910 910 Partners in Health 301 280 581 Quedgeley 139 280 419 Rosebank Health 547 1,591 2,138 Total 4,810 620 1,100 1,500 2,295 2,297 594 236 13,536

26 1.5iii Gloucester City list size growth

Projected list Registered list size Registered list size size April Practice April 2015 Jan 2019 2031 Longlevens 7,113 8,530 10,004 Gloucester City Health Centre 7,853 7,933 9,681 Hucclecote surgery 8,962 8,968 9,302 Alney Practice 12,812 12,438 13,408 Bartongate Surgery 8,885 8,723 9,002 Brockworth Surgery 8,750 9,626 13,018 Quedgeley Medical Centre 4,515 6,048 6,727 Kingsholm Surgery 4,950 4,512 4,640 Partners in Health (Pavilion) 13,804 14,009 14,950 GHAC & Matson 4,389 7,579 10,331 Rosebank Health 23,112 24,271 27,736 Hadwen Medical Practice 17,545 18,147 19,043 Churchdown 13,594 13,930 17,956 Aspen Group 29,328 29,763 30,609 Total 165,612 174,477 196,406

27 1.5iv Gloucester City ILP surgery sizes

Gap for Registered Projected GIA 2019 Gap for GIA for 2031 list size list size popn 2019 2031 popn Practice April 2015 April 2031 m2 m2 popn m2 % diff popn m2 m2 % diff Longlevens 7,113 10,004 405 708 -303 -42.8% 833 -428 -51.4% Gloucester City Health Centre 7,853 9,681 233 632 -399 -63.1% 807 -574 -71.1% Hucclecote surgery 8,962 9,302 409 747 -338 -45.2% 775 -366 -47.2% Alney Practice 12,812 13,408 619 935 -316 -33.8% 1106 -487 -44.0% Bartongate Surgery 8,885 9,002 404 727 -323 -44.4% 750 -346 -46.1% Brockworth surgery 8,750 13,018 518 802 -284 -35.4% 931 -413 -44.4% Quedgeley Medical Centre 4,515 6,727 291 504 -213 -42.3% 561 -270 -48.1% Kingsholm Surgery 4,950 4,640 310 376 -66 -17.6% 387 -77 -19.9% Partners in Health (Pavilion) 13,804 14,950 610 1000 -390 -39.0% 1039 -429 -41.3% GHAC & Matson 4,389 10,331 749 648 101 15.6% 861 -112 -13.0% Rosebank Health 23,112 27,736 1834 1791 43 2.4% 1988 -154 -7.7% Hadwen Medical Practice 17,545 19,043 1245 1172 73 6.2% 1210 35 2.9% Churchdown 13,594 17,956 1250 997 253 25.4% 1,167 83 7.1% Aspen Group 29,328 30,609 2455 2064 391 18.9% 2,099 356 17.0%

28 1.5vAspen Group Primary Care Network (Gloucester City) –Premises Overview to 2026

• 1 Practice in PCN • Registered population in January 2019 of 29,763 • Population projections - 30,609 patients by 2031 • Services have been provided over 5 different buildings • Total current space equates to around 2,450 m2 GIA versus expected of 2,100 m2 GIA for 2031 population Aspen Medical Practice • Key development was the completion and opening of new Aspen Centre in August 2014 • Three practices involved (Barnwood, Heathville and Road) originally colocated and merged in 2018 along with Saintbridge surgery, who had a significant site elsewhere in the City, which has remained open. • The Group also operate a branch in the South East of the City • Overall, over the last 5 years, the number of buildings has reduced from 5 to 3. • No key developments over the next five years as the capacity and provision is in place for the development of service strategies

