Hundreds of surgeries that rent premises from the NHS have been hit by the increased charges. Practices say they may have to close or else cut back on nurses and doctors. Some surgeries that have refused to pay the invoices have been sent letters threatening legal action and the use of debt collection agencies. The demands are being made by NHS Property Services (NHSPS).

NHSPS is a limited company owned by the Department of Health. It is headed by Elaine Hewitt, a former BT executive, who was paid more than £265,000 in 2015-16, including a bonus of more than £65,000. The organisation, which has a £3.5bn property portfolio and covers about 10% of the NHS estate in England, took over the property management of about 1,400 GP practices when primary care trusts were abolished in 2013.

Practices facing demands of up to £100,000 in extra maintenance costs complain that the charges are unfair and unjustified. They also say that some of the figures have been miscalculated.

“We can’t pass on these costs to the customer — the only way for us to sustain ourselves is to cut services,” said Gaurav Gupta, a GP who is part of a British Medical Association team disputing the charges, formed after doctors started disputing the increased fees; it is overseen by the British Medical Association (BMA), the doctors’ union.

“This is an NHS body trying to run NHS practices out of business. It’s complete madness — it should never have got to this stage.”

NHSPS says it has increased what were traditionally low service charges to reflect more accurately the maintenance costs at practices. GP practices have their rents reimbursed by the NHS, but pay service charges out of their own budgets.

GPs say the increases have been introduced too fast and many of the charges have been “plucked out of the air”.

Among the hardest hit is Shepperton Medical Practice in Surrey, which is facing about a 1,000% rise. It has been billed an extra £100,000 in backdated service charges, more than 11 times last year’s costs, with another £100,000 charge to follow next year.

The surgery said it might be forced to close if the bill was not reduced.
“They’ve increased the service charges out of all proportion to what they’re actually providing,” said Simon Bellamy, a GP at Shepperton. “They appear to have stuck a finger in the air and come up with a sum, basically. If we have to pay all of that money then the practice won’t be viable — we won’t be able to provide the service any longer.”

Bellamy added that 19 of the 48 practices in his area were facing similar charges from NHSPS. NHSPS said the bill sent to Shepperton was incorrect and it was meeting the GPs to discuss the fees.

Kent Mullis, 70, from Leigh-on-Sea in Essex, is a patient who has been campaigning against the charges. His local practice, Valkyrie Surgery, closed one of its premises in September, partly blaming the NHSPS which had increased its bill by thousands of pounds.

NHSPS now says the figures were incorrect, according to the practice.
Mullis said the charges were disgraceful. “I can’t understand why one part of the NHS is ripping off another part of the NHS,” he said.

Evergreen Practice in Bracknell, Berkshire, had service charges increased by 320% from £14,976 in 2015-16 to £62,916 this financial year. This included annual management fees which rose from £1,127 to £43,000.

Prash Nelli, a GP at Evergreen, said: “If this carries on we will have to shut down. And I don’t think other practices can survive either.”

Faversham Medical Practice in Kent says its service charge bill rose from £15,000 in 2014-15 to £60,000 in 2015-16 and then to £80,000 in 2016-17.
These included an increase in maintenance fees from £2,600 two years ago to £40,991 this year and an increase in electricity and gas charges from £5,000 to £12,000 over the same period.

Ian Hume, head of GP premises for the BMA, said: “NHSPS needs to reconsider urgently any charges it intends to levy if these are going to threaten the ability of that practice to deliver patient care.”

Surgeries standing up to their NHS landlord may face legal action. NHSPS threatened one GP surgery with “immediate referral to an external debt recovery agency” and “possible commencement of legal proceedings” if it did not pay up in seven days.

“This is a national issue affecting almost every GP practice which occupies NHSPS property,” said Victoria Armstrong, a partner at Sintons Law, a Newcastle-based firm helping practices to dispute the bills. “There is no real basis in most cases for the increased charges. Our advice is: don’t pay the increase. It would financially cripple practices.”

She said one practice with four partner GPs had received a backdated demand for £100,000. Some GPs had been sent the wrong invoices, while others had been charged extra for gardening and cleaning already covered by their rent.
NHSPS says it is increasing the service charges to reflect maintenance costs more accurately but is keen to address GPs’ concerns. It said: “We have been getting better information about the space our customers actually occupy and this is one reason why some are seeing costs increase and others reduce.