GP practices General practitioner Practice manager

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Support with Community Health Partnership (CHP) and NHS Property Service issues (NHS PS)

We are aware that many practices in NHS PS or CHP buildings are experiencing issues, such as significant increases in service charges.

These increases are being levied with seemingly no reference to the contractual arrangements (or lack thereof) that are in place, or the sums historically paid. This issue is further complicated as practices are often not provided with an itemised list of charges, or when they are, there are often errors or incorrect charges included.

These issues often coincide with NHS PS attempting to negotiate a lease with practices.

 

Freedom of information (FOI) requests

The BMA has taken the unprecedented step of issuing FOIs in respect of excessive and erratic rises in service charges.

Read about the FOIs to NHS PS and CHP

 

Read our advice to practices

  • Lease negotiations

    In respect of lease negotiations, although we support the view that practices should engage in the process, it is vital that you do not sign any lease or Heads of Terms (including those purporting to be based on the national template GP lease negotiated between the BMA and NHS PS) unless and until you fully understand and are comfortable with your potential liabilities. To this regard appropriate due diligence as to your potential liabilities should be carried out.

    Particular care should be taken on the issue of service charges so as to avoid a situation where there is an exposure to uncapped and unreasonable costs that bear no resemblance to what arrangements previously existed.

    On the point of lease negotiations, we wanted to confirm that we are aware of a recent communication that has been issued by NHS PS within which they threaten to refer practices to NHS England or the Department of Health if they do not engage with their agents in respect of their lease regularisation programme. Albeit the tone is unsettling, this communication should only be viewed as an attempt to encourage practices to engage in discussions over the terms of a new lease.

  • Transitional funding

    We are aware that some transitional arrangements are being offered to either:

    1. cover increased costs that NHS PS wish to charge; or
    2. act as an incentive for practices' to sign a new lease.

    Such arrangements should only be entered into where you are entirely satisfied that when the transitional period ends that you are not inadvertently left having to meet increased costs without the benefit of increased funding. In the view of the BMA, transitional arrangements are not the solution. More permanent arrangements which align a practices' funding to their costs are needed.

  • Current charges

    In respect of current charges, practices should only make payments to both the extent that they are both satisfied as to the legal basis upon which they are payable and their accuracy.

    Read more about service charges

    GPC are aware that this issue is causing practices significant stress, and we would like to reassure you that GPC will stand with you in circumstances where, despite there being no legal basis to do so, NHSPS seek to enforce these charges. To this regard, if NHS PS take action to enforce charges against you please let us know immediately.

    Ultimately we are pushing to reach a negotiated agreement nationally, but we are prepared to consider all and any other possibilities to realise a situation whereby a fair and reasonable process for calculating service charges is agreed, which has due regard to historic arrangements and does not result in practices having to fund the historic neglect of buildings.

  • Standard lease

    In 2015, GPC agreed to negotiate a template lease that could provide the basis for new leases for practices that are occupying NHS PS and CHP buildings without written documentation. We agreed a template lease which is very favourable for the tenants, including:

    • a break clause allowing a practice to break their lease if they lose their core contract, and favourable assignment clauses enabling a practice to assign the lease to different partners or NHS allowed entities – these will ease the 'last man standing' phenomenon
    • maximum lease term of 30 years, with in-built renewal clause
    • mechanisms built into the lease to ensure that reviewed/revised rents match what will be reimbursed via the premises cost directions
    • a requirement for service charges to be agreed before the lease is signed

    The lease is intended to be a framework for practices to negotiate with NHS PS, and details of the lease will be negotiated on an individual basis. Before entering into a lease, we would strongly advise practices to undertake due diligence and seek legal advice.

    Find out more about the template lease

    BMA Law have produced a blog on top tips when negotiating heads of terms. Read the blog.

     

  • Letters to practices

    24 February 2017 regarding ongoing issues with NHS PS

    3 April 2017 regarding heads of terms

    8 May 2017 regarding service charges

    27 July 2017 providing an update on developments

    15 September 2017 update on further developments