Premises
GP premises
PCC supports commissioners, primary care teams and provider organisations to navigate the increasingly complex landscape of GP premises funding, commissioning and contractual requirements.
Effective management of GP premises is essential to ensuring practices can continue to provide high-quality services and respond to changing population needs. This requires a clear understanding of premises ownership models, rent reimbursement arrangements, capital grants, leases, the National Health Service (General Medical Services Premises Costs) Directions and the wider guidance that governs GP premises.
PCC provides practical support and expert advice across all aspects of GP premises management, helping organisations to address challenges, reduce risk and make informed decisions. Our support is available through a national programme of training and events, locally delivered workshops, specialist advice services and access to experienced premises experts.
Local workshops and one to one support
Our premises team can deliver a range of workshops for your organisation, neighbourhood, place or system Whether you are developing neighbourhood hubs, exploring co-location opportunities, planning estate transformation, or managing existing primary care premises, we can provide practical and strategic support.
Workshops can be delivered virtually or face to-face and can be tailored to local priorities and challenges.
We also offer:
- One-to-one support and mentoring for new team members
- Development of standard operating procedures to manage GP premises reimbursement and developments
- Bespoke virtual sessions focused on specific estates or premises issues
- Facilitation and expert input at neighbourhood, place or system meetings
To discuss your requirements, please contact enquiries@pcc-cic.org.uk.
Training and support for commissioners, providers and neighbourhood teams
PCC delivers a national training programme to support organisations responsible for planning, commissioning and managing health and care estates.
Courses are delivered virtually, with full details available through our events page.
- Building the future: premises planning for neighbourhood health centres – this workshop, delivered in conjunction with Mills Reeve is designed to support integrated care board (ICB) commissioners and estates teams in navigating the complexities of planning and delivering successful neighbourhood health centres.
- Understanding GP premises: a practical introduction – an online workshop that provides a high-level introduction to the management of the GP estate. The session explores different ownership and occupation models, premises funding arrangements, and the reimbursable premises costs that contractors are entitled to receive, in line with the National Health Service (General Medical Services Premises Costs) Directions 2024 (PCDs).
- GP premises reimbursement explained: requirements and practical application – an online workshop exploring reimbursement mechanisms, funding arrangements and the regulatory framework governing premises costs.
- Navigating GP premises capital grants: framework, funding, and abatements – a workshop run over two sessions examining the opportunities and processes associated with estate improvement schemes, capital investment and premises development. Delegates will gain insights into the requirements for securing funding and delivering estate transformation projects.
- GP premises dispute resolution for commissioners – a practical workshop focused on managing disputes relating to premises reimbursements and associated contractual matters. Participants will gain an understanding of dispute resolution processes, governance requirements and the steps commissioners should take when handling premises-related disputes.
PCC premises helpdesk (annual contract holders only)
Commissioners who have specific commissioning and contract queries in relation to the GP premises matters can submit queries to PCC’s expert premises team via our online helpdesk https://helpdesk.pcc-cic.org.uk/
PCC’s medical and premises surgery sessions (annual contract holders only)
PCC hosts quarterly expert surgery sessions where commissioners can discuss medical contracting and estate challenges, seek advice on complex issues and share learning with peers. Sessions also cover emerging national policy developments and their local implications.
Training and support for practices
Understanding premises matters is a key component of general practice management. Yet many practice teams have not been afforded the time or opportunity to understand the regulatory requirements and practical application of the reimbursement of premises costs.
PCC can equip your practice teams with the knowledge and tools needed to navigate the complexities of premises management effectively.
Our bespoke training packages can include:
- Regulatory requirements – an overview of the regulatory framework governing premises funding and estate management, including the National Health Service (General Medical Services Premises Costs) Directions and related guidance.
- Ownership and occupancy models – an introduction to different ownership, leasing and occupation models, together with the funding and reimbursement arrangements associated with each approach.
- Premises reimbursement processes – a practical guide to reimbursement mechanisms, local processes and timelines, providing insight into the requirements associated with premises funding.
- Capital funding and estate development – an introduction to the NHS capital grants process and requirements set out in the National Health Service (General Medical Services Premises Costs) Directions and related guidance.
- Neighbourhood health estates planning – support for practices and neighbourhood teams to understand how estates can enable integrated, multidisciplinary care, including co-location opportunities, neighbourhood hubs and flexible use of community assets.
If you are interested in discussing how we can support with premises training, workshops or strategic advice for your practices please get in touch – enquiries@pcc-cic.org.uk.
Further resources and updates
Premises related terms and acronyms
PCC has developed this document to provide commissioners, GP practices and other NHS stakeholders with a clear and consistent reference guide to commonly used premises-related terms and acronyms. The NHS estate is supported by a complex framework of property, funding, valuation, leasehold and compliance arrangements, and understanding the terminology associated with these areas is essential for effective decision-making and service planning.
Empowering primary care infrastructure development with Section 106 funding solutions
Primary care plays a crucial role in ensuring the health and well-being of our communities. High quality premises are the cornerstone of patient care. It therefore essential to secure available funding sources. This is where Section 106 and Community Infrastructure Levy (CIL) funding come into play. Read more to understand why to engage with local authorities and how to access support to gain these funds.
Primary Care Utilisation and Modernisation Fund 2025/26
In the autumn budget the government announced specific funding of £102 million for primary care estates.
The capital funding guidance 2025/26 provides further information. Funding will be managed in accordance with the National Health Service (General Medical Services Premises Costs) Directions 2024. Proposals should align with local integrated care system infrastructure strategies (2024), PCN estates needs toolkit (2022-23) and prioritise high-quality, fit-for-purpose estate (classified as “core” or “flex”) over “tail” assets. Schemes must be deliverable by March 2026, and approval will depend on value for money and measurable patient benefits, including increased clinical appointments.
PCC can help with supporting ICBs and practices through the process. Our expert team has a proven track record in helping practices develop credible and compelling and business cases and project initiation documents (PIDs), as well as support ICB teams with the application process and steps to project implementation. To find out more information please contact enquiries@pcc-cic.org.uk.
ICBs will also need to ensure that they are following the guidance set out in the primary care capital grants policy published in July 2024 (updated in October 2024).
New Premises Costs Directions
The long-awaited National Health Service (General Medical Services Premises Costs) Directions 2024 (PCDs) came into force on 10 May 2024. The new directions supersede all previous versions of the directions and set out how payments should be calculated and made to general practice contractors in respect of premises costs. PCC has summarised the main changes. A useful summary and guide to the changes is also available on NHS England’s website.
Rent review memorandum
A rent review memorandum is a key document with its purpose to accurately record and update changes in rental amounts as specified in the lease agreement. In this article we consider the relevance and importance of a rent review memorandum in the rent review process for leasehold premises. Read more.
Sale and lease back
Sale and leaseback is being seen as a recognised method for retiring or other property-owning partners to obtain a capital receipt from a previous investment and can be a solution for partnerships to resolve issues such as succession planning and recruitment. We consider the steps and processes practices need to consider before actioning a sale and lease back. Read more.
Energy Efficiency Standards and how they may impact on GP premises
Contractors who lease their premises should ensure that their landlords are compliant with the minimum energy efficiency standards. In this article we look at the purpose and requirements around the energy performance certificate (EPC). Read more.
Blog series: Primary care estate – what does the future hold?
In response to the Health and Care Act 2022, which received Royal Ascent in April 2022, PCC is pleased to publish a series of blogs that put the spotlight on the opportunities presented by of system-owned and -controlled assets. With thanks to NHS England for their support in curating this series.
Build back healthier: the role of NHS estates in population health (Michael Wood)
Supporting the green agenda with our primary care estate (Jacqui Bunce)
‘One stop shops’ and community activation in Derby City (Tina Brown)
How can our primary care estate help with addressing inequalities? (Mark Harrod)
System controlled assets and customer focussed delivery (Philip Roberts)
No more quick fixes: how system ownership can foster stronger partnership working (Nicki Collas)
Sharing estate beyond health colleagues (Claire Darbyshire)
“Up against the wall”: barriers presented by the current GP estate (Carla Ingram)
The long-term plan is a pipedream without changes to asset ownership (Dr Riten Ruparelia)
Primary and community care after COVID-19 – What next? (Jo Fox)
Tackling health inequalities in Plymouth (Richard Ayres)
The opinions expressed in this publication are those of the authors. They do not purport to reflect the opinions or views of PCC or NHS England.
Premises owner-occupier legal advice – April 2021
It is becoming increasingly common for retiring GPs to maintain ownership in their former practice premises alongside the current partners. In these circumstances it would be good practice to formally document the occupancy arrangements between the contractor and the ex GPs. It has previously been agreed that for the purposes of rent reimbursement, this arrangement can be treated as being owner-occupied and be paid notional rent. Increasingly however, parties to this type of arrangement want to formalise the agreement and sign up to an actual lease. At the time that the Premises Costs Directions (PCDs) were first published, in 2004, this type of arrangement was not envisaged and a definition of owner-occupier was not included. This increasingly common situation has resulted in a lack of clarity as to what type of reimbursement should be made by the commissioner, notional rent or actual rent. NHS England took legal advice on the matter (April 2021) and the opinion of the lawyers was that if the parties want to formalise their occupancy arrangements by way of entering into leasehold arrangements then the contractor should be reimbursed leasehold premises rent under Direction 32. If they are happy to occupy the premises under a, less formal, occupancy agreement then the contractor should be reimbursed notional rent in accordance with Direction 42.
