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In case you hadn't noticed, doctors' surgeries are getting bigger, writes Wendy de Silva.

Countrywide, the small surgery with several partners is still the norm, and some premises are still procured traditionally, with revenue funding from central government. But the latest wave of building in this sector is being rolled out under the government-sponsored Private Public Partnership route, otherwise known as LIFT (Local Initiative Finance Trust).

There are 42 LIFTs in the UK, each one covering a specific geographic area and with responsibility for a wide range of projects, from small refurbishments to multimillionpound projects. LIFTs have been set up to procure new primary-care centres on a rolling programme over the next 20 years; the first schemes under the programme represent a £1 billion investment.

So, what does this mean for the specifiers and manufacturers of products? Well, possibly quite a lot, with plenty of scope for product development to suit this emerging market. LIFT schemes are taking longer than anticipated to reach financial close, but if all goes to plan, there will be unprecedented opportunities for users, architects, contractors and manufacturers in this sector to work together to identify suitable products and then continually refine and develop them. The monitoring of materials used and feedback on buildability and performance (often lacking in architecture) is built into the 'system'.

The products specified must satisfy several groups, each with their own criteria: typically the architect, the contractor and the client/final user.

And, more unusually for this sector, the input of the facilitiesmanagement firm, responsible for maintenance and lifecycle costs, is beginning to have much more of an influence on design and specification.

NEW-LOOK PRIMARY CARE In terms of specification, the world of primary care is fast shifting from the homely, reassuring place that was domestic in feel, with carpets in consulting rooms and sinks and basins discreetly disguised in vanity units, to harder-edged clinical rooms with washable vinyl floors, elbow-action taps and clinical basins with no overflows. Infection-control nurses, having recently gained political support at the highest level, are confident in their demands for washbasins to be located within the curtained areas of consulting rooms ahead of current guidance.

The most useful current guideline is Primary and Social Care Premises Planning and Design Guidance, which can be found at www. primarycare.

nhsestates. gov. uk - a website that provides access to excellent general as well as detailed information on this building type of building.

Wendy de Silva is a director at Dransfield Owens de Silva

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