The BMA has written to NHS Property Services threatening to take legal action over the ‘astronomical’ rises in charges faced by GPs in recent years.
BMA solicitors have today written to NHSPS to warn of legal action if the company fails to explain the significant increases in service and lease fees.
Also today, the National Audit Office (NAO) has published a report that found the NHSPS’s approach to collecting lease fees does not work ‘effectively’ and highlighted that the amount of outstanding debts owed by tenants – including GPs – almost tripled in five years, from £210m in March 2014 to £576m in March 2019.
The NAO has called for the NHSPS, the Government and national bodies to ensure that NHSPS and its tenants ‘will agree tenancy details and amounts by 31 March 2020’ alongside ‘an efficient dispute resolution process whereby all disputes are settled within 90 days of invoicing and a plan to clear outstanding disputes’.
The BMA previously urged practices not to sign leases unless they fully understand the terms and liabilities.
Pulse reported in April that 10 practices in the Bristol, North Somerset and South Gloucestershire area had been under pressure to sign new leases with increased service charges, with one practice manager saying their annual fee rose from £14,000 to £48,870.
As part of reforms made under the Health and Social Care Act 2012, NHSPS – a company wholly owned by the health secretary – took over the management of NHS properties and facilities from PCTs in 2013.
But since the takeover GP tenants have experienced issues, such as significant hikes in service charges, potentially resulting in layoffs and salary cuts.
The BMA said it is aware of examples of incorrect charging, including one practice that was invoiced for fees for a lift that did not exist, and others faced with demands for charges that had already been paid to their local council.
According to the NAO report, although GP tenants only occupy 18% of all NHS-owned properties, they owe the highest percentage of the outstanding debts compared with other tenants – 30% – with rent accounting for 48% of the debt.
The report states: ‘In our view, too many NHS organisations and GPs seem to regard paying for their premises as optional, with almost £700m either written off or still unpaid.’
Responding to the report, BMA GP Committee chair Dr Richard Vautrey said: ‘Problems with practice premises and the financial pressures that go alongside owning or leasing surgery buildings are constant frustrations for hardworking GPs, and have an important negative impact on GP recruitment and retention.’
He added: ‘It is simply not the case, however – as this report claims – that GPs see paying for premises as “optional”. Practices want to pay a fair and appropriate rent but this needs to be reimbursed by CCGs.
‘A lack of funding in recent years means commissioners cannot keep up with sky-rocketing commercial rents demanded by NHS Property Services, and they’ve simply passed the problem and the cost to family doctors. This is unacceptable at a time when practices are already under huge financial strain.’
NHSPS chair Ian Ellis said: ‘The report comments on some of the legacy issues NHSPS has inherited from operating in the widespread absence of formal rental and service agreements and the significant impact this has had on the company’s ability to agree charges with customers for accommodation and services provided, reduce billing disputes and recover outstanding debts.
‘We fully acknowledge that whilst improvements have been made, these have been at a slower pace than we wanted but support is also required from the broader health system to fully address this.’
In response to the BMA’s threat of legal action, an NHSPS spokesperson said: ‘We have been and continue to work collaboratively with the BMA and recently carried out an in-depth review of specific cases, as agreed with the BMA, which concluded that NHSPS charges were broadly correct.
‘Following this review, NHSPS set up a meeting with the BMA and NHSE to discuss the underlying central issue of affordability. We received a further letter on 5th June from BMA’s legal advisors, setting out six specific GP cases where they were considering action but asked NHSPS to work with them collaboratively to agree a way forward.’
In 2016, Pulse reported that practices were refusing sign new premises leases, which would see their fees hiked by 400%.
Local leaders also warned that practices were being ‘financially crucified’ by a huge increase in service fees.