Is the row over GP premises about to boil over?
Impasse over new leases could be reaching breaking point, finds Alex Matthews-King
The row between GPs and NHS England regarding hikes in service charges could be about to boil over.
Premises – online – 330x330
The BMA’s GP Committee has announced it could consider legal action on the matter, which has left some of the 14% of GP practices under NHS Property Services (NHSPS) facing an increase in service charges of more than £60,000 a year.
The GPC issued the warning after NHS England and NHSPS missed the 2 May deadline to put forward a national solution that ‘doesn’t expose practices to unreasonable and uncapped charges’.
In a letter to GP practices, the GPC included a questionnaire to help it understand ‘the breadth of issues’, saying it would ‘look at all… options available to us in order to bring this issue to a head’.
Asked whether the options on the table included legal action, GPC deputy chair Dr Richard Vautrey told Pulse this had not been ruled out.
He said: ‘All options means just that: we are considering all options available to resolve this issue.
‘We are doing all we can, working closely with our legal advisers to get a solution.’
The row has come about because many of the practices affected have operated with a variety of historical payment and charging arrangements from their PCT days, and often without a formal written lease.
We hope this issue will now come to a head
Dr Gavin Ralston
NHS England is determined all practices in NHSPS premises should sign formal leases. However, there are no mechanisms for it to enforce such a change, apart from eviction. Instead, the GP Forward View in April 2016 gave incentives to practices to sign leases before November 2017, with promises to cover legal fees and stamp duty land tax and offer temporary reimbursement of cost increases.
However, some of the leases sent to practices involve service charges jumping by as much as 400%, equating to around £60,000 a year.
NHSPS claims these leases have been agreed with the GPC, but the GPC says it has only agreed a template lease, setting out the minimum standards, and has warned practices to take legal advice before signing any new leases.
NHS England has been increasing the pressure on practices to sign leases, with Pulse reporting that regional teams have threatened to withhold long-awaited premises funding from practices that do not sign.
At the LMCs Conference in Edinburgh in May, GPC executive member Dr Gavin Ralston announced he was ‘hopeful’ the issue could be resolved in GPs’ favour, and expected it to ‘come to a head in the next month’.
NHSPS said it was ‘keen to continue discussions’ with the BMA when asked to account for not responding to the GPC’s ultimatum. A spokesperson told Pulse: ‘Property costs are applied in line with nationally agreed NHS funding arrangements and we are confident our charges are comparable with other practice landlords.
‘We are in discussions with the BMA and NHS England to try to help resolve some of these issues and we are keen to continue those discussions.’
GP leases saga
Responsibility for a large number of practice leases is transferred from PCTs to the new Department of Health-owned NHS Property Services management company, although these are often informal, historical agreements
LMCs warn that practices face being hit with an average £17,000 service charge increase as a result of the change
NHS Property Services reveal plans for ‘all costs [to be] recovered from tenants’ rather than CCGs, leading to fears that charges for GP practices will be hiked up even more
Pulse reports warnings from local leaders that some practices are being hit by a £50,000-£60,000 hike in service charges.
The GPC announces it has agreed a template lease with NHS England that guarantees minimum standards for GPs who rent premises from NHS Property Services, but warns practices not to sign new leases if they are not sure what new charges are for. The GP Forward View says practices that sign a lease will have their stamp duty reimbursed and be allowed to break their lease if they lose their core contract
NHS England regional teams threaten to pull funding from practices unless they sign new leases, despite those practices waiting more than a year for premises investment
Central Lakes Medical Group in Cumbria says it might have to lose a member of staff after finding its service charges could increase from £21,000 to over £45,000 in 2017/18
The GPC surveys practices and says it could consider taking legal action against NHS England for the service charge hikes