The BMA’s 2025 GP Premises Survey - conducted between 13 June and 18 August - gathered insights from almost 2,000 GPs and Practice Managers, representing nearly one-third of General Practices in England and all Integrated Care Boards (ICBs). The results reveal widespread concern about the condition, capacity, and sustainability of GP premises across the country. The government's 10-year Health Plan, which relies on delivering patient care closer to home through neighbourhood health, can only be achieved with an urgent and substantial investment into GP premises.
What We Found
- Many practices face critical infrastructure challenges to caring for their patients.
- Staff welfare and training are hindered by inadequate facilities.
- Integration of additional workforce, including Primary Care Network (PCN) staff is limited by space constraints.
- Service charge disputes with NHS Property Services (NHSPS) and Community Health Partnerships (CHP) are putting practices at risk of closure.
Our recommendations
1. Urgent Funding
An urgent targeted investment package is needed to upgrade and build new GP premises. Investment is needed in staff welfare facilities like meeting and staff rooms to improve morale in the workplace.
2. Capacity Expansion
Practices need support to unlock space and digitise records. NHS England should fund the removal of paper notes from GP premises and reimburse practices that have already paid for digitisation or off-site storage of notes.
3. Service Charge Reform
Immediate action is required to resolve and settle historic service charge disputes and explore alternative ownership models for premises held by Department of Health and Social Care (DHSC) owned companies, NHS Property Services (NHSPS) and Community Health Partnerships (CHP).
Key findings
- 50% of respondents considered their premises to not be suitable for present needs.
- 83% of respondents consider their premises to be unsuitable for future needs.
- 74% of respondents do not have enough space to provide training for new GPs.
- A quarter of respondents reported having been invoiced with inaccurate service charges and less than half of these described the charges as ‘resolved’.
- The responses from NHSPS and CHP tenants highlight a stark difference between buildings managed by these landlords. Over 65% of respondents in NHSPS buildings and over 74% in CHP buildings said they have received incorrect invoices.
- 54% of NHSPS tenants and 35% of CHP tenants said that service charge disputes were affecting the sustainability of their practices.
35% of NHSPS tenants and 26% of CHP tenants have considered handing back their GP contract due to service charge disputes.
Capacity
The survey results highlight significant infrastructure challenges faced by practices since joining Primary Care Networks (PCNs).
- 83% of respondents reported that since joining a PCN they do not have enough space for additional staff on site
- 77% of respondents reported that being part of a PCN has made improvements more necessary.
Some practices have taken costly steps to adapt, such as outsourcing paper medical record storage to create clinical space—highlighting the urgent need for investment in physical infrastructure to support growing teams.
Practices shared powerful examples of how space constraints affect staff wellbeing and service delivery:
- “We have 50 staff and a kitchen that fits one person standing.”
- "Only one toilet for 35 staff.”
- “Hot-desking clinical rooms, no space for meetings or medical students.”
Investment
The data highlights that much of England’s GP estate is ageing and underfunded—posing serious challenges for modern healthcare delivery.
- 71% recorded that their main site is more than 26 years old, with many significantly older.
- Half of respondents reported that significant modifications or extensions have been made to their premises.
- 14% of respondents reported that the last significant modification or extension to their premises took place 26 years ago or more.
Of respondents whose practice applied for a grant since 2022:
- 42% received a rejection
- 30% are still awaiting a response
- 28% got their application approved
Considering this high rejection rate, it is worth considering that 88% of these grant applications were for less than £150k
Service Charges: NHSPS and CHP
266 free text comments were received from NHSPS tenants and 80 from tenants of CHP, reporting widespread issues with incorrect invoices for service charges—many ongoing for over a decade.
Key issues raised:
- Incorrect and inconsistent billing
- Charges for non-existent services
- Sharp and unexplained increases in service charges
- Lack of transparency and supporting documentation
- Poor customer service from NHSPS and CHP teams
Impact on practices
Practices report spending extensive time disputing charges, with some considering staff redundancies due to rising costs outpacing funding. Examples include:
- Being charged for lift maintenance in a building that does not have a lift.
- Being charged for snow clearance and gritting when it has not snowed
- Mould growing in the reception area
- Curtain cleaning charges despite using disposable curtains
- Service charges increased fourfold, with no clear explanation
- Repeated requests for payment of already settled charges
These accounts highlight the urgent need for transparent billing, fair service charges, and permanent dispute resolution of service charge disputes to protect the sustainability of general practice in England.
The need for alternative models of ownership
The current model of ownership of DHSC premises by NHSPS and CHP has not worked either for the practices or for patients. There is a need for urgent consideration of alternative models of ownership for these premises.