Hospital trusts invited to bid to take over GP practice premises

Exclusive Trusts in the South East of England have been asked to signal their interest in taking over GP practice premises currently owned by NHS Property Services by this Friday.

This follows national guidance that was published in January but had not been explicit in the plans regarding GP premises.

In correspondence seen by Pulse, trusts in the South East have been asked to coordinate with their ICBs to submit expression of interest (EOI) forms for properties owned by NHSPS by 13 March. 

It lists a number of regional GP premises as ‘core’ NHS estate that is in scope for the invitation, encouraging trusts to effectively become landlords.

A timeline laid out in the correspondence said that formal applications will open from April to June, and the first transfers are set to take place from September. 

Once expressions of interest have been submitted, ICBs and trusts will be able to able to develop business cases through a pipeline agreed with NHS Property Services, according to the guidance.

NHSPS owns more than 1,000 GP practices in England. Premises owned by Community Health Partnerships (CHP) are not in the scope of the scheme. 

The policy focuses on the transfer of ‘core’ clinical properties – defined as buildings that are ‘fit to deliver modern, joined-up healthcare in the long term’ – though trusts can also request ownership of ‘flex’ properties – which are ‘suitable for now but may not be appropriate for future models of care’ – if they commit to investing in them.

It follows NHS England guidance published in January, which stated that transfers to local authorities and general practices were not permitted. 

In an accompanying ‘policy messaging’ document, the Department of Health and Social Care explained the scheme’s benefits as facilitating ‘a shift towards greater local ownership’ of the NHS estate and supporting ‘local level decision making and delivery, productivity, and the wider ambitions set out in the Government’s 10-Year Health Plan’. 

DHSC also said that no transfer will take place until a binding agreement is in place between NHS Property Services and occupiers for the settlement of any outstanding debt relating to the property.

NHSPS may also continue to provide services after the transfer, as both the guidance and correspondence to ICBs make clear.

The policy messaging document said: ‘We encourage trusts to come forward with expressions of interest as early as possible. Following publication of the policy, the period up to end of March will be for trusts to engage with us to and raise any further queries, before the formal transfer period opens.

‘As this is a voluntary process and based on demand from trusts, we do not have any targets or projections of how many properties will transfer.’

It added that trust ownership of NHSPS premises will allow to ‘align investment decisions more closely’ with clinical strategy, and bring forward improvements to patient facilities.

However, YORLMC medical secretary Dr Brian McGregor told Pulse: ‘Ownership of the buildings will not magically make capacity within those buildings increase – we need proper investment into expanding the estates within general practice if we truly want to see a shift of hospitals to community, analogue to digital and treatment to prevention. This plan of giving the estates to financially incompetent secondary care trusts is unlikely to achieve that.’

The BMA expressed concern about the ‘puzzling’ approach laid out in the ICB correspondence, with the earlier deadline indicating they have ‘excluded’ GP practices from the transfer process.

BMA practice business policy lead for the GPC in England, Dr Clare Bannon, told Pulse: ‘We have significant concerns about the proposed transfer of buildings to trusts and find their approach puzzling.

‘ICBs have, for some reason, chosen not to follow its own guidance, bringing the deadline forward by two weeks and excluded partnerships from expressing their own interest in property transfer. There’s also the unresolved issue of outstanding debt on practices, which will be causing a great deal of anxiety.

‘It is evident that the current ownership model for premises held by DHSC, via NHSPS and CHP, is not working for many GP practices and General Practice Committee England (GPCE) supports removing these unhelpful layers of bureaucracy.’

Specialist medical accountant Andy Pow said: ‘For neighbourhoods to work, there needs to be flexible use of premises. Whether trusts lead on neighbourhoods will depend on various factors, but they are a key part of the system. Only allowing trusts to apply seems limited, but they may be able to move quicker than others in some areas which may be why it has been limited in this first phase.’

Long-running service charge disputes between NHSPS and GP practices have forced some to hand back their contracts and prompted the BMA to demand Government intervention over the matter.

Mr Pow cautioned GP practices ‘will need to be careful about future commitments’ with ‘many problems still existing in terms of agreeing outstanding charges’.

Bryn Morgan, a partner at specialist law firm Hempsons, said it could mean a ‘light at the end of the tunnel’ for some practices with long-running disputes.

He said: ‘Acquiring NHS Trusts will be keen to know that not only are historic charges addressed but also that there is agreement on the charging mechanisms going forward. Many practices in this position do not have written leases, so this may also be a valuable opportunity to put arrangements on an agreed formal footing that provides clarity and greater security.’

A Department of Health and Social Care spokesperson told Pulse: ‘We have published a voluntary asset transfer policy that sets out how NHS trusts may apply to take ownership of certain NHS Property Services buildings, where it will support local decision making, delivery, and productivity.

‘By placing ownership of appropriate assets with the organisations delivering care it can help accelerate the shift to neighbourhood level, integrated, preventative care while maximising value for money from the NHS estate.’

Last year, a survey found that half of GPs and practice managers did not think their premises are suitable for current needs, with GP leaders warning it is ‘directly undermining’ the 10-year health plan.