Money

The whole project is aimed to be substantially Cost Neutral to the GP’s.

The main practice costs will be for (this list is not exhaustive but main items) :

• Personal chairs to consulting rooms)_ (Existing Chairs & Couches Couches ) may be suitable)
• Legal advice (PCT usually pay for this)
  Project Manager / Survey / Advisor (PCT usually pay for this)
• Computers (PCT usually pay for this)

When a site and building layout has been finally agreed between all parties (GP’s PCT/DV) we will then discuss with the DV to agree figures for the gross internal floor area (GIA) that the building design proposes including expansion space. From this the net floor area (NIA) will be calculated by the deduction of staircases / structural walls / lobbies / plant rooms etc.

At this point we will have the NIA floor area that the NHS will reimburse to the practice by way of a notional rent which will be the same as the rent set in the lease document.

Once we have the rent agreed we can then finalise with our Funder, the development finance needed for the project.

Additional space can be constructed to provide for the future expansion. This can be made available at the same rate to the practice if required for non GMS use in the short term, and a plan can be worked up to provide additional space should the practice require additional GMS space or PBC space or private consulting room space. The options are available to be discussed.

Lease

The structure of the legal agreement is that we have two documents a Lease Agreement’ and a ‘Lease’. The lease agreement sets out what we agree to do and what you agree to do i.e .you agree to take a lease on the agreed terms if we deliver the property in the manner agreed as set out in the specification.

The lease is usually 20 Years on an Internal Repairing (IR) basis with 3 Year Rent Reviews. CHP insures the building and you are responsible for the insurance of the internal areas and fittings including Doors and glass in doors and windows.

Usually we agree Heads of Terms’ which are then submitted to the Lawyers to prepare the documents. A pro-forma set of ‘Heads of Terms’ is available for download.

A draft copy of a lease can be provided if required to see what is involved. There are a number of specialist Lawyers who are experienced in this area of the law and should be used to ensure that you are properly represented. It also makes our job a lot easier if your Lawyer knows what he is doing.

Development Risk

Always a concern to all of us. What are the risks to the GPs in entering into a development of this type. The GPs are agreeing to rent space in a completed building. If the building is not completed then they do not sign a lease and thus have no liability.

Between the GP lawyer, the investor lawyer (CHP) the Funder's lawyer the probability of the building not being completed is very slim. The Funder's have the rights to step in to complete the build contract, should the contractor fail during the construction process. All this is at the risk of the developer and not the GPs or the NHS.

GP Risk

The GPs agree to take a lease for 20 years. This they can pass on to a replacement GP or pass to the PCT whilst a replacement GP is found when they wish to retire or re-locate. As long as the practice is dealing with the patients and in receipt of NHS support for the delivery of the services there is not usually an issue with GP signatory departure as the rental income from the PCT is geared around the practice and not the GP. Thus, a salaried GP can take the place of a partner departing and the rental payments from the NHS will still continue to cover the rent payment for the premises. The Funder's do however stipulate a minimum number of signatories on the Lease, depending on the size of the practice.

Design of Facility

Please review Philip's planning rational as it gives a very good overview of the issues that need to be considered in designing the new premises. Apart from that and within the realms of reasonable cost and long term maintenance you can have a building style that you wish for. The internal layout will reflect how you run the surgery now but also having in mind that the layout must be flexible to allow for change of both delivery of services, personnel and ensure that it does not become obsolete. Plus of course it must have the approval of the PCT / NHS. The Planning Authority will also have an impact on the design etc!!!!

Disposal of / or exiting your existing premises

There are so many options available depending upon each individual situation. The key point is that we are pleased to discuss / review and generally assess the options and assist if you wish us to get involved in this aspect of the proposal.