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On 9 May 2024, the Department of Health and Social Care published the National Health Service (General Medical Services – Premises Costs) Directions 2024 (the 2024 Directions), taking effect from 10 May 2024 and replacing their 2013 counterpart. Changes under the 2024 Directions are long-awaited, having formed part of the GP Contract in 2019.

Key Changes

One of the largest changes relates to development and improvement grants for GP premises. Under the 2013 Directions, Commissioners were only permitted to award grant funding of between 33% and 66% of a project's value. However, under the 2024 Directions, grant funding awarded by Commissioners (including ICBs) can now cover up to 100% of the value of a project.

The changes will apply to a broader variety of developments and improvements than those under the 2013 Directions, including:

  • The building of new premises,
  • purchase of land or premises,
  • development of premises,
  • sale and lease-back; and
  • improvements which are to be the subject of a premises improvement grant application (including fit-out works and works required by regulatory changes).

These changes are viewed as a positive step in advancing services and providing the best possible care for patients. However, there will be no additional funds for ICBs under the 2024 Directions, raising concerns at a lack of resources to support the changes.

Further to this, any overpayments made in relation to grant funding will now be recoverable by NHS England. However, NHS England will be required to consider and agree a payment plan where appropriate and retain a right to waive repayments where reasonable to do so.

Other notable changes include:

  • Applications for financial assistance towards rental costs may include the cost of premiums paid to developers, so long as such a premium has the effect of reducing the rent payable over the lease term.
  • Contractor's leasing premises must use reasonable endeavours to ensure that VAT is not charged on rent by the landlord. However, NHS England will have the discretion of whether to reimburse any VAT where a provision to exclude VAT is not agreed.
  • NHS England may assign a lease to an NHS England nominee in the event that a partner wishes to retire but cannot find a suitable successor within the practice, targeting the issue of being 'last partner standing'. The Directions require NHS England to release a protocol setting out the criteria to determine whether a lease should be assigned in such circumstances.

If you are interested in learning more about the impact of the 2024 Directions, please do contact us.