29 1.5viHQR Primary Care Network (Gloucester City) – Premises Overview to 2026

• 3 Practices in PCN • Registered population in January 2019 of 44,249 • Population projections - 52,419 patients by 2031 • Services have been provided over 6 different buildings • Total current space equates to around 3,400 m2 GIA Hadwen Medical Practice versus expected of 3,700 m2 GIA for 2031 population – Quedgeley Medical Centre roughly in line Rosebank Health • Vast majority of plan already completed • New Kingsway surgery (3rd site for Rosebank Health) opened in December 2018 • Substantial refurbishment and extension of Glevum site (main building of Hadwen Medical Practice) completed in September 2018 • Hadwen- Wheatway branch already closed and St Michaels branch will close December 2019 • Overall, number of buildings will reduce from 6 to 5 • Review and potential refurbishment and extension to Quedgeley Medical Centre

30 1.5viiInner City Primary Care Network (Gloucester City) – Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 42,756 • Population projections - 48,604 patients by 2031 • Services have been provided over 7 different buildings • Total current space equates to around 2,306 m2 GIA

versus expected of 3,844 m2 GIA for 2031 population Bartongate Surgery Gloucester City Health Centre • Key priority is the completion of a new City Centre (GCH) Primary Care Hub for around 18,000 patients. Gloucester Health Access Approved by the CCG in June 2019, this is due to open Centre (GHAC) by the end of 2020 – this will see the colocation of Kingsholm Surgery GHAC (City Centre branch) and GCH into one building Partners in Health • Extension and refurbishment of Bartongate surgery • Linked to the regeneration and rebuilding of Matson Estate (long term 15 to 20 year plan led by Housing Association) the replacement of the existing Matson lane site of GHAC as part of improved and integrated neighbourhood facilities • Overall , number of buildings will reduce from 7 to 6

31 9.5viiiNorth & South Gloucester City Primary Care Network – Premises Overview to 2026 • 5 Practices in PCN • Registered population in January 2019 of 53,492 • Population projections - 63,688 patients by 2031 • Services have been provided over 8 different buildings • Total current space equates to 3,201 m2 GIA versus expected of 4,812 m2 GIA for 2031 population Alney • Number of elements of plan already delivered Practice • Extension to Longlevens surgery completed and open in December 2017 Brockworth • New Churchdown surgery for around 19,000 patients completed and open in Surgery March 2018 Churchdown • College Yard branch surgery closed in 2018 (Alney Practice) Surgery • Key priority is the development of a single primary care centre for the Hucclecote colocation of Brockworth and Hucclecote surgeries to cater for around 22,000 Surgery to 24,000 patients - business case due Autumn of 2019 and subject to Longlevens approval, would be open Autumn/ Winter of 2021 Surgery • Development of options for the replacement or improvement of Cheltenham Road surgery (Alney Practice)Extension to the Highnam branch surgery (Alney Practice) - improvement grant application submitted in the summer of 2019 • Watching brief on Longlevens Surgery over long term • Overall, number of buildings will reduce from 8 to 5 32 1.6 Stroud & Berkeley Vale ILP

33 9.6i Stroud & Berkeley Vale ILP summary

• Culverhay refurbishment and extension completed Acorn Practice • Delivery of new surgery Cam & Uley Family • New joint surgery for Stroud Valleys and Practice Berkeley Vale The Chipping Surgery Locking Hill in Town Centre Culverhay Surgery • Development of Strategic Plan for Beeches Marybrook Medical Centre Green Health Centre site for 2021/ 2026 Walnut Tree Practice • Development of primary care facility in Beeches Green Surgery Frithwood Surgery Stonehouse remains a key priority for Stroud Cotswold Minchinhampton Surgery 2016/ 2021 Surgery • Refurbishment of Chipping surgery and Rowcroft Medical Centre business case finalisation for phase 2 Frampton Surgery extension key priority for 2021/ 2026 or High Street Medical Centre sooner Locking Hill Surgery Prices Mill Surgery • Severn Health Review development requirements in light Regent Street Surgery of Council housing review, Stonehouse Health Clinic particularly around Berkeley, Cam, Stroud Valleys Family Practice and the Gloucester City fringe

