Dear Colleague NATIONAL CODE OF PRACTICE FOR GP PREMISES GP PREMISES LEASED FROM PRIVATE LANDLORDS

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1 Population Health Directorate Primary Care Division Addresses For Action NHS Territorial Board Chief Executives Integration Authority Chief Officers For information NHS Boards Premises Sustainability Loan Coordinators NHS Board Primary Care Leads NHS Boards Heads of Estates Lead Co-ordinator, Practice Manager Network Chair, BMA SGPC Policy Enquiries to: Michael Taylor Primary Medical Services 1 Rear St Andrew's House Edinburgh EH1 3DG Tel: Michael.Taylor@gov.scot 30 August 2018 Dear Colleague NATIONAL CODE OF PRACTICE FOR GP PREMISES GP PREMISES LEASED FROM PRIVATE LANDLORDS Introduction 1. This letter provides advice to NHS Boards, Integration Authorities and GP contractors on the implementation of the policy for GP premises leased from private landlords as set out in the National Code of Practice for GP Premises ( the Code of Practice ) In this letter, references to eligible GP contractors are references to all of a Health Board s GP contractors who lease their premises from private landlords. Background 3. The Code of Practice sets out that the Scottish Government s long-term strategy is, that no GP contractor will need to enter a lease with a private landlord. Health Boards will, over the course of the next fifteen years, take on the responsibility for negotiating and entering into leases with private landlords and the subsequent obligations for maintaining the premises from GP contractors who no longer want to lease privately. 2 1 The National Code of Practice for GP Premises available at 2 Code of Practice, section 15.1

2 4. The Code of Practice sets out the actions that GP contractors who no longer wish to lease their premises from private landlords must take to allow Health Boards to take on that responsibility. These steps include ensuring the premises are suitable for the delivery of primary medical services and sufficient to meet the reasonable needs of patients; meeting statutory obligations regarding the premises; and meeting the cost of the dilapidations claim agreed with their landlords. 5. GP contractors who wish to continue to provide their own accommodation are free to do so. However, the Scottish Government s plans are based on the assumption that a significant number of GP contractors will request that their Health Boards takes on the responsibility of providing the practice premises during the next 15 years. The rate at which responsibility transfers to Boards 6. The Scottish Governments recognises that Health Boards do not have the capacity to take on the responsibility for providing premises to all or even most eligible GP contractors within a short period of time. It is the Scottish Government s intention that this process is spread over a period of 15 years. Health Boards should prepare their plans for the transition along with their Integration Authorities and in consultation with the local Area Medical GP Sub-committee. 7. For the first years of the Code of Practice, it is expected that Health Boards will concentrate on taking on responsibility for providing accommodation to those practices whose leases are closest to expiry. Leases expiring within five years 8. Eligible GP contractors who no longer wish to continue leasing their premises from private landlords should formally advise their Integration Authority and Health Board as soon as they reach the point where their lease has no more than five years until the expiry date. This will give the parties time to develop the options for a plan for the GP contractor to either continue in the existing premises or in alternative premises. 9. If the eligible GP contractor s lease already has less than five years until its expiry date and the GP contractor no longer wishes to continue leasing its premises, it must formally advise the Health Board and Integration Authority at the earliest practicable date. 10. Health Boards and Integration Authorities should inform all eligible GP contractors of the method by which GP contractors can formally advise them. Register of leases - assignation 11. In line with section 19.1 of the Code of Practice, Health Boards must establish a register within the Estates Terrier Section of the Estate and Asset Management System (EAMS) of the leases where they are willing to accept an assignation of the

