Issue - meetings

GP Services and Access to Primary Healthcare

Meeting: 27/09/2023 - Adult Social Care and Health Overview and Scrutiny Committee (Item 5)

5 GP Services and Primary Healthcare pdf icon PDF 678 KB

The Integrated Care Board (ICB) and the County Council (Infrastructure Planning) to provide a joint presentation. The focus for this item is NHS estates and the use of developer contributions, the identification of areas where there are perceived challenges, an update on the key projects being progressed and an overview of each of these projects.



The Committee received a joint presentation from the Integrated Care Board (ICB) and the County Council. The presenters were Simon Doble of the C&W ICB and Janet Neale from WCC’s Infrastructure Team. Tim Sacks (ICB) was also present to respond to questions. In opening the item, the Chair mentioned that the focus was on estates aspects rather than access issues. Janet Neale commenced the presentation covering the following areas:


  • The Local Plan process, with an outline of the key stages leading to formal adoption of the Local Plan. There was a clear need for both WCC and the ICB to be very involved in this process.
  • Section 106 (S106). This was a legal agreement between local authorities and landowners/developers detailing obligations required as a result of a planning application. Effectively it was a charge against the land.
  • Community Infrastructure Levy (CIL). A tax on net new floor space set locally and paid to the district or borough council. The requirements around levying and use of CIL were outlined. In Warwickshire to date, only the Stratford and Warwick Districts had adopted CIL, with Rugby Borough pursuing the use of CIL currently.
  • Further slides showed the pros and cons of the S106 and CIL approaches.
  • The proposal to introduce a new mandatory Infrastructure Levy, set locally (similar to CIL). This would be based on the assessed uplift value of the land, as a result of development. This approach had attracted strong challenge during the consultation process by a wide range of organisations.


Simon Doble then spoke to the NHS aspects:

  • Primary Care Estate Context. This included the transfer from the former Clinical Commissioning Groups (CCGs), frustrations for general practice and responding to known population growth with limited funding.
  • Primary Care Estate Environment. This confirmed there was no new funding, a historic lack of investment, before raising the challenges from existing funding streams, build costs, workforce aspects and ownership of premises.
  • The current picture. A slide giving an understanding of the ICB’s position, the baseline and portfolio of the ICB estate. It detailed the current and projected population and the known shortage of rooms for patient appointments. 
  • Growth areas and priorities for further work.
  • Opportunities, including a collaborative working approach.


Questions and comments were invited with responses provided as indicated:


  • The Stratford and Warwick District Councils were producing a joint Local Plan for the South of Warwickshire. Such plans included a ‘target’ number of new dwellings, and one consideration was whether to extend existing settlements, or development of new settlements. It was questioned from a health perspective which option would be easier to plan more reliable services for.
  • Tim Sacks replied that there were challenges both in terms of buildings and workforce with a need to increase both, to improve access to services. The S106 funding received was not sufficient to build new premises. Options were expansion of existing premises within the funds available, or providing a new premises which was reliant on an external funding contribution to make up the shortfall,  ...  view the full minutes text for item 5