National deal to tackle service charge hikes may be close, says GPC

GP leaders are hopeful that a national deal can be agreed soon to ease pressure on practices facing huge service charge increases, after an LMC reached an agreement to write off thousands of pounds in costs.

GPC premises lead Dr Ian Hume
GPC premises lead Dr Ian Hume

Hopes of a deal come just months after GP leaders warned that practices facing huge increases in costs under plans to impose market rates of rent for NHS organisations had been 'frozen in time' - with partners unable to recruit or retire.

Around one in five GP practices across England operate from premises owned by NHS Property Services (NHSPS) or Community Health Partnerships, which manage NHS-owned estates. GPs in NHSPS properties have been landed with up to six-figure increases in service charges for the use of their premises.

GP leaders have been warning since 2016 that the huge extra costs could force practices to close if they were not reversed.


But after successful talks in Northumberland that have brought more transparency over how the service charges are calculated, agreement to reduce some charges, and a deal that wipes out any increased service charge costs that had been imposed on practices for the 2015/16 to 2017/18 financial years, GPC leaders are hopeful that a national agreement could be close.

GPC premises lead Dr Ian Hume told GPonline that any LMC or local organisation agreeing a deal on service charges needed to ensure that the offer was fair and reasonable, and to be clear what the service charges were for.

'If you agree to any subsidy, it will eventually run out - and GPs need to be sure that the final deal is sustainable,' he warned. 'Through national negotiations we are looking to cover off those issues. We want a national solution. Each area has its own peculiarity, and anyone entering into an agreement has to take their own professional advice – if accepting a transitional deal, you need to be sure the final outcome is something you are happy with and that charges are fair and can be accounted for.'

He said the GPC was aware that transitional deals had been offered in Northumberland and elsewhere in England, but reiterated that the BMA's GP leaders were continuing to work with NHS England and NHSPS to reach a nationally agreed position.


'We want a national deal as quick as possible. I really hope that is close. The whole issue of service charges is causing tremendous uncertainty for practices and we want to resolve it as quick as possible.'

GPs at this year's LMCs conference demanded full reimbursement of any increased service charges 'as a matter of urgency'. Dr Hume said it could be something delivered as a direct payment, or through the cost element of the GP contract. 'We are looking for fair and sustainable funding that gives sustainability to practices,' he added.

Northumberland LMC medical secretary Dr Jane Lothian told GPonline that GP leaders and local NHS leaders had agreed a local solution to tackle service charge increases to try to end chronic uncertainty over finances that was undermining practices.

'We couldn’t wait for a national solution,' she said. 'We had lots of practices locally saying we can’t recruit because of this cloud hanging over us financially.'

GP subsidy

Dr Lothian said NHS bosses had agreed that the gap between what practices paid in the past for service charges and the increased fees had been labelled an 'historic subsidy' and that additional funding had been identified to wipe out costs that practices were facing for the three financial years from 2015/16 to 2017/18.

She welcomed NHS England and CCG staff working closely with practices affected to provide more transparency over how the increased service charges were calculated, and said that many practices had been able to negotiate down the fees they faced during this process.

The LMC will continue to negotiate over the total fees practices will be charged in future, and is in the process of confirming that agreement to the three-year write-off of outstanding service charges will not prejudice future talks, or constitute agreement that practices accept the service charges are fair as they stand.

As many as 60% of the 40-odd practices in Northumberland were affected by increased service charges, Dr Lothian said.

'Some practices feel they have now got to a postition they can accept,' she added. 'We are still facing significant extra costs for this year and going forward, and we are still working on that with the CCG. But at least the situation for past three years has been clarified.

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