34 1.6ii Stroud & Berkeley Vale ILP housing by practice

Stonehouse Cam & Stroud Valleys Cotswolds Gloucester Total cluster Dursley Berkeley & town Cluster Wotton Severnvale fringe windfalls Charfield housing Acorn Practice 288 12 300 Beeches Green Surgery 221 11 232 Cam & Uley Family Practice 288 12 300 Chipping Surgery 66 11 917 994 Culverhay Surgery 67 12 453 532 Frampton Surgery 72 30 11 113 Frithwood Surgery 23 12 35 High Street Medical Centre (Stonehouse) 695 11 706 Locking Hill Surgery 221 12 233 Marybrook Medical Centre 558 11 569 Minchinhampton 340 11 351 Painswick surgery 37 15 11 63 Prices Mill Surgery 102 11 113 Regent Street Surgery (Stonehouse) 695 11 706 Rowcroft Medical Centre 221 11 232 Stonehouse Health Clinic 348 11 359 Stroud Valleys Family Practice 221 11 232 Walnut Tree Practice 0 287 0 0 0 11 298 Total 1,738 863 558 1,349 37 133 72 45 203 1,370 6,368 35 1.6iii Stroud & Berkeley Vale ILP list size

Practice Registered list Registered list Projected list size size April 2015 size Jan 2019 April 2031 Acorn Practice 4,204 4,184 4,670 Cam & Uley Practice 10,116 10,556 11,040 Culverhay Surgery 6,256 6,328 7,190 Frithwood surgery 6,606 6,944 7,011 Hoyland House, Painswick 4,779 4,818 4,920 Locking Hill Surgery 9,248 9,643 10,020 Marybrook Medical Centre 4,959 5,051 5,973 Minchinhampton Surgery 7,172 7,656 8,225 Prices Mill Surgery 8,521 8,873 9,056 Regent Street Surgery 4,115 4,225 5,369 Rowcroft Medical Centre 11,593 12,073 12,449 Stonehouse Health Clinic 2,371 2,961 3,543 Stroud Valleys Family Practice 4,093 4,765 5,141 The Chipping Surgery 8,370 8,701 10,311 The Health Centre (Beeches Green) 7,866 8,665 9,031 The High Street Medical Centre, Stonehouse 5,628 5,992 7,136 The Surgery (Frampton) 5,017 5,150 5,337 Walnut Tree 4,671 4,924 5,407 Total 115,585 121,509 131,825 36 1.6(iv) Stroud & Berkeley Vale ILP surgery sizes GIA Gap for allowance 2019 GIA allowance Gap for for 2019 population for 2031 popn 2031 popn Practice M2 popn m2 m2 % diff m2 m2 % diff Stonehouse Health Clinic 120 247 -127 -51.3% 295 -175 -59.3% Regent Street Surgery 195 352 -157 -44.6% 447 -252 -56.4% Locking Hill Surgery 386 803 -417 -51.9% 835 -449 -53.8% Minchinhampton Surgery 340 638 -298 -46.7% 685 -345 -50.4% The Health Centre (Beeches Green) 411 722 -311 -43.1% 752 -341 -45.4% The High Street Medical Centre, Stonehouse 336 499 -163 -32.7% 594 -258 -43.5% Culverhay Surgery 351 527 -176 -33.4% 599 -248 -41.4% Rowcroft Medical Centre 553 919 -366 -39.8% 935 -382 -40.9% Cam & Uley Practice 520 856 -336 -39.3% 876 -356 -40.6% The Chipping Surgery 543 725 -182 -25.1% 846 -303 -35.8% Frithwood surgery 390 578 -188 -32.6% 586 -196 -33.4% Stroud Valleys Family Practice 295 397 -102 -25.7% 428 -133 -31.1% Walnut Tree 326 410 -84 -20.5% 450 -124 -27.6% The Surgery (Frampton) 347 429 -82 -19.1% 444 -97 -21.9% Acorn Practice 326 349 -23 -6.5% 389 -63 -16.2% Marybrook Medical Centre 467 421 46 11.0% 498 -31 -6.1% Prices Mill Surgery 713 739 -26 -3.5% 754 -41 -5.5% Hoyland House, Painswick 545 401 144 35.8% 410 135 33.0%

