Boosting GP Practice income in challenging times

gp notional rent

During these difficult times, the attention of GP practice teams will understandably be focused on supporting the health needs of patients and adapting to the evolving nature of General Practice delivery. However, financial questions will understandably have arisen, with many practices under additional pressure owing to the knock-on effects of COVID-19.

Receiving the appropriate practice income

Now more than ever practices must make sure that they are receiving the appropriate income. As part of this process it would be highly advisable for GP practices to ensure that the Notional Rent the surgery receives is fair and reasonable and in line with other surgeries.

Checking and challenging a GP practices Notional Rent figure

Under the terms of the GP contract, practices are entitled to obtain a second opinion of District Valuer Services (DVS) valuation. A practice has three years to appeal the proposed figure, providing they do not accept. The three years starts from the date stated on a practice’s Notional Rental figures letter (CMR6). When seeking a second opinion on the valuation, it is highly advisable to use an experienced Chartered Surveyor who specialises in primary care premises.

It is important to be aware that the DV’s Notional Rent valuation is purely their opinion of the value of the practice premises and this can be challenged. However, a challenge must be supported by comparable evidence of rentals prevailing on other primary care medical properties in the locality. This evidence is not widely available in the public domain, hence the need for an experienced, specialist firm to undertake this work.

Once a surveyor is instructed they will check your Notional Rent figure and you will either be given reassurance that your reimbursement is at the correct level or you will be advised that a challenge would be worthwhile.

Successful Notional Rent challenges

If the challenge is successful, NHS England should begin to pay the practice the increased Notional Rent accordingly. Successful challenges are backdated to the practices review date and the practice should receive the back pay accordingly.

Practices should seek a second opinion from a specialist surveyor every time they receive a new Notional Rent figure from NHS England (usually every three years). Even if a practice has not made any physical improvements to the premises, its value can be increased by other external factors. A surgery’s value may have simply gone up with the market, which can change significantly over three years. During this period, a specialist surveyor is likely to have gathered additional up-to-date comparable evidence, which can be used to support a challenge for an increase. Even if a practice received a large Notional Rent increase last time, they should still seek a second opinion.

Notional Rent increases

GP Surveyors negotiate average Notional Rent increases of 9%* per surgery, over and above the DVS initial valuation. Some Notional Rent cases result in increases vastly above the average.


*Statistics based on agreed figures from 2016-2018.