2025/26 saw a welcome boost to the capital funding available for GP premises with £102million for premises improvements through the Utilisation and Modernisation Fund. Reflecting on the process during 2025/26 we consider what have been the lessons learnt, so that we can take onboard for future years.
Helen Simmonds
One of the most common themes we heard while 2025/26 was delays in the process due to issues relating to ownership, lease arrangements and property rights.
A clear and robust understanding of the legal status of the premises is essential before any NHS capital funding is approved. Issues relating to ownership, lease arrangements and property rights are among the most common causes of delay in GP capital schemes. Both practices and integrated care boards (ICBs) need confidence that the organisation receiving funding has the legal authority to deliver the project and meet the ongoing obligations attached to it.
Ownership structure
The starting point is to establish who owns the property. GP premises can fall into several categories:
- GP partner-owned (freehold or long leasehold)
- Third-party landlord-owned (leased premises)
- NHS-owned estate (e.g. NHS Property Services or Community Health Partnership buildings)
For example, in leased premises, the GP practice may not have full control over the building, which can limit what works can be carried out.
Lease arrangements and security of tenure
Where a practice occupies a leasehold property, the length and terms of the lease are particularly important. ICBs will expect assurance that:
- The lease is long enough to cover the required minimum use period of the grant
- The practice has security of tenure – the legal right for a tenant to continue occupying a property for a specified period, with protection against eviction or non-renewal except under defined conditions.
- The lease permits the proposed works for example structural alterations or extensions
Short or restrictive leases can present a significant risk, as they may not provide sufficient certainty that the NHS will benefit from its investment over time.
Landlord consent
If the premises are leased, formal landlord consent is usually required before any capital works can proceed. This may include approval of the design and scope of works and agreement to structural changes. Without this consent, projects cannot move forward. It is therefore essential to engage landlords early and ensure their cooperation.
Title checks and site constraints
For both freehold and leasehold properties, appropriate title checks and due diligence must be undertaken. This helps identify:
- Restrictive covenants, for example limitations on use or development
- Rights of access
- Boundary issues
- Planning or zoning constraints
Unresolved issues can impact the viability or cost of the project and may prevent funding approval if not addressed.
Ability to grant a legal charge
Any capital funding over £144,000 require a legal charge over the property to protect public investment. This means the funding body has a secured interest in the property and there is a mechanism to recover funds if conditions are breached (e.g. sale, change of use)
To facilitate this, the practice must have sufficient legal interest in the property and obtain consent from any existing lenders or landlords. If a legal charge cannot be granted, funding may not proceed.
Alignment between legal and operational responsibility
It is important that the organisation responsible for delivering the project also has appropriate legal control of the premises. In general practice, this alignment can sometimes be complicated by historic arrangements, particularly where former GP partners remain named on leases or property titles. This misalignment, where individuals no longer involved in the practice still hold legal interests can create challenges around:
- Decision-making (e.g. who has authority to approve works)
- Accountability (e.g. who is responsible for obligations under the lease or funding agreement)
- Compliance with grant conditions (e.g. entering into legal charges or meeting minimum use requirements)
Before progressing a capital scheme, practices should ensure that legal documentation reflects the current partnership structure, and that all parties with a legal interest are identified and engaged. This may require:
- Updating lease arrangements or partnership agreements
- Securing consent from former partners or removing them from the title/lease where appropriate
- Putting in place clear agreements between all relevant parties
Addressing these issues early helps avoid delays during approval and ensures the NHS investment can be properly secured and managed.
Helen Simmonds, adviser, PCC
Find out more about how PCC can support with the development of capital bids, and other primary care estate matters enquiries@pcc-cic.org.uk.