37 1.6vBerkeley Vale Primary Care Network Premises Overview to 2026

• 6 Practices in PCN • Registered population in January 2019 of 39,744 • Population projection of 44,596 patients by 2031 • Services have been provided over different buildings Acorn Practice • Total current space equates to around 2,533 m2 GIA Cam & Uley Family versus expected of 3,658 m2 GIA for 2031 population Practice • Services provided over 6 sites - down from 7 sites The Chipping Surgery Culverhay Surgery • Culverhay surgery refurbished and additional clinical Marybrook Medical Centre capacity through ETTF grant support Walnut Tree Practice • Chipping surgery – 2 phased refurbishment and extension • Stroud District Council housing review currently being consulted upon. Significant additional requirements likely to mean consideration of development options for Marybrook Medical Centre in Berkeley and Cam & Uley Family Practice

38 1.6viStroud Cotswolds Primary Care Network Premises Overview to 2026

• 5 Practices in PCN • Registered population in January 2019 of 40,156 Beeches Green Surgery • Population projections - 41,636 patients by 2031 Frithwood Surgery • Services provided over 5 different buildings Minchinhampton Surgery • Total current space equates to around 2,239 m2 GIA Painswick Surgery versus expected of 3,366 m2 GIA for 2031 population Rowcroft Medical Centre • Beeches Green surgery development capital bid submitted as part of a wider wave 4 application (replacement of NHS Propco Health Centre) in 2018- not supported by NHSE/I Long term strategic Plan needs to be agreed as presently unable to develop that site • Business case for the replacement of Minchinhampton surgery expected Autumn of 2019

39 1.6viiSevern Health Primary Care Network Premises Overview to 2026

• 7 Practices in PCN • Registered population in January 2019 of 41,609 • Population projections - 45,598 patients by 2031 • Services have been provided over 6 different buildings Frampton Surgery • Total current space equates to around 2,392 m2 GIA High Street Medical Centre, Stonehouse versus expected of 3,798 m2 GIA for 2031 population Locking Hill Surgery, Stroud • Locking Hill and Stroud Valleys part of capital bid Prices Mill Surgery, submitted through wave 4 application (replacement of Regent Street Surgery, Stonehouse NHS Propco Beeches Green Health Centre - co-locating Stroud Valleys Family Practice 3 surgeries in 2018 - not supported by NHSE/I. Stonehouse Health Clinic Currently both practices are progressing business case options for a joint development on a different site • Development of Frampton surgery site through improvement grant investment • Development of primary care facility in Stonehouse remains a key priority for 2016/ 2021 as part of section 106 arrangements

40 1.7 Tewkesbury ILP

41 1.7iTewkesbury ILP summary • Population projections 50,230 patients without West Cheltenham by 2031 • The possibility of the Ministry of Defence site at being developed as part of a new Garden Town of around 11,000 homes is Church Street Medical not included. If the site goes ahead assume Practice another surgery site will be required. Mythe Medical Practice TWNS However, in early years of, it is Doctors Practice anticipated patients will register at the Staunton & Corse Deveraux Centre Surgery West Cheltenham • Parts of Tewkesbury Borough housing targets impact on practices outside of Tewkesbury • Condition of remaining estate • West Cheltenham Medical Practice included in Cheltenham ILP figures relatively acceptable but Newent undersized and remains a priority – watching brief for PCIP • West Cheltenham housing (North West Elms) aligned with Cheltenham ILP geography 42 1.7iiTewksbury ILP housing by practice

