Exclusive Practices in PCT-owned premises are facing reviews of their leases and the threat of steep service charge rises as trusts across England prepare to hand over their estate ahead of their abolition next year.
GP leaders have advised practices to seek legal advice if they are unsure about the status of their lease, amid warnings some PCT managers are demanding service charge increases of up to 300% and others are hurriedly drawing up leases after it was discovered that none existed.
PCT-owned premises – estimated to house as many as one in ten practices across the country – are expected to be handed to either the NHS Commissioning Board, or other providers, when PCTs are abolished next year.
Londonwide LMCs has written to all GPs in London to alert those in PCT-owned premises that their leases are being reviewed.
The statement said: ‘This is to caution those practices in PCT-owned health centre buildings to clarify the terms and conditions of their lease.’
‘It is likely that the new contract holders will try and impose new service charges etc, so it is advisable that if you are uncertain about the status of your lease and its contents, to consult a lawyer.’
Dr Nigel Watson, chief executive of Wessex LMCs, said several practices in his area were facing renegotiations.
He said: ‘The PCT is pressing to get the lease sorted out, but for a number of practices they don’t have any lease at all.’
‘For some, suddenly the service charge has changed because the practice has been paying significantly less than the market rate. In two or three cases they are looking at 200 to 300% increases.’
‘Some of these health centres are occupied by PCT staff too, but the PCT has not proportioned it out, so that the practice has been taking on an unfair burden of the service charge.’
Surrey and Sussex LMCs has warned GPs to check their lease agreements for service and maintenance charges and use of space and to ensure they have adequate paperwork if they do not have a clear tenancy agreement.
They recommend: ‘Where you do not have a clear written agreement, please ensure that you have a clear and documented trail of itemised payments you have made to the PCT to establish a “tenancy at will” agreement.’
Bob Senior, chair of the Association of Independent Specialist Medical Accountants and director of medical services at RSM Tenon, said service charges have not always been maintained at market rates.
‘Actual increases in heating and cleaning costs can come as a nasty surprise,’ he said.
Adam Thompson, a chartered surveyor with Primary Care Surveyors, is acting for eight practices in Hampshire whose properties are being transferred to a new community foundation trust, but no formal leases exist.
He said the lack of consistency about rents and service charges levied by PCTs that own GP premises is a real problem.
He said: ‘There is no transparency or consistency in service charges. For some clients, the service charge has always been very high- others are very modest and doctors can’t believe their luck.’
GPC negotiator Dr Peter Holden blamed the lack of lease agreements on ‘amateur management’ by PCTs, and warned GPs to seek independent advice from surveyors and solicitors.
He said: ‘We have come across a number of instances where people were too miserly to consult their own solicitor. If you were cheese-paring 20 years ago, it may come home to roost now.’
‘If you have a lease agreement then property law applies. If you just have a licence to occupy premises, then you are less secure.’