Understanding and Maximising Your GP Surgery’s Notional Rent

If your GP partnership owns its premises, you’ll be aware of Notional Rent – the reimbursement mechanism by which NHS England compensates GPs for using their premises for approved NHS services. But do you know if you’re getting the maximum reimbursement due to you? Recent market shifts have underlined just how crucial it is for practices to keep a close eye on their Notional Rent valuation. In this article, we’ll guide you through the basics of Notional Rent, how it’s calculated, when it’s reviewed, and how to challenge an assessment if you think it might be too low.

What Is Notional Rent?

Notional Rent is essentially an agreed amount of money that NHS England pays to GP practices that own their surgery buildings. This sum reflects the property’s Current Market Rent (CMR)—what the premises could reasonably command in the open market under a standard set of lease terms (typically a 15-year term, with the tenant responsible for internal repairs and the landlord responsible for external and structural repairs and building insurance).

Several factors influence the CMR, including:

• Property Characteristics:

  The size, age, and quality of the building.

• Condition & Maintenance:

  How well the property is maintained and presented.

• Local Market Comparisons:

  The going rate for similar GP surgeries in the area.

• Recent Improvements:

  Any modifications or capital investments that enhance the property and increase its value.

How Often Is Notional Rent Reviewed?

By default, Notional Rent is reviewed every three years to ensure practices receive an amount aligned with current market conditions. However, an earlier review may be triggered if:

• The building’s use changes significantly (e.g., expanded services, new clinics, or other NHS-related purposes).

• You’ve made further capital investments (e.g., major renovations or extensions) that could affect the property’s valuation.

Practices often receive forms (commonly referred to as CMR1 or Prem1 forms) from NHS England or their local commissioning group, prompting them to submit updated information about the premises. A District Valuer (DV) - usually from District Valuer Services (DVS) - is then appointed to assess the CMR (and consequently your Notional Rent figure). After their review, you’ll receive a “Notional Rent determination letter,” letting you know the new reimbursement amount.

Why You Might Want to Challenge Your Valuation

It’s not uncommon for GP surgeries to feel the District Valuer’s figure is lower than the property’s true market value. Indeed, many practices find that challenging a DV assessment can yield a higher Notional Rent - often adding up to substantial backdated increases.

If you suspect your reimbursement is undervalued, consider these steps:

1. Obtain a Second Opinion You’re contractually entitled to seek an independent valuation. Look for a surveying firm with primary care expertise, as they understand the nuances of healthcare premises and have access to local comparable evidence.

2. Notify NHS England of Your Intention to Appeal You can do this at any point within three years from the date on your Notional Rent determination letter, provided you haven’t formally accepted the figure. Some local commissioners may tell you that you have only three months to appeal, but contractually you have up to three years in most circumstances.

3. Authorize Your Surveyor Once you’ve engaged a specialist, formally let NHS England (or your local commissioner) know they’re representing you. The surveyor then liaises directly with the DV to negotiate a potentially higher reimbursement.

4. Agree on a Revised Valuation If negotiations are successful, the revised Notional Rent is usually backdated to the start of the relevant review period. This can result in a significant lump-sum payment for your practice.

Key Considerations

• No Win, No Fee Arrangements: Many specialist surveying firms operate on a commission-based model, charging only if they successfully increase your Notional Rent.

• Review All Notifications: Keep an eye out for CMR or Prem forms - late submission can delay your review and any potential backdated payment.

• Documentation: Ensure you maintain accurate records of any building changes or improvements; this helps demonstrate the increased value of your property.

• Stay Proactive: If you haven’t seen a new Notional Rent figure in the last three years, contact NHS England or your local commissioner to confirm when your next review will take place.

Real-World Payoffs

With rising construction costs and inflation, real estate specialists are reporting that GP surgeries often undervalue their reimbursements if they rely solely on initial DV assessments. Some practices report increases of up to 8% or more when valuations are challenged and negotiated by a specialist. This can translate into a five-figure additional payment over the three-year Notional Rent period—no small sum in today’s challenging healthcare environment.

Considering Outside Expertise

While this article is not sponsored by BWH Surveyors, one of the co-founders of My Practice Manager has used them on several occasions in their own practice. They have been knowledgeable, fast, and efficient, offering a commission-based pricing structure where they charge a percentage of the extra rent they manage to negotiate. If you’re contemplating an appeal, you may want to consider using a specialist surveying firm like BWH Surveyors to maximize your outcome.

Final Thoughts

Securing the highest possible Notional Rent isn’t just about extra income - it can significantly affect the financial sustainability of your practice. With GPs under pressure to offer more services and face rising costs, every avenue of fair reimbursement counts. By understanding how Notional Rent is calculated, knowing when to seek an appeal, and engaging the right expertise, you can ensure your practice gets the income it rightfully deserves.

If you’re unsure of your current Notional Rent status or think you’re being underpaid, take action now—the next review might be just around the corner. And if your practice hasn’t had a Notional Rent review in some time, reach out to your local commissioner to make sure you’re not missing out on valuable reimbursement.

Disclaimer: This article is provided for general information and does not constitute legal or financial advice. For specific guidance tailored to your circumstances, consult with a qualified surveyor or relevant professional.