21 Sep 2021

The NHS’s buildings and its need for more modern space are impacting upon patient care and efforts to clear the backlog of tests, treatments and consultations, according to healthcare workers in a survey we commissioned from YouGov. 

Four in ten (40%) healthcare professionals say the premises they work in are constraining the services that can be provided to patients, while one-third (34%) say their premises are holding back progress on tackling the backlog of care.

The survey of more than 1,000 healthcare professionals including doctors, nurses, midwives, ambulance workers, public health staff and people in NHS facilities and maintenance roles also found that the vast majority (84%) of those surveyed say fit-for-purpose premises will be important or essential in delivering effective hybrid primary care to patients (care delivered through both face to face and remote appointments). One in five (19%) said they believed premises were hindering recruitment to the service they work in.

It comes as the BMA’s Support Your Surgery campaign calls for more investment into areas such as GP premises across the country, and as new research published in the British Journal of General Practice highlights the impact of GP recruitment challenges in areas of highest healthcare need.

Our CEO, Jonathan Murphy, said: “In our survey last year, healthcare workers told us how their premises had often made the never-before-seen challenge of COVID even more difficult to deal with, and what they thought community healthcare premises of the future will need to deliver to help the NHS do its job. We’re already putting their ideas into bricks and mortar on the ground but the clear message this year is that this can’t happen fast enough. Health professionals want to see investment in physical infrastructure now to support both the recovery and evolution of primary care as it seeks to work at scale, to play its full part in emerging Integrated Care Systems and – most importantly - to make sure patients are getting the care they need, when they need it, where they need it.”

Additional findings:

Participants were also asked for examples of how they saw the premises they work in constraining efforts to clear the backlog of care. Answers given included: 

  • “Numbers which can be seen at any one time are very restricted due to ongoing social distancing measures and lack of rooms.”
  • “Rooms are too small to adhere to social distancing rules so clinics are very limited resulting in continued long waiting lists.”
  • “Not enough space, not enough staff.”
  • “Facilities already at 100% capacity pre pandemic. No room/capacity to increase to catch up on backlog.”
  • “Insufficient isolation rooms and dated premises.”
  • “Waiting room space to social distance.”
  • “Old buildings, difficulty in social distancing, ventilation old and does not meet new standards. Lack of single rooms, lack of separate toilet and shower facilities.”
  • “Not enough big rooms for consultations. Need time to wipe down after each patient. Stage times of appointments so not too many on waiting rooms at any one time.”
  • “Not enough treatment rooms.”
  • “Not enough capacity to treat large number of covid and non-covid patients.”
  • “The estate is one of the oldest in the NHS, crumbling, leaking. Lack of investment over decades slows progress now.”
  • “Small waiting room so unable to have too many so face to face not as prominent as previous, doing respiratory reviews on phone where possible. This creates backlog.”
  • “Very elderly buildings without extra assistance for infrastructure or extra space for dividing patients into isolation areas.”
  • “Footprint is too small, buildings too small for catchment area.”
  • “Old and run down premises.”
  • “Old buildings with small room. Newer hospitals poor ventilation.”
  • “We have lost our gym and our day room, which now has other services in it and our gym is being used as a staff hub. We cannot have classes with outpatients any more.”
  • “The premises are TINY and old. Not able to follow the covid guidelines set out by the trust to do work safely so still working at a slower pace to keep safe.”

Positive impacts of fit-for-purpose space mentioned: 

  • “New building, many rooms allowing us to take on more trainee GPs, meaning more patient appointments.”
  • “Has the capacity to run extra clinics.”

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1008 NHS employees. Fieldwork was undertaken between 12th - 17th August 2021. The survey was carried out online. The figures have been weighted and are representative of all NHS employees by occupational group.