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“I am certain that the quality of the premises has a direct effect on the care that we can provide.”


Dr Toni Hazell trained at St. Mary’s Hospital Medical School and did her GP training at Northwick Park Hospital. In her time as a GP, she says she’s worked in the good, the bad and the ugly of GP premises. Her spare time is largely taken up by looking after two small children, but she enjoys running and swimming when she has the time. She is also a medical writer and editor  – so we asked her to share her perspectives on the importance of fit-for-purpose primary care buildings…


The state of GP premises isn’t something to be proud of – half of premises in Leeds aren’t fit for purpose1 and this isn’t a new problem; a remarkably similar statistic was published about Barnet in 20062. I have worked in swanky new purpose built premises, and practices run from a converted Victorian terrace. I am certain that the quality of the premises has a direct effect on the care that we can provide.

Imagine working in an old converted building. It’s too small for the number of doctors, so you’ve been shoe-horned upstairs. No lift, so you can’t see anyone in a wheelchair, with poor mobility, or who has a buggy. Your patients have to climb a flight of stairs before they see you, putting their blood pressure up. From my upstairs room, I regularly had to ask patients to sit and wait before rechecking their blood pressure, which played havoc with my timekeeping. Such rooms are usually small which has knock-on effects; it is harder for relatives or interpreters to attend appointments or for trainees to sit in if the desk and couch take up most of the room.  If there isn’t space at the end of the couch, gynaecological examinations must be done from an odd angle, a potential cause of back pain for the doctor. A more significant safety issue is that it may not be possible for the doctor to be between the patient and the door – panic buttons are fine, but if a patient pulls a knife, the only thing you want to do is get out of the room quickly. I’ve worked in rooms that were so small that the examining couch was in a different room, a hugely inefficient system which makes keeping to ten minute appointments impossible.

Now close your eyes and I’ll transport you to new premises. Purpose built, every room designed for seeing patients. Ample storage, so you always have enough kit – no more time wasted hunting for the correct size speculum or spare gloves. Rooms are big enough for air to flow freely and are warmer in winter and cooler in summer. There is space for anyone who needs to be in the consultation, and it is fully compliant with disability legislation. Already you are feeling less stressed and that shows in your consultations. Happy doctors, happy patients and a safe working environment – what’s not to like? It is a disgrace that in a developed country such as the UK, so many doctors still work out of premises that are not fit for purpose and funding to improve the situation needs to be immediately forthcoming.


*As a professional medical writer and editor, Dr Hazell was paid for supplying this article.