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Extending surgery

Q: I own surgery premises with cramped conditions. I have planning permission to extend, which would cost approximately £70,000. As PCTs are cash-strapped, I have little hope of getting an improvement grant. However, I am happy to borrow the money. After the extension is built, will I automatically get higher rent or do I have to seek permission beforehand? Can a PCT refuse any rent assessments altogether?

A: The rules relating to rent reimbursement appear in part 5 of the NHS (GMS Premises Costs) Directions 2004. Paragraph 41 notes among other things that, where you incur borrowing costs as a result of purchasing a building or significantly refurbishing practice premises but have not elected to receive any payments from the PCT, the PCT must consider an application (having regard among other matters pertaining to the budgetary targets it has set) and make notional rent payments.

There are two key elements here in that, first of all, the PCT will have to be satisfied that the additional refurbished accommodation is essential for you in order to carry out your proper GMS services.

If it approves this, then it would normally reimburse the additional notional rent, although it always has the ability to claim that it does not fall within its budget. If it claims the latter, but accepts that it is required for GMS purposes, then there would be little excuse for it not including the additional notional rent in budgets for future years.

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