New & , Allocation to Tewksbury * Red Staunton & practices Mitton town (FOD) Corse (FOD) Windfall Total Church Street 250 1227 0 0 84 1561 Mythe 250 1227 0 0 84 1561 Holts Health, Newent 0 0 384 0 0 384 Staunton & Corse 0 0 0 59 0 59 Total 500 2,454 384 59 168 3,565 *1,900 homes target allocated to Tewkesbury town are assumed to be delivered by Ashchurch MOD site

Note: 628 homes part of TBC plan to Bishops Cleeve (Cleevelands and Stoke Road), 224 homes to Winchombe (Winchcombe surgery), 594 homes in Shurdington and Brockworth (Brockworth surgery) 320 homes to Highnam, Maisemore and Minsterworth (Alney Practice) – share of windfalls also included 83 or 84 homes each to Church Street, Mythe, Brockworth, Alney, Winchombe, Cleevelands and Stoke Road

43 1.7iii Tewkesbury registered list

Registered list size baseline April 2015 Registered Est. Forecast (using July list size Jan Population Practice 2014 list) 2019 2031 Church Street Practice 13,145 13,086 15,615 Holts Health Centre 10,560 10,899 11,838 Mythe Medical Practice 12,441 13086 15,615 The Surgery (Corse/Staunton)** 6,107 6,874 7,162 Total 42,253 43,945 50,230

**Increase of 12.6% over last 4.5 years or 2.8% per annum - house building and natural rate (birth v death) indicates slow rate of growth going forward- links to expanding student population at Hartpury assumed

Note: Holts Health Centre and Corse/ Staunton are located in Council. Housing plans are to 2026. List sizes extrapolated to 2031 for overall alignment based on assumed average growth until 2026. 44 1.7.ivTewkesbury ILP surgery sizes

GIA GIA allowa allowan Gap nce for Gap for ce for for Registered Registered Projected 2019 2019 2031 2031 list size list size Jan list size popn popn popn popn Practice April 2015 2019 April 2031 m2 m2 m2 % diff m2 m2 % diff Church Street Practice* 13,145 13,086 15,038 963 961 2 0.2% 1,043 -80 -7.7% Holts Health - Centre 10,560 10,899 11,838 537 871 -334 38.3% 910 -373 -41.0% Mythe Medical Practice* 12441 13086 15,038 1237 961 276 28.7% 1,043 194 18.6% The Surgery - (Corse/Staunton) 6107 6,874 7,162 460 572 -112 19.6% 597 -137 -22.9%

*Allowances are based on practice in separate buildings being colocated means some shared services reducing overall requirements *Share of building is currently 54% to Mythe and 46% to Church Street.

45 1.7vTWNS Primary Care Network Premises Overview to 2026

• 5 Practices in PCN (West Cheltenham practice added) • Registered population in January 2019 of 47,284 • Population projections – 62,293 patients by 2031 • Services have been provided over 7 different buildings – now 5 buildings Church Street • Total current space equates to around 3,470 m2 GIA versus expected of Medical Practice, Tewkesbury 4,582 m2 GIA for 2031 population (including West Cheltenham) Mythe Medical • Large scale Devereaux Primary Care Centre completed and open in Practice, Tewkesbury Tewkesbury • Significant proposed house building along the Cheltenham/ Tewkesbury Newent Doctors boundary has secured a section 106 agreement for a new GP facility, Practice currently linked to the West Cheltenham Practice for around 10,000 Staunton & Corse patients Surgery • Potential for Ministry of Defence site at Ashchurch (North Tewkesbury) to West Cheltenham Medical Practice become a Garden Town and over 10,000 homes – if site goes, another surgery site will be required with some flowing to the Devereaux Centre, particularly in early years of any housing development • Condition of remaining estate relatively acceptable but Newent undersized and remaining priority over long term - NHS Propco site 46