Bucklebury Says No! Regulation 19 Consultation: Healthcare
West Berkshire Council (WBC) Local Plan Review: Regulation 19 Consultation
20th January – 3rd March, 2023
Specific Objections, No. 3 : Healthcare provision
The North-East Thatcham development plan (SP17) proposes a 450 sq m primary healthcare facility with the suggestion that a GP Surgery be offered to the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board or other such appropriate body. However, the document is bereft of detail or insight into strategic healthcare planning.
Proposals for a major development that is likely to have a significant health impact in relation to its size and location, should be accompanied by a fit for purpose Health Impact Assessment (HIA) in accordance with the current guidance from Public Health England. The HIA should include reference to how the proposals for development have been discussed with health service providers regarding impacts on primary health care services. The development proposals should demonstrate how the conclusions of the HIA have been considered in the design of the scheme because an unacceptable impact on the health and wellbeing of existing or new communities will not be permitted. It is of concern that neither WBC nor the developers, as public and private stakeholders respectively, appear to have arranged or published a prospective HIA specific to the proposed North-East Thatcham development.
Tackling health and wellbeing requires a multi-agency approach. The Berkshire West Health and Wellbeing Strategy 2017-2020 2021-2030, has been developed by the Reading, West Berkshire and Wokingham Health and Wellbeing Boards together with the Berkshire West Integrated Care Partnership. Developers are encouraged to engage with the healthcare providers at the earliest opportunity in order to determine the health care requirements associated with new development. It is of concern that there appears to have been no direct engagement between the North-East Thatcham Development Consortium and local general practices.
Few new GP practices are commissioned by NHS England, even where they consider there to be patient demand for improved services. NHS Digital figures of patients registered in the NHS Berkshire West Clinical Commissioning Group (CCG) confirm there is an even worse shortage of GPs in other areas of the country. There is therefore no realistic prospect of a new GP practice being established in Thatcham or West Berkshire in the foreseeable future.
GP practices look to create efficiencies and economies of scale to make general practice more financially sustainable and to increase access and extend the range of services and primary healthcare professionals available on a single site. It would make no financial, organisational or geographic sense for an existing local GP practice to set up a branch surgery on the proposed new development because of the additional administrative, computing and staffing costs and encumbrance working across two sites.
There has been no approach by WBC or the developers to any local GP practice to discuss an appropriate site, floor-space or location to which one or more practices could relocate. An enlarged primary healthcare site is required and might be better located close to the middle of Thatcham to improve access and minimise traffic as the proposed NE Thatcham development is peripheral to the centre of the population. This would be likely to be supported by Thatcham Town Council but has not been suggested in the sustainability appraisal of site options. Local practices did not have input with the inadequate 450 sq m floor size proposal which they only discovered with the SP17 Policy of December 2022, Appendix D.
The proposed North-East Thatcham development site is covered by the existing practice boundaries of Thatcham Medical Practice (west of Harts Hill Road), Burdwood Surgery (east of Harts Hill Road) and Chapel Row surgery (the whole area). All three practices are already overstretched. The two Thatcham doctors’ surgeries run independently of each other, and their combined lists include approximately 27,800 patients that equates to just under 2,000 patients per GP. Newly registered patients moving into housing developments tend to make a greater demand on GP services because there are more young children, a higher maternity workload, less local extended family support and there is initially a higher housing turnover. One permanent and repeated temporary pharmacy closures in Thatcham have further exacerbated pressure on primary care locally.
Thatcham dental practices are unable to provide dental care for the whole population with a significant minority of patients needing to travel further afield for NHS and private dental care. Thatcham Vision, endorsed by WBC in 2016, confirmed only 60% of residents were registered at a Thatcham dentist (with 17.5% registered with a doctor outside Thatcham). There is no evidence provided that either WBC or the developers have approached any local dental practices regarding the potential impact of increased workload resulting from additional housing.
Reviewing the scanty healthcare recommendations within the Thatcham Strategic Growth Study (David Lock and Associates) - Stage 2: Thatcham Present, paragraph 4.10 states: ‘A dialogue with the relevant healthcare and education agencies should be established early in the master planning process to address concerns that social infrastructure may not be provided.’ The Stage 3: Thatcham Future report published in September 2020 includes no further detail except the outcome of a community representatives’ workshop, that the existing GP facilities are at capacity and suggesting a new health centre.
WBC and the developers appear to have neither arranged a relevant HIA nor provided evidence of having appropriately liaised with local health care agencies or providers. They are proposing a healthcare site that is unsuitable for NHS primary care and so have not made provision to mitigate the burden that 1,500 or more new houses will make on a local NHS struggling to cope.
The objective of WBC and the North-East Thatcham Development Consortium to improve access to the health service component of community infrastructure has not been met as they have not provided evidence for the provision of a viable primary care medical facility.
Please could you inform friends and neighbours whom you think may not see this message.