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Practices fear closure after nine-fold increase in bills



A cluster of practices in one region have warned they may have to close after a change in the management of their premises left them with bill increases of up to 900%.

The practices in Staffordshire have been told that they will have to pay expenses for the cost of utilities, maintenance and cleaning their buildings, which had been previously subsidised by PCTs under the NHS ‘Local Improvement Finance Trust’ scheme.

NHS England says that this is to bring them in line with other practices in the region.

However, the affected practices say that they had originally moved to the premises as part of an agreement with the PCTs, and they may have to close as a result of NHS England’s decision.

The GPC says that practices across England are starting to feel the pressure from the removal of these subsidies.

The change in billing has arisen following the switch in management of the LIFT building programme from PCTs to Community Health Partnership (CHP) in 2013.

The charges were subsidised by the PCTs in the past ‘to encourage practices to locate to improved premises and to foster greater integration with other healthcare services’, which transferred to NHS England when CHPs took over the management.

But in April 2014, NHS England removed the subsidised funding.

Dr Chandra Kannaganti, a GPC member who works at the Goldenhill Medical Centre in Stoke-on-Trent, says that practices are starting to see the results now and many practices are fearing they may have to close.

He told Pulse: ‘I believe there will be closures…it will have a huge impact on practices and they could become non-viable.’

Dr Kannaganti’s own non-reimbursable expenses bill appears to have shot up from £5,000 a year to £22,000, and he said that the GPs took on the practices without being aware that the bills could increase this much

He added: ‘We were never informed of the real costs and we signed the leases based on these original costs. They changed it without informing us.

‘If I’d known before, I would have factored this into my original business plan and bid.’

Other practices in the area have been hit hard, including:

  • Dr Phil Turner, a partner at the Biddulph Primary Care Centre in Staffordshire, said non-reimbursable charges have rocketed from £4,000 a month to £7,000. He adds that it feels ‘like a whole row of nails in the coffin’ and there could ‘uddenly be 21,000 people in our town without a GP’
  • Jenny Manley, practice manager at Alton surgery in Stoke-on-Trent, said ‘we were being charged £3,134 (net of VAT) per year and are now being charged £2,259 a month (£27,108 a year)’.
  • Julie Shaw, practice manager at the Westen Coyney Medical Practice, Stoke on Trent, says that last year non-reimbursables were charged at £1,200 and now that are £2,600 per month. She adds ‘we don’t know what we are being charged for’.

GPC premises lead Dr Brian Balmer said: ‘This is going to happen to lots of practices…they are going to say, ‘where did this come from?’’

Dr Balmer has been approached by a number of practices in Staffordshire. ‘It is an issue there but it is also being experienced all over England,’ he adds.

‘CHP has said openly, in face-to-face meetings, that it is working to properly identify the costs involved (in LIFT buildings) and cover all those costs. The big one to watch for is the management and service charges.’

A spokesperson for NHS England (North Midlands) said: ‘NHS England fully reimburse the costs of rent, business and water rates of all GP practices in Staffordshire – including those occupying CHP buildings.

‘In common with all practices in Staffordshire, those practices occupying CHP buildings will have to bear the cost of utilities, maintenance and cleaning. These costs are not reimbursed by NHS England. 

‘Whilst there may have been some historic subsidy of these non-reimbursable costs, this has not been the case as of April 2014  to ensure that all practices in Staffordshire are treated equally and charged in the same way.’