3.1 Most first tranche LIFT projects have concentrated on re-providing existing primary care services in modern premises. Quick wins were needed to meet pressing local needs. For example, in April 2001 prior to starting LIFT, Sandwell found 80 instances across 39 of their 87 premises where it was considered either technically unfeasible or uneconomic to achieve compliance with modern statutory standards, particularly the requirements of the Disability Discrimination Act 1995. Sandwell's first LIFT projects were therefore focused strongly on replacing some of the worst existing premises to make an immediate impact on the local modernisation agenda.
3.2 While the most pressing need has been to accommodate GPs, some projects are incorporating wider primary care services. The Church Road scheme in East London is a flagship one stop centre. Complementary services include a pharmacy, a dental suite, radiology, psychology and transfer of cardiology outpatients from the acute sector.16 Firm commitment to some services from stakeholders has, however, not been obtained as at April 2005. Future developments in East London could also incorporate key worker housing and an opportunity for Sure Start17, another national initiative implemented locally, to run advice sessions for young parents.
3.3 It is difficult when entering into a 20 year partnership for local health economies to predict changing shifts in service provision and the population's needs over the longer term reliably. Flexibility and adaptability, although desirable, come at an additional cost. Some first tranche projects have nevertheless been designed to allow for changing use in the future. In the Church Road project, the radiography suite, for example, can easily be adapted for alternative use in the future.
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16 Acute care is provided, normally in a hospital setting, to those whose illnesses are short term or episodic.
17 Sure Start is the Government's Programme to deliver the best start in life for every child by bringing together early education, childcare, health and family support.