3 tenant s interests. All Health Boards who have GP contractors who lease from private landlords must now establish this register. 12. Health Boards must inform their eligible GP contractors of the establishment of the register and of the arrangements for applying to be included in it. Those arrangements must be consistent with section 19.4 of the Code of Practice. Financial support to GP contractors GMS / PMS contract standards and dilapidations 13. GP contractors who no longer wish to continue leasing their premises from private landlords will be required to ensure that their premises meet the standards required by the GMS / PMS contracts 3 and the standard required by their lease (dilapidations). 14. GP contractors remain responsible for meeting any dilapidations claim by their landlord and for the cost of ensuring their premises meet the standards required by their GMS / PMS contracts. 15. The Scottish Government is making available two funding streams, grants and loans, to assist GP contractors with these costs where it is appropriate to do so. Grant funding 16. The Code of Practice envisages circumstances where grants from the GP Premises Sustainability Fund ( the Fund ) may be used to assist GP contractors with settling dilapidations claims or ensuring the premises meet the standards required by the GMS / PMS contract: GP contractors who have, in the opinion of their Health Board, taken all reasonable steps to maintain their property to the standards required by their leases and the Premises Directions, may be able to recover part of the cost of any reasonable dilapidations claim from the GP Premises Sustainability Fund. This will be permitted only where budgets allow. The GP contractor must take all reasonable steps to reduce the amount payable to its landlord in respect of dilapidations The Scottish Government does not intend to put in place a formal application process for eligible GP contractors who wish assistance from the Fund with settling dilapidations claims or ensuring the premises comply with the GMS / PMS contract standards. Instead, GP contractors should inform their Health Board if they wish assistance. The Health Board will then decide if providing assistance is consistent with the Code of Practice. The amount of any assistance will then be agreed between the Health Board and the Scottish Government. 3 The National Health Service (General Medical Services Contracts) (Scotland) Regulations 2018, Schedule 3 & The National Health Service (Primary Medical Services Section 17C Agreements) (Scotland) Regulations 2018, Schedule 4 4 Code of Practice, section 18.6

4 18. Any grants from the Fund in support of leased premises should be used in the first instance to assist with carrying out remedial works to the premises. Where a grant is agreed, funding will be provided to the Health Board. The Health Board will then ensure that the remedial works are carried out and paid for. The Health Board may directly instruct the remedial works to ensure that they are carried out. 19. A grant from the Fund may only be used for other costs associated with the transfer of leases to Health Boards (such as legal or surveying costs) where the amount of funding available is greater than the cost of carrying out remedial works. Loan funding GP Premises Repair loans 20. The Scottish Government is making available additional support by way of interest-free loans to eligible GP contractors to assist them with meeting dilapidations claims and for the cost of ensuring their premises meet the standards required by their GMS / PMS contracts. Loans will be provided where grant funding is not provided or is insufficient to meet the full cost of remedial works. 21. These GP Premises Repair Loans will be unsecured and will be repayable over an agreed period of time. 22. GP Premises Repair Loans are different from the previously announced loans for GP owned premises ( GP Sustainability Loans). The allocation of grant funds for leased premises 23. The Scottish Government intends that, over the next 15 years, grant funding to support the transfer of leased premises will be allocated to Health Board areas in a way which is broadly proportional to the amount of financial assistance with rent that Health Boards provide to the eligible GP contractors in each area. 24. However, there will be annual variations in the proportion of assistance from the Fund which each Health Board area receives. For example, a Health Board which has only one eligible GP contractor will receive its entire allocation in the year that it takes on responsibility for those premises. 25. The allocation of funds will also depend on the proportion of eligible GP contractors in each area who wish their Health Board to take on responsibility for providing their premises. 26. The amount of funding provided for each Health Board area in 2018/19 to support the transfer of responsibility for leasing premises will be worked out in consultation with Health Boards as their plans develop over the course of Health Boards will be formally notified of their funding allocation for 2018/19 by December Further information

5 28. GP contractors who wish further information should contact their Health Board in the first instance. Health Boards may request further information on the implementation of the Code of Practice and the GP Premises Sustainability Fund from Yours faithfully RICHARD FOGGO DEPUTY DIRECTOR