Assura : Not an issue to put on ice

'Horrendously pressurised '; 'My worst yet in the NHS'; 'Medical students asked to support GP practices.' Just a few of the headline statements in the media this month to reflect the day-to-day reality of life in GP surgeries in January, as the effects are felt of bugs spreading more easily during Christmas get-togethers, colder weather exacerbating existing conditions and the isolation felt by older and less mobile patients, social care provision stretched thin and cases of flu hitting more than 4.5m people.

It's a month when cramped waiting areas and consulting rooms in surgeries may feel even smaller than usual, given the volume of patients who need to be seen. Poor layout may be even more of a frustration if GPs are having to share offices, if a gust of cold air hits the waiting area every time the door opens, or if there's no lift to get wheelchairs or prams to upstairs areas. Lack of privacy at reception may be felt particularly acutely as coughs and sneezes abound.

The challenges facing some GP premises are felt all year round, but the question is often put to us during these colder months: how could better GP buildings help with winter pressures?

The buildings on which we're most proud to have worked are those which allow GPs to offer and link in easily with other services, regardless of their building size. The precise combination is different at every site: in some places, like Moor Park in Blackpool, it's access to local authority services, a leisure centre and general practice under the same roof which works so well. For other places, like Eagle Bridge Medical Centre in Cheshire or Sudbury Community Health Centre in Suffolk, it's about being able to have services like musculoskeletal physiotherapy, diagnostics and community midwifery just down the corridor rather than across town. In others, like Lanchester Medical Centre, it's the ability to offer minor surgery which came with purpose-built space - all chipping away at the need for patients to visit hospital sites.

Academic evidence is hard to find on the specific impact of fit-for-purpose primary care infrastructure - and its ability to help move services traditionally found in hospitals closer to home - on easing winter pressures on A and E. But by creating the facilities and space so that some patients can be diagnosed and treated away from hospital, infrastructure does have a part to play.

Paracetamol won't cure flu symptoms, and nor will better GP buildings rid A and E departments of all but the most seriously-ill patients overnight. But premises which are fit for 21^st century healthcare, which can allow primary care teams the space to offer more NHS services in the community, are a vital part of the prescription.

Claire Rick is our Head of Public Affairs