Get approval for your scheme

As of 1 April 2004, new schemes competing for cash limited money need to be approved by PCTs but will then be prioritised by lead PCTs, subject to agreements between lead PCTs and their SHAs.

Funds are allocated to lead PCTs for subsequent allocation to individual PCTs based on SHA-agreed regional priorities. The bidding process at project level will normally require the primary care practice to produce a business case for its PCT. If approved, the proposed development should be included in the PCT's SSDP.

Lead PCTs act as fund-holders/managers of growth element funds. They approve funding for new schemes in line with SHA-agreed regional priorities. They advise SHAs on factors relevant to funding decisions and on the establishment and running of the priority scheme.

Priorities should be established from the SSDPs of individual PCTs. However, there is no national model for this process and it is for PCTs collectively (lead PCTs and their associated PCTs) to make their own arrangements. Funds are allocated to lead PCTs according to a 'modified weighted capitation formula', which includes a 'premises market forces factor' (details yet to be published). Individual PCTs should subsequently advise their practices of the amount of funding that is available in their area. Apart from projects that have received 'approval in principle' (but not reached financial close) before April 2004, it is likely to be difficult to progress projects until the local PCT has produced an SSDP. This may put non-LIFT projects, which may not be covered by existing SSDPs, under an additional burden. Most PCTs will need to appoint specialist advisors and contractors to assist with the procurement process. The initial steps that GP practices should take when proposing premises developments/improvements are:

• ensure the Local Medical Committee (LMC) supports the proposal
• ensure the DV (or other independent valuer appointed by the PCT) and PCT recognise that the proposal represents value for money
• ensure the PCT recognises that the proposal supports the GMS contract and its estate strategy for investment prioritisation
• prepare a business case for submission to the PCT for approval
• once approved by the local PCT, ensure that funding approval is sought from the lead PCT and SHA
• if premises are leasehold, ensure the PCT is satisfied on issues such as security of tenure and the intention of the contractor to occupy the premises for a sufficient period thereafter
• if premises are leasehold, provide the PCT with sight of the landlord's consent to proposed works
• obtain planning and building regulation consents
• ensure the PCT is satisfied that adequate processes (e.g. tendering and provision of plans etc) have been addressed, and that the requisite planning and design guidance will be followed