LIFT (Local Improvement Finance Trust) is a pioneering 20-year, £1 billion Government health project, aimed at reinvigorating primary care buildings, up grading or replacing up to 3,000 primary care premises and funding 500 new one stop primary care centres, which it is hoped will make a real difference to the quality of primary care facilities all over the country.  It aims to encourage innovation from GPs and other health care providers in some of the most deprived inner city and rural areas. 

Approximately 90% of all patient contact with the NHS occurs in general practice. What research has revealed is that many of the deprived urban areas, where health need is greatest, suffer from a disproportionately high number of sub-standard premises.  Currently, only 40% of GP premises are purpose built, with the other 60% being based in adapted residential buildings or in converted shops, both of which often have poor access for patients.

There has been a legacy of under investment in the NHS, with many primary care premises being over 30 years old, or being too small and cramped to provide effective modern primary care.  The aim of the LIFT scheme is to redress that balance. 

NHS LIFT’s aim to empower and assist the regeneration of local communities by providing better healthcare facilities that will involve local businesses.  A local LIFT will build and refurbish primary care premises, which it will own, but it will rent out accommodation to GPs on a lease basis.

Each local LIFT will be a public private partnership (PPP). It will be set up as a limited company, with the local NHS and the private sector as shareholders.  As a shareholder, the NHS will be better placed to direct investment to the areas of greatest need.

This investment in primary care is the biggest of its kind since the formation of the NHS in 1948, and at the heart of the reform lies the vision of a modern, effective and well resourced primary care sector where GPs and other primary care health providers can deliver an extended range of services in the community.  

The first of the  'super surgeries' opened a year ago in East London.   These surgeries provide 'one-stop services' which offer a range of healthcare services traditionally available only in hospitals, as well as access to GPs and other health and social care professionals.

To launch the LIFT scheme, £200 million of public money has been made available.  Improved choice and access to services is a key element of the scheme, the aim being that if people are treated quickly and conveniently, then this will result in better health outcomes.
 
Case Study

This is the style of service being offered to patients of the brand new Marfleet Primary Health Care Centre in Hull, which opened its doors for the first time in October 2005.   The centre, which has been built at a cost of £2.3 million, is Hull's first true LIFT scheme - although another pre-cursor scheme at St Andrew's Retail Park is already in operation (see second case study).

Hull Citycare, the city's LIFT company, has built and will manage Marfleet on behalf of Eastern Hull Primary Care Trust. The centre is just one of many new health buildings which are being constructed across the city over the next few years. There are criticisms; the project was somewhat delayed and ran over the original budget, but the city notables are delighted at the improved access to GPs, and look to the private sector for expertise not available in the public domain.

The Marfleet Primary Healthcare Centre houses the Marfleet Group Practice, a Lloyds Pharmacy as well as several nursing and administrative teams from the Primary Care Trust. The development allows patients to access a whole range of health services in their own local community setting. Patients receive treatment in highly equipped consulting rooms and other on-site facilities, including the provision of minor surgery and therapy services, as well as outpatient and child health clinics. The Primary Health Care Centre also offers an opportunity for on-the-job training for students from the Hull and York Medical School HYMS 

Case Study

The £7.6m St Andrew's Retail Park incorporated a health centre from the outset withtailor-made space for 3 GP practices.  District nurses, antenatal care, physiotherapist, chiropody, dental and minor surgery facilities were all planned into the scheme.  

One advantage that has been seen is a reduction in missed appointments and fewer requests for home visits - being near the shops has meant that there are better transport services available.

Solo GP Dr Bhushen Koul had worked in a converted Victorian shop prior to moving to St Andrew’s. He says he needed "more space because of increasing health demands."  The new premises also meet the needs of the Government's Disability Discrimination Act - an issue which can be of real concern for those in older buildings.  

But the new premises have not been without issue.  The cost of renting and running the new practice is more, and the first-floor location over the shops was a concern. There were many things to consider but in the end, it came down to a matter of space - a new housing development locally meant that the doctor's list will grow and managing that need in quality accommodation has to be the priority.