Thousands of GP practices are operating in cramped and overcrowded buildings that are "wholly inadequate" to meet growing patient demand, doctors have said.
Patients are being affected because GPs do not have the room to provide extra consultations or accommodate new staff, according to the British Medical Association, which has said that the "fossilised" infrastructure of the British GP care system is "the elephant in the room" that will undermine government pledges on GP access.
Constraints on local NHS budgets and a lack of "coherent strategy" nationally means that new building projects and surgery expansions are being delayed or scrapped altogether.
One surgery, in Epsom, Surrey, has been prevented from moving to new premises that have been empty for a year because the local NHS Area Team has been unable to approve funding for the move. The new larger building, which would replace premises that are a quarter of the size required by NHS regulations, has now been put up for sale, and the practice, which has 9,500 patients, is facing closure.
"We have been warned that unless something is done we face failing our next Care Quality Commission inspection, yet despite attempting to move premises for the last 10 years we have been frustrated at every attempt," said Dr Andrew Sharpe, a GP at the Ashley Centre Surgery. "We have lobbied our local MP and Jeremy Hunt and still nothing … Due to endless amounts of red tape and total disinterest from the area team our new building could be sold off before our eyes."
Dr Chaand Nagpaul, who chairs the BMA's general practice committee, said that at his own North London practice, space was at such a premium that doctors regularly had to queue to use a computer to check and enter patient information.
"My own surgery is typical of thousands of practices," he said. "At a national level there is no coherent strategy around investment in GP premises … until this is addressed patients are being short-changed on a daily basis."
A spokesperson for NHS England's Surrey and Sussex Area Team said funding decisions for all practices were "on hold until new national guidance has been finalised".