Wallingford Medical Practice has outgrown its current home on Reading Road. A solution seems possible- but we are likely to need the support of the town in order to achieve it.
The GP surgery in Wallingford has grown in size at various intervals over the last four decades. Alongside the gradual increase in population has been a gradual increase in what GP surgeries are required to do for their patients, and a number of expansions to the building have allowed us to grow to meet this demand over time. Over the last few years however, it has become apparent that our plan needs to change. We are bulging at the seams. The current premises approximate to 5400 square feet whereas the new building needed will provide 20,000 square feet. Such is the scale of the problem.
After much work, planning permission was granted in 2020 for a small expansion on the current site, but it was apparent by the time the permission came through that the project was no longer a cost-effective solution to the problem. Spending public money comes with a clear responsibility to spend wisely, and due to rapidly escalating costs (contributed to by Brexit uncertainty at the time and the evolving pandemic) the small increase in space that was achievable did not justify the price tag.
Alternative solutions have been sought on the current site to no avail, including alternative designs (all constricted by the site and essentially too small) and even obtaining land or existing buildings from our neighbours, which has not been possible. The move towards more remote working during the pandemic did not offer any temporary reprieve, as we found that the social distancing constraints on those left working in the building increased the overall pressure on space. Thankfully the move back towards seeing more patients in person is well under way. The pandemic may be easing, but the urgent pressure on space has not gone away.
The population increase continues relentlessly and our patient list size continues to grow with it. There are varying projections of population change in the area over the coming years, but all seem to point towards likely significant increases. The Oxfordshire Strategic Housing Market Assessment (2014) estimates an additional 215,000-245,000 people in the county in the 20 years between 2011 and 2031, an increase of 35%. Oxfordshire County Council’s housing-based projections for population increase by locality predict at least an 18% increase across all age groups in the South Oxfordshire district for the period 2017 to 2027 (approximating to a list size of 20,000 patients), with the greatest proportional increase in older patients who rely most on GP services. Looking further forward, Oxfordshire County Council’s Research and Intelligence Team forecasts a population increase between 2016 and 2040 of 39%, which would anticipate a patient list size in Wallingford of approximately 22,500. The pressure will therefore continue to grow.
As well as population growth and the migration of traditionally hospital-based work into GP practices, the era of Primary Care Networks (PCN’s) means new services are appearing at GP Practices too. Neighbouring practices work together in PCN’s to provide additional services to the wider patient group. This work involves an ever-increasing number of additional new staff working alongside the GPs and nurses, such as clinical pharmacists, physiotherapists, paramedics, visiting services, mental health practitioners, social prescribers and so on. These services increase the quality and convenience of the care patients receive but put more pressure on space. Additionally, the roles are often centralised at the larger practice in the network- in our case this is us. The funding projections to pay for these roles indicate that they are going to increase significantly in number over the next few years. We need space to put these people.
The risk, of course, without sufficient space to expand is that there will be either a more limited range of services on offer, more difficult access to these services, or lower quality services, or some unenviable combination of the above. No one in Wallingford wants this, not least the Medical Practice itself. It is clear that in the minds of the health care commissioners the direction of travel is for an increasing number of community-based services to be delivered to a growing population at larger, better equipped, modern GP centres. We must keep up. And to do this we have to move.
Alongside our clinical work, we have been working closely over the last 18 months with property experts experienced in medical centre developments, in order to navigate the complexities of property development, planning, building finance, and to identify opportunities. In keeping with the geographical distribution of our patient list, the likely source of future patient number increases, and in consultation with the Clinical Commissioning Group (CCG), we conclude that a strategically suitable site would be as close the current Practice as possible and to the west of the River Thames.
Following extensive work by our expert advisors we have identified and now focus on a potentially viable option in the Winterbrook Meadows development site area, identified in the Neighbourhood Plan as Site E. The site, to the north of the A4130 Wallingford Bypass. has planning permission approved for the development of up to 502 dwellings (including an extra care facility). The land is now owned by the developer Berkeley Homes, whose plans for this development continue to be finalised. Within this site is a parcel of land which was earmarked for the provision of a Primary School within the original planning permission. The County Council has not taken the option of this land, preferring instead to locate a new Primary School elsewhere in town. The fate of this parcel of land is yet to be determined. We note in South Oxfordshire District Council’s Planning Committee records that the developer’s own representative has stated that if the school Site were not required for education, it would be made available for community use or health.
The former school site within Site E is an excellent prospect for General Practice in Wallingford and an excellent prospect for the health and wellbeing of the patients of Wallingford Practice. It is the only good quality suitable option available to safeguard the future of community medical services in the town. It is central, and with appropriate care in the planning process, ease of access via foot, bicycle, bus and car can easily be maintained. We would remain close to the Wallingford Community Hospital where we have a long history of providing medical cover. The site will make possible an accessible, modern, spacious facility which with careful screening can be discrete and private too.
Our discussions with Town, Local and County Councils, with the CCG, and with experienced medical centre developers, have led us to this site. We were grateful in December last year to receive written CCG support to enable an allocation of 1.5 acres of this site for a new General Practice premises. We have met with Berkeley Homes too and opened up a dialogue about options for the site. There is much to be done to bring this project to fruition, but these represent important first steps in making the new Wallingford Medical Centre a reality.
The most important stakeholder of all is our patients. It is essential for this project to work that the patients feel it is the right course of action, and if not to help us to understand where the alternatives lie and how they are better. Ultimately the Medical Practice is a service to the community. We firmly believe that a larger, more modern development on the former school site at Site E represents the best and only realistic option for Wallingford. We expect many hurdles ahead, but these will be easier to overcome if we can demonstrate your backing.
Our hugely supportive colleagues at Wallingford Town Council have been liaising with Berkeley Homes to continue the dialogue about options for the school site. They will also be leading in the wider publication of our plans in due course.
All feedback, comments and suggestions should be forwarded to Wallingford Town Council (Cllr Katharine Keats-Rohan) via firstname.lastname@example.org, and not directly to Wallingford Medical practice at this stage.