GP leaders warned practices are 'bursting at the seams' and called for clear NHS policy on premises expansion.
Delays in approving bids for extra funding threaten to kill off expansion projects, leaving CCGs unable to shift work into the community, experts warned.
Delays have occurred because PCTs are 'scared' to sign off rent reimbursement deals extending beyond April, when trusts will be abolished.
Birmingham LMC executive secretary Dr Robert Morley said that within Birmingham and Solihull NHS Cluster, several business cases for new premises and rent increases had not been signed off.
'It is an absolute shambles at a time when GPs are encouraged to take on more work,' he said. Dr Morley added that some practices had applied for rent increases to allow them to use rooms in health centres vacated by other services.
'Premises are now lying idle,' he said. 'We can't utilise them unless our expenses are covered.'
Dr Morley's Birmingham practice has been waiting since September for approval to expand its minor surgery and consulting rooms.
In some cases, DH officials are understood to have stepped in after PCTs refused to authorise rent reimbursements beyond 1 April, asking them to sign off the requests.
John Hearle, joint chairman of the Primary Care Premises Forum, an association of private sector representatives with specialist knowledge, said NHS reform had created uncertainty over premises. 'Nobody seems to know who will sign things off. There is a huge backlog that has been going on for 18 months.'
He added: 'The fear is that nothing has been put in place and all these projects will flounder around, potentially for months, which could result in some being killed off. PCTs are scared to sign them off, and there are a lot of fed-up GPs.'
GPC negotiator Dr Chaand Nagpaul said the DH needed a clear strategy to move care into the community. 'General practice is bursting at the seams,' he said. 'Many practices cannot offer surgeries and appointments because of lack of space, never mind expanding.'
A spokeswoman for NHS England (formerly the NHS Commissioning Board) said its area teams would handle rent from 1 April. Birmingham and Solihull NHS Cluster had yet to reply as GP went to press.