Commercial mortgages for healthcare premises

How difficult is it to get a commercial mortgage?

By Medical Centre Property Finance · · Reviewed 20 June 2026 · 4 min read

How difficult is it to get a commercial mortgage?

The short version

  • A commercial mortgage is more involved than a home loan, but for a healthcare business with steady income it is far from difficult.
  • Lenders weigh four things: the income that repays the loan, the people behind it, the property as security, and the loan structure.
  • Affordability is tested with a debt service cover ratio (DSCR), not just loan to value. Most lenders want profit to cover payments comfortably, often above 1.25.
  • Good packaging is what makes a case easy to say yes to. That is the part we do as arranger and introducer.

Buyers often arrive expecting a commercial mortgage to be hard work. It is more detailed than a residential mortgage, because the lender is underwriting a business as well as a building, but for a healthcare practice with a track record it is usually very achievable. This article explains how difficult it really is, and exactly what a lender assesses.

It sits under our hub on commercial mortgages for healthcare premises.

How difficult is it, really?

The honest answer is that difficulty scales with how clear and reliable your income is. A GP partnership receiving NHS notional rent, or a pharmacy with a long NHS contract, is a comfortable case for many lenders. A new private clinic with no trading history is a harder ask, not because it is impossible, but because the lender has less evidence to rely on.

What feels difficult to a first-time commercial buyer is usually the amount of information involved, not a high bar to clear. Most refusals come from gaps in the paperwork or a mismatch between the case and the lender, both of which are avoidable.

Most commercial mortgages are not declined because the business is weak. They stall because the case was sent to the wrong lender, or sent half-packaged.

What lenders assess

A lender breaks the decision into four parts. Understanding them tells you exactly what to prepare.

The four things a lender weighs
AreaWhat the lender looks atHow to strengthen it
IncomeAccounts, and the contracts behind them, for example NHS notional rentProvide clean, up-to-date figures and the underlying contracts
The peopleExperience of the partners or directors in the sectorShow a track record of running this kind of business
The propertyValue, condition and how saleable it isA proper valuation; flag any specialist features early
The structureLoan to value, term and repayment basisA sensible deposit and a term the profit can support

We go deeper on the income side in our guide to how lenders assess healthcare covenants.

The affordability test: DSCR

The single most important affordability test is the debt service cover ratio, or DSCR. It is the profit available to service debt divided by the cost of the loan over a year. A ratio of 1.0 means profit exactly covers the payments, with nothing spare; lenders want a margin, and most look for comfortably above 1.25.

Making your case easy to say yes to

The difference between a smooth approval and a frustrating one is almost always preparation. A well-packaged case answers the lender's questions before they are asked.

What a strong application carries

  • Two to three years of accounts, or a credible forecast for a newer business
  • The contracts behind the income, for example NHS notional rent confirmation
  • A clear statement of the deposit and where it is coming from
  • A valuation, or at least a realistic view of the property value
  • A repayment that profit covers with a comfortable DSCR

This is the work we do as an arranger and introducer: assembling the case, matching it to the lender most likely to back a healthcare business, and managing the questions through to offer. Sister reading: how much deposit you need and how rates are built.

Where we fit, and regulation

We are an arranger and introducer, not a lender, so we are not constrained to one lender's appetite. We compare the market and place the case where it fits. Most commercial mortgages are unregulated business lending, but where a loan is secured on your home, or otherwise inside the FCA perimeter, that part is regulated and we refer it to an authorised firm.

For the full route from enquiry to drawdown, see our guide to the commercial mortgage process for healthcare premises, and the wider options at our healthcare finance hub.

FAQ

Frequently asked questions

How difficult is it to get a commercial mortgage?

More detailed than a home loan, because the lender underwrites the business as well as the building, but usually achievable for a healthcare practice with steady income. Most cases that stall do so because of gaps in the paperwork or a poor lender match, not because the business is weak.

What do lenders assess for a commercial mortgage?

Four things: the income that repays the loan, the experience of the people behind it, the property as security, and the loan structure. Affordability is tested with a debt service cover ratio, with most lenders wanting profit to cover payments comfortably above 1.25.

What credit score do I need for a commercial mortgage?

Commercial lending looks more at the business and its income than at a single personal credit score, though serious adverse credit is a concern. Clean accounts and a clear, contracted income matter more. See our hub for what lenders weigh.

Talk to us about funding

Tell us what you are buying, building or refinancing and we will come back with indicative terms. No obligation.