GPs have been under pressure for a considerable time from the CQC requiring practices to ensure their surgery premises are compliant in terms of suitability and safety.
NHS England has itself set the direction of travel in the NHS Five Year Forward View by confirming that primary care is the cornerstone of the provision of a joined up out of hospital care for patients. It has encouraged improvements to be made to surgery premises and technology to allow a wider range of services to be delivered.
The requirements of both the regulators and NHS England often require considerable improvement to be carried out at the premises, thereby requiring a level of financial investment that more often than not has simply not been available. Practices are continually squeezed financially and the NHS England approvals process for expenditure on premises has tightened over recent years.
This has made it extremely difficult for practices to progress any improvement in their surgery buildings.
Many practices have found a range of ways of negotiating these hurdles, whether that be a sale and leaseback to an investor who then carries out improvements, borrowing money themselves to fund the improvements or new development, setting up a development company to carry out the improvements or development and leasing the premises back from that company or submitting a bid for a share of NHS England’s dedicated Primary Care Transformation (formerly Infrastructure) Fund.
A GP surgery development is complex and it is essential that practices obtain the expert advice of a range of professionals before embarking upon a project, including healthcare specialist project managers, accountants, surveyors and solicitors.
We have supported a large number of GP Practices in developing new surgery premises or extending/refurbishing their existing premises and can support you through all aspects of your project.
Our assistance will usually begin with supporting you in exploring the initial possibilities for development. We will then work as part of your ‘project team’ for the entirety of the project including:
- helping you to secure support from NHS England and the CCG for the development;
- acquire the site for development, including rectifying any title issues;
- negotiate construction contracts and development agreements on your behalf;
- deal with the legal aspects of setting up a separate property company/partnership;
- review and where necessary update your partnership agreement to ensure it is up to date and covers the arrangements chosen for development;
- negotiate agreements for lease and leases with any tenants (such as dentists, pharmacies, secondary care organisations) in order to secure their occupation in the premises; &
- liaise with any third parties who have an interest in the property or development.
We have advised on the legal aspects of a variety of structures and funding options available for practices wishing to carry out a new development or improvement to existing premises. Our team has assisted GPs in securing a range of bank funding, submitting Project Initiation Documents and business cases for NHS England funding, setting up separate property development companies or partnerships to carry out developments and entering into sale and leasebacks to third party investors/developers.
We also have an excellent network of strong contacts throughout the healthcare sector, which enables us to work closely with other specialist professionals with ease. This will help to ensure that your development is managed correctly and progressed efficiently to completion.