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Independents' Day

GP practices owe over £90m in premises fees, NHS Property Services claims

Exclusive NHS Property Services has urged GPs to pay what it says has accrued to more than £90m of outstanding premises fees.

Data supplied to Pulse by NHS PS showed that their tennants owe millions for rent and service charges, fees that have been disputed by practices and the BMA. 

In this latest development in the long-running dispute, the company - which is fully owned by the Deaprtment of Health - reiterated its call for practices to pay the fees.

But the BMA, which has not ruled out a legal challenge over premises fee hikes, told Pulse the amount of unpaid fees showed ‘the resolve of practices’ and urged NHS PS to work with GP representatives to ‘resolve 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 many leases were operated without contracts and that PCTs had been subsidising premises fees at vastly varying levels.

Since then, NHS PS has brought rent up in line with market valuation of properties, removed subsidies and hiked services charges - sometimes by five-figure sums - with the overall bill to practices rising by nearly half (46%) in just two years.

But the BMA has said that there has been little clarity for practices about why their charges have changed and what parts will continue to be reimbursable in the longer term.

Now, the new data provided to Pulse reveals that £91.5m remains unpaid by practices, including:

  • £55m of the £113m invoiced to GP practices in 2016/17  (49% of the total)
  • £28m from 2015/16 - 30% of the total invoiced
  • £8.5m from 2014/15.

An NHS PS spokesperson said: ‘Most of the increase in the amount invoiced will be due to the move to market rent, which was introduced to help improve understanding of the true cost of occupation.

‘It is only by knowing these costs that we can address them. GPs are not financially affected by this as rent is reimbursed by commissioners. We always take time to discuss outstanding debts to resolve queries.’

They added: ‘It is important that bills are paid so that we can continue to reinvest in the NHS estate. Last year, we invested £67m to upgrade and develop new facilities across England.’

But BMA GP Committee premises lead Dr Ian Hume said: ‘Simply paying the service charges which have increased significantly will have a destabilising effect on practices.

‘The data provides further evidence of the resolve of practices following GPC’s advice and the need for NHS Property Services to work with us to resolve this issue and for a swift conclusion to our negotiations.’

As previously reported by Pulse, LMCs have also advised practices to pay their premises fees at pre-increase rates, including in Oxfordshire where practices are disputing a 400% fee increase.

The dispute has also seen BMA advise practices not to sign new leases unilaterally imposed by NHS PS.

What has NHS Property Services billed GPs and what is yet to be paid?

YearTotal costs invoiced to GP tenants in year - £mTotal costs charged to GP tenants that were outstanding at 31 July 17 - £m
2016/17 112.9 55.1
2015/16 89.5 27.8
2014/15 77.5 8.6
 Total 279.9 91.5

Source: NHS Property Services

Readers' comments (11)

  • So GP owners of premises will also be paid market rent, or does it work only the NHS PS way like everything else in the country. If you are nobility, you get paid more, if you belong to serfdom - even God forsakes you! Liquidate NHSE which in some cases are infiltrated and governed by former bosses of failed PCTs and Trusts - that's where savings should come from and not from fleecing hard working GPs at every step.

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  • Vital date are missing from this article.
    1. The Conservatives are planning to sell off NHS property by implementing the Naylor Review (March 2017).
    2. The basic message of the Naylor Review is that some NHS assets should be sold in order to improve the rest.
    3. Robert Naylor, former head of UCLH, was asked to “develop a new NHS estate strategy”. The “estate” is the land and buildings owned by the health service and it is worth tens of billions of pounds.
    4. NHS Property Services, a company owned by DH, was created in order to implement this decision (Theresa May Spectator interview, 22 May 2017).
    5. Part of the "estate" are the "premises" in this article.

    It is now perfectly obvious that NHS PS are charging GPs exorbitant fees to force them out into cheaper accommodation, thus leaving the premises to property developers.

    I presume our "leaders" are familiar with these facts.

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  • This stance by NHSPS is clearly disingenuous. Of course GPs know that rents will be fully reimbursed (for now !)There is an issue about ensuring that the rents set are appropriate.The major problem where we work is the outrageous hike in maintenance and service charges. Massive increases which are applied and duly invoiced without any discussion or negotiation and with absolutely no substantiating evidence to explain the figures. Our maintenance charges are higher then the rental and seem to have been plucked out of thin air. Ten years of trying to get any explanation has been to date fruitless. I supect much of this money is being witheld against fatuously inflated bills for this as much as rental figures.

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  • Unscepted GP Partner- Spot on. Jpoin the merry go round where very 2-3 years self-styled GP's swop roles between BMA, GPC etc etc; that might not be a problem, believe me, i have met some- and many are completely sincere. The problem comes with the CCG's and contracts, premises, so many GP owners have not/never appointed new GP partners. Stunning to say, the profession does not see the professional iatrogenesis it has caused when Gp Practices have no intention of developing its own workforce and instead join the bandwagon of the usual song , our poor downtrodden profession. Remember the phrase 'The end of the Medical Profession' started appearing 7-10 years ago.. look at some of the medics in power/money positions who share a cup of tea with you and say what a lovely dr you are..

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  • Most of us have historical contracts in place. Ours involves invoices going back to the 1970's We have continued to pay the reimbursed money and to pay what we have historically paid- mostly for electricity gas and cleaning. The rest we have declined to pay as we have no contract to pay it. I don't think NHSPS can force us to pay anything different until they have negotiated a new lease. We have tried to engage with them to do this but they are basically incompetent and we have got nowhere with them despite being open and reasonable.

    I think the government hoped we would all settle into new leases and then NHSPS would be attractive to sell off. Now they are seen as badly run I don't know what the government can do. Be we have tried to engage with them to negotiate a lease starting two years ago and through no delays on our part we are still nowhere close.

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  • This comment has been moderated.

  • NHS PS are completely incompetent, they are trying to increase my charges by 500%. Also billing me for things I don't use. They are trying to double charge by quadrupling my rent but also moving services that the landlord should maintain onto my non reimbursable service charges. Charging a commercial rent is also nonsense as when I compared what I am paying and the cost of office accommodation it is approximately the same, in other words the NHS PS are trying charge four or five times the market rent.I continue to pay the historic charges. NHS PS are adding to the stress and problems we already face as GPs. They should be facilitating us in doing our job as front line NHS workers

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  • Yes. We are doing the same as Richard and Mark. I have to agree with sceptic. Why else would service charges increase from around 8k a year to 100k?

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  • This issue affects 10% of practices nationally (including my own)These practices tend to be in urban areas with high rates of deprivation.

    This issue, along with indemnity, should be the highest priorities for the GPC. There should be a clear and united message to all practices - DO NOT PAY A PENNY OVER INFLATIONARY RISES TO YOUR SERVICE CHARGES.

    Who will service the patients of 10% of practices if they choose to remove our contracts? We absolutely must stand united and we need our leaders to actually lead.

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  • I am surprised at the service charge hike for NHS owned premises used by GPs but when CCG/NHS England use privately owned GP premises, GPS are expected to allow to use free of charge.
    And our premises 'rents' don't go up as much NHS owned premises. We have to go through hoops before even slight increase is accepted
    NHS owned premises are considered of higher standards or specification but many of those are not and some of those are decidedly substandard.
    There should be an even playing field and as many GPs complained rightfully so the service charge should be justfisble. Stop once again exploiting these GPs

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  • PS
    Fight fight and fight collectively
    Pen pushers are bullies and I know that as been there done tha and came on other side pride intact(on different matter but what a fight it was!! FYI it was GMC vs little me and I won)
    I know you musty be doing this. Just a suggestion :- if you rent a flat you get your own meter
    If you are not paying gas and electricity bills yourself then get the meter separately to your premises (if others services are provided from the same premises you can still get sub meter
    Water and council tax is paid by NHS England and the rent as well
    Private landlord insures own premises, I do from the rent reimbursement so should NHS England
    Why 400% increase
    I better look at what we are getting paid for the rooms service charge and ask my PM to put up that service charge not 400/not 300% but at least 200%. I will be laughing to the bank all the way - that's even playing field???

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