GP practices must make sure that they are receiving the appropriate income, part of this process should be ensuring that the Notional Rent the surgery receives is fair and reasonable in comparison with other surgeries. Paul Conlan explains just what a Notional Rent appeal involves.
The Notional Rent valuation that a practice receives from NHS England is usually carried out by District Valuer Services (DVS) and the figure is purely their opinion of the value on your premises. Under the terms of your GP contract, you are entitled to get a second opinion of your valuation. When seeking a second opinion on the DVS valuation it is highly advisable to use a specialist primary care surveyor.
Following your surveyors’ assessment of your Notional Rent, 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.
When should your practice seek a second opinion on their Notional Rent?
GP 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 you haven’t made any physical improvements to your surgery premises, its value can be increased by other external factors. Your surgeries’ value may have simply gone up with the market, which can change significantly over three years. During this period your surveyor is likely to have gathered additional up-to-date comparable evidence, which can be used to support an appeal for an increase. Even if the practice received a large Notional Rent increase last time, you should still seek a second opinion.
How does your practice challenge its Notional Rent?
If your surveyor believes that your practice is being underfunded, they will advise you to notify NHS England that you plan to challenge. You will need to provide NHS England with your surveyor’s details so they are authorised to proceed with the case on your behalf. You should also advise NHS England that your surveyor will provide them with reasons for the challenge including comparable evidence.
How long does your practice have to appeal?
NHS England will sometimes inform you that your practice must submit your appeal within a specific time frame, which is commonly three months. However, contractually you have three years to appeal, from the date stated on your rental figure letter.
If NHS England tells you that you cannot appeal because you have not notified them within the correct timescale, please speak to your surveyor who will advise you further.
What does the Notional Rent appeal process involve?
Once you have notified NHS England that you plan to appeal your Notional Rent and have appointed your surveyor, the practice doesn’t need to have much direct involvement with the appeal process.
Your surveyor will present your case for a Notional Rent increase to NHS England and the District Valuer (DV). This will include providing a valuation of the surgery and supporting comparable evidence on similar premises, in similar condition and location. Therefore, it is advisable to use a specialist surveyor who has experience in the primary care sector, specifically with Notional Rent appeals. This should ensure that they have the necessary comparable evidence available. The more specific and up to date the evidence the better.
In the majority of cases, these negotiations will continue until an agreement has been reached with the DV, at which time your surveyor will notify you of the outcome.
What happens if your surveyor and the DV do not reach an agreement?
If your surveyor takes on your appeal but is unable to reach an agreement with the DV, they can refer the case to NHS Resolution for a decision. NHS Resolution will check that all possible efforts have been made to resolve the case at a local level before providing a final determination. This process should require minimal input from your practice, as it is usually managed by the surveyor directly. All the practice need do is provide their surveyor with a copy of their GP contract and authority to act.
What happens if the Notional Rent appeal is successful?
If the appeal is successful, NHS England should begin to pay you the increased Notional Rent accordingly. However, it can sometimes take a few months for this to happen and NHS England may need to be chased.
Successful appeals are backdated to your review date and your practice should receive the corresponding back pay accordingly. For example, if the appeal is successful a year after you were initially given your new Notional Rent figure, then you should receive back pay for that year as a lump sum and an increase in monthly payments up until your new review in two years.
What should practices do if they are unhappy with the result of the surveyor’s review?
If your surveyor is unable to achieve a reimbursement increase, following their initial valuation and before negotiating with the DV, nothing is stopping you from speaking to another specialist for their opinion.
How much can practices expect their Notional Rent to be increased by following a successful appeal?
In the previous three years (2016-2018) GP Surveyors negotiated average increases of 9% per surgery (over and above NHS England or the Health Board’s initial valuation). This amounts to an average increase of £10,939 over the three-year Notional Rent period.
Some of our Notional Rent cases have resulted in increases amounting to five-figures a year. Which goes to show the importance of seeking a second opinion on your Notional Rent figure.
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