GP surgery & medical centre finance

Who GP surgery finance is for

Most of the partners we work with own, or are buying, the building their general practice trades from. GP practices come to us to secure the funding for that building, and the partnerships behind these practices range from a single-handed practice to a large multi-site group. Some are moving the practice off a lease and into ownership for the first time. Others are existing owner-occupiers refinancing a surgery, funding an extension, or buying out a retiring partner. We also act for the partner left holding the premises in a last-partner-standing situation, where the property needs to be refinanced or sold as the partnership changes shape.

GP premises finance sits apart from ordinary commercial property lending because so much of the income behind it is NHS backed. Where a practice receives notional rent or a cost-rent style reimbursement towards its premises costs, lenders can treat that as a durable, contract-like income stream. That reliability is the reason GP surgery lending often attracts higher loan-to-value support and longer terms than a comparable commercial building with purely private income.

We also help salaried GPs and locum doctors who are stepping up into partnership and taking on a share of the premises for the first time, and private GP businesses buying or refinancing their own premises where the income is private rather than NHS reimbursed. A private GP practice is read slightly differently by lenders, because the premises costs are not reimbursed, so the strength of the trading business does more of the work. If you are weighing whether to buy in, or choosing the right ownership route for a new private practice, the property side of the decision is exactly where we can give you a clear, indicative view before you commit.

Notional rent and NHS premises reimbursement

Notional rent is the payment NHS England makes towards the premises costs of a practice that owns its own surgery, broadly reflecting the open market rent the building would command in third-party hands. It is assessed by the district valuer and reviewed periodically. For owner-occupier partners, that reimbursement is often the single most important number in a GP premises deal, because it underpins the practice's ability to service borrowing against the building.

Lenders look closely at the reimbursement position. A current notional rent figure, a recent or upcoming rent review, and a clear understanding of the lease or licence arrangements all help us present the case well. Where the building is held by the partners rather than a separate property company, we will set out how the income flows and how the debt is serviced. Where there is a cost-rent legacy scheme or an improvement grant in the background, that needs to be factored in too.

We do not give financial advice and we are not the district valuer, so we will never quote you a guaranteed reimbursement figure. What we will do is build the lending case around the reimbursement you actually receive, and approach the lenders most comfortable with NHS-backed primary care income.

What GP surgery finance is used for

We typically arrange GP surgery finance for one of three purposes. The first is buying a premises, often moving an owner-occupier partnership off a lease and into ownership of its own medical centre. The second is refinancing, whether to release equity for the practice, fund a partner buy-in or buy-out, move off an expiring facility, or improve on the current terms. The third is development and refurbishment, funding an extension, an additional consulting room or the conversion of a building into a modern surgery.

Many cases combine more than one of these. A partnership buying a building may also want to fund the works that bring it up to standard, or a refinance may release the equity that funds a retiring partner's exit. We will structure the facility around what the practice actually needs rather than a single off-the-shelf product.

Funding options beyond the premises mortgage

Premises finance is the largest piece, but it is rarely the only funding a practice needs, so it helps to see the wider funding options together. Alongside the commercial mortgage we can arrange business loans for working capital, asset finance for medical equipment such as diagnostic kit, clinical furniture and IT, and refurbishment loans for the works that modernise a surgery. Where you trade through a limited company or a partnership, lenders will weigh the practice accounts and the management structure behind each request.

The cost of each option turns on the asset, the term and the repayment profile you choose. A commercial mortgage spreads the cost of the building over a long term with a steady repayment, while equipment loans are usually shorter and matched to the working life of the asset. Repayments on a long mortgage are lower each month but run for longer, and we will set out how the payments compare across the options so you and the practice management can choose clearly. Practice finance of this kind helps a partnership secure the premises and the kit it needs without tying up all its cash, and getting the repayment structure right keeps the practice on a secure financial footing. We do not advise on insurance, but lenders often expect appropriate cover to be in place, from buildings insurance on the premises to professional indemnity insurance and key-person or locum insurance for the partners and staff, so the borrowing is protected if circumstances change.

Eligibility and what lenders look for

Lenders assess the premises, the income behind it and the partnership running the practice. On income, they look at the strength and durability of NHS funding, including the premises reimbursement, the patient list size and the general financial health of the practice accounts. On the property, they look at type, condition, location and likely valuation, and whether the building is genuinely fit for purpose as a surgery. On the people, they look at the experience and stability of the partners, and how succession is being managed.

Clean practice accounts, a clear partnership agreement, an up-to-date premises position and a sensible contribution from partner funds all strengthen a case. Because GP premises income is contract backed, lenders are often willing to support a higher loan-to-value than they would for a purely private commercial building. We will tell you honestly where your case is strong and where a lender is likely to want more comfort. We are a broker arranging practice finance, not financial advisers, so where the decision touches your wider financial planning we will tell you to take independent financial advice, and where a lender is itself authorised and regulated by the Financial Conduct Authority for any regulated element we will make that clear.

Indicative terms

Terms vary by lender, by the strength of the practice and by the building, so the figures here are indicative ranges rather than an offer. Owner-occupier commercial mortgages for GP premises commonly run over fifteen to twenty-five years, sometimes longer for the strongest cases. Loan-to-value support is typically meaningful, and well-evidenced NHS premises reimbursement can support leverage at the higher end, with the balance covered by partner deposit or existing equity. Rates are usually priced over a reference rate and move with the market and the risk in the case.

We will give you a realistic, indicative view for your specific surgery once we understand the premises, the reimbursement position and the partnership. All terms are indicative and subject to status, valuation and full lender approval. Commercial finance of this kind is not regulated by the Financial Conduct Authority, and nothing here is financial advice.

How we arrange it

We start with a short conversation about the surgery, the partnership and what you want to do. We then approach the lenders most likely to support a primary care building with NHS-backed income and come back with indicative terms. If you want to proceed, we package the case, instruct valuation, work with your solicitor and the partners, and manage the lender through to formal offer and drawdown. You deal with us throughout, and we keep the practice and its advisers moving.