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Medical Centre Development – What Does The Future Hold For You?

The future will take you to a crossroads full of options and deliberations. What is inevitable for a GP owner is the plethora of decisions that need to be made.

This maybe something that keeps you awake at night or something that you can’t let go of during the day. The solution is to have a conversation with someone who can assist and listen. Where do you start? What are the current issues that can become troublesome, when they form a continuous train of thought, day in, day out.

Whether considering new surgery premises, broadening your current service provision or exit options, it can all add up to a constant whirl of deliberation and calculation.

What anxiety is presented to you at your crossroads at the moment?


1) The Current Surgery Environment

Maintaining the current surgery can be an initial first port of call, but for many surgery buildings they are not CQC compliant. What has to be assessed is the delivery of the service, not necessarily the building.

Older premises may not be able to serve a community that they once did with warmth and spirit. There may be limited disabled access, lifts not being implemented within Grade II buildings and the once charming rooms just aren’t right for the mid part of this decade.

So, what are the options for the current surgery:

  • extend and develop the current surgery premises
  • identify further service provision and retain the freehold to create rent off the existing building (to maximise return)


2) Look At New Premises

A longer-term vision could be to have the desire to embrace new premises within a suitable location. The ultimate dream can be a modern space that has longevity, low maintenance and low running costs. More importantly the new practice becomes an asset to the community.

The wish for new premises could be high on the agenda and to sleep better at night, the attainment of a contemporary space would solve those taxing moments.

So, what are the options to having new premises:

  • continue working within existing premises with a view for a new space
  • work with a team to find a new site
  • move to new premises that delivers the right product for the locality
  • existing premises are planned for best alternative use value (or retain as an investment)

Once a new space is identified then the next consideration is to maximise alternative use value so the old premises are dealt with in the best way.


3) Identify A Successor

It may be business as usual within the current surgery premises, but consideration may start to be given to finding a successor. Where do you start?

If the current surgery is not CQC compliant, is a successor going to buy into an environment that is substandard and inherit a large debt from an Evergreen Loan, within deteriorating premises that requires a modern service? It can take considerable investment to bring to CQC standard. There needs to be a way that is identified for someone to eventually take over the building.

So, what are the options to identifying a successor:

  • carry on working and try to recruit a future partner
  • identify a future partner on a leasehold basis where they are not having to buy into the premises
  • organise a new site for a successor and create an exit strategy, whilst the community still has a reliable GP facility


4) Exit Strategy

Exiting a problem and disposing of the challenges can become the biggest release of worry and uncertainty.

If you have a desire to exit, who will take on the premises? It could become residential use, as long at the value is able to clear the debt. A change of planning use can provide alternatives. There are many uncomfortable decisions to confront.

Many surgeries just aren’t practical for their community anymore. If surgeries are to remain the heart of a community, they need to serve it well. The consideration for an exit strategy may become ever more real. The ideal scenario is when you exit, you have a successor and the surgery has a GP providing services at the time when you leave.

So, what are the options for your exit strategy:

  • retire and hand contract back to the NHS
  • someone to purchase existing premises
  • relieve further investment into premises that you have accountability for


The solution for any anxiety, uncomfort, concern and distress is to start with a conversation with someone who understands the issues that you currently face.

To live a live of fulfilment and to achieve the goals that you may have, no GP can attain this without the assistance and support of others. To begin a dialogue with someone who can empathises, listen and to build a relationship can become the answer to the sleepless nights and the disturbed moments during the day.

Your first small step for change begins with a discussion. If you’d like to have that chat call Jonathan on 01202 744990 or email jon@charleshiggins.co.uk



“To end my working days in such a place considering that 31 years ago when I started we worked from two very small rooms. It’s been magnificent.”

Dr Geoff Walder, Retired Senior Partner, Lilliput Surgery, Sandbanks

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© 2013 Charles Higgins