The BMA survey, of nearly 2,000 GPs and practice managers, reveals widespread concern about the state of surgeries across England; mould growing in waiting rooms, treatment rooms with cracked walls and inadequate space for staff