The findings from the BMA’s 2025 GP premises survey reveal widespread concern about the state of the primary care estate in England. These concerns are far from new; they echo the conclusions of the Darzi independent review in 2024, which found the primary care estate ‘unfit for purpose’.
Key findings
The survey reveals that half of GP premises are not suitable for current needs, and a staggering 83% are unfit for the future. Space constraints are acute: 74% of practices lack the room to train new GPs, and 83% say they cannot accommodate additional primary care network (PCN) staff. These limitations directly undermine the government’s ambition to deliver more care in the community and to expand the primary care workforce.
Staff welfare is also at risk. Respondents described kitchens that fit only one person, converted containers as staff rooms, and a single toilet for dozens of staff. Such conditions are not conducive to staff wellbeing or retention and the integration of new roles and services.
Investment and grant applications
The estate is ageing with 71% of main sites are over 26 years old, and many have not seen significant refurbishment in decades. While some practices have secured grants for modernisation, 42% of recent applications were rejected, and most were for less than £150,000. This points to a chronic underinvestment that threatens the sustainability of general practice.
NHS Property Service (NHSPS) and Community Health Partnerships (CHP) and the service charge crisis
Service charge disputes with NHSPS and CHP are destabilising practices. Over 65% of NHSPS tenants and 74% of CHP tenants have received incorrect invoices, with many facing unsustainable financial pressures. Some practices are even considering handing back their contracts due to unresolved debts and unpredictable costs.
The BMA concludes that the current model of ownership of Department of Health and Social Care premises – managed by NHSPS and CHP – has not worked for the practices or for patients and calls for an urgent review of alternative ownership models.
BMA recommendations
The BMA calls for three urgent actions:
- Targeted investment in GP premises (including non-clinical spaces), helping to support workforce development and retention
- Unlocking capacity through digitisation of records, improving operational efficiency and freeing up space
- Reforming service charge and ownership models
Comment
Given the government’s commitment to shift care to the community, investment in GP premises is essential. Without it, the ambitions for integrated, patient-centred care will remain out of reach, and the primary care estate will continue to fall short of a modern health and care system.
This article was originally published on Mills & Reeve’s website. Read the full version here. If you require support from a legal team with your GP premises or grant applications – do contact Jennifer Lewis.
PCC can act as an honest broker to help review service charges, can help practices develop business cases and project initiation documents and help integrated care boards to appropriately manage investment in primary care premises. Contact enquiries@pcc-cic.org.uk or visit https://pcc-cic.org.uk/premises-practices/ to find out more.
