NHS England has published plans to take on the premises liabilities of practices in leased surgeries "where they are of strategic importance".
Following a review of GP premises, NHS England said that existing practice leases would be assigned to "NHS bodies or other appropriate entities". The review looked at ownership models, funding and contracting, and the utilisation of premises with the intention of ensuring GP premises are "fit for purpose, both now and in the future".
The details of which leases are seen to be of "strategic importance" and covered by the plans will be subject to further discussions between the British Medical Association (BMA) General Practitioners' Committee (GPC) and NHS England this year.
In a media briefing, NHS England said that it would now make "more sense for the NHS to stand behind the lease and relieve GPs of the worry of the liabilities". One of the proposals would see the NHS directly pay for the "core estates provision" while GPs would not have to claim reimbursement.
This would be in part to address the problem of "last person standing" identified by the NHS England-commissioned partnership review, published earlier this year by Wessex LMCs Chief Executive Dr Nigel Watson.
NHS England Primary Care Strategy and Contracts Director Ed Waller said the team will be exploring the separation of the partnership model and premises ownership so that new partners can step in and run the contract without taking the estate. He said: "There are some scenarios in which people are concerned about entering leases for various reasons, such as the time they’ve got to work before retirement or the length the commitment involves, and that can be a barrier both to lease signatures and people joining partnership where there’s a lease involved.
"What the review has concluded is that we would do a further bit of work to precisely define the circumstances about the where GP primary care premises is bound to be part of the feature, ie it’s a strategically important place to provide primary care services".
The review said that a model where the choice to own premises is separate to becoming a partner "could support the future development of the partnership model in general practice". NHS England said that some partnerships already operate in this way and it would "support a shift" to the model becoming more widespread.
The documents said that any future investment in practice premises owned by GPs would be contingent on practices having "robust governance arrangements" in place relating to premises. The review said: "Separation of the premises-owning and partnership entities could be one way of demonstrating good governance".
NHS England added that it would be developing "best practice guidance" on how practices could do this.
The NHS England documents are available at www.england.nhs.uk.
Last reviewed 2 July 2019