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Independents' Day

Talks break down over practices' six-figure service charge bills

Talks between the BMA and property companies over sky-high service charges have completely broken down, while practices are continuing to be presented with six-figure bills.

The BMA’s GP Committee has had to resort to the ‘unprecedented’ action of sending out freedom of information requests to find out why practices are facing these service charges.

In a statement ahead of today’s LMCs Conference, the BMA said that they had received some reassurances that practices will be protected from the costs. However, it said that one of the two property companies are now ‘backtracking’ on these commitments.

It also said it was supporting a GP who had made a complaint to NHS England after receiving a bill for non-reimbursable costs for £265,000.

NHS Property Services says it 'doesn't recognise' the BMA's figures. 

In September, Pulse reported that NHS Property Services (NHS PS) were claiming that GPs owed them a cumulative £90m in historic service charges.

The BMA had advised GPs not to pay service charges, and it was in negotiations with NHS Property Services and Community Health Partnerships (CHP), which is also charging practices.

It says that practices are facing charges of up to £100,000, which is ‘well above the precedent set for historic rises in this area’.

In a statement today, the BMA said: ‘The BMA’s GP committee has met with NHSPS on a number of occasions to highlight the destabilising effect that these service charge increases are causing and seek a negotiated resolution.

‘CHP offered GPC some reassurances that practices would have protections over these increases, but now seem to be backtracking on these commitments. We have received no acceptable reasons as to why these issues have emerged or what action both organisations intend to take to resolve them.’

It added: ‘As a consequence of this lack of movement, the BMA has been forced to take the unprecedented step of issuing FOIs directly from the BMA’s GP committee to NHSPS and CHP asking a series of questions that we have been unable to get answers to in our official correspondence with both organisations.’

GPC negotiator Dr Krishna Kasaraneni said: ‘The BMA has been attempting to work constructively and positively with NHSPS and CHP in order to resolve the escalating number of complaints from GP practices about excessive and erratic rises in service charges. In one case, a GP practice reported an increase in fees of almost £100,000.

‘Unfortunately, despite repeated requests, we have had no clear reassurance from NHSPS or CHP which explains why these issues have emerged or a commitment to resolve them.

’We have reached the stage where issuing freedom of information requests is necessary for full transparency, and we will also consider other proportionate and appropriate action to protect GP services and patient care.’

An NHSPS spokesperson said: ’We do not recognise the figure quoted. In many cases there has been no significant change in the total amount we have invoiced on a property. Changes to local subsidy arrangements by commissioners mean that some GPs are receiving bills for their own costs which were previously met by other NHS bodies.

’We will continue to work positively with the BMA, GP practices, commissioners and NHS England on this issue.’

NHS PS took over the leases for GP practices in rented premises from PCTs when these were abolished in 2013. Upon doing so, it found that PCTs had been subsidising premises fees at vastly varying levels. 

A spokesperson for CHP said: 'We do not recognise that figures quoted.

'In 2013, CHP inherited the historic prices charged by former primary care trusts which were often subsidised and did not reflect the actual cost of provision. Where an extant lease or other legal agreements exist, which specify charges below cost, CHP honours that agreement.

'In the five years since Community Health Partnerships became the Head Tenant in the NHS LIFT buildings, services charge increases have been below the rate of inflation. Our associated building charges simply recover the actual cost of services provided, such as soft facilities management. We provide fully transparent evidence to support these charges and review supplier contracts to ensure we achieve best value for our tenants.

'We continue to work constructively with the BMA; our newly appointed chief operating officer is very keen to engage and have an open dialogue.'

This article was amended on Saturday 11 November at 13:45. It originally stated that a practice was hit with a bill of £100,000. This should actually have read £265,000


Readers' comments (2)

  • Sound like the BMA needs to bill thw NHS for the actual cost of our services, and the non core service we provide. If not paid we should withdraw all not core service asap and refer to secondary ECGs, spirometry,ear syringing(£45 per ear privaetly locally),home monitoring of bp,24 hour tapes,alll share care agreement to be sent back to secondary care to manage,non cocoperation with CCGs.we need to fight the BMA need to stand and be counted, if not inductrial unrest withdrawal of cooperation with the destruction of the NHS.We need to fight for the future of GP land, we need a last stand.

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  • I agree with Turn out the Lights. While the disagreement is ongoing these practices MUST make things difficult for the NHS overall. Running a practice in an expensive way will cost the taxpayer a lot more than these service charges. Practices in dispute should be acting in that way out of protest. I would suggest:

    - Declining minor injuries - can go to A+E.
    - All cost saving work declined.
    - All drugs prescribed as branded drugs (the most expensive choice)
    - 1 session = 12 appointments, everyone else directed to A+E.

    I promise if all of that happens, then NHSE will start to take notice. Just be upfront and say you cannot take on the cost saving work because of the stress of the property issues. None of that goes against the contract (although you might have to give up an enhanced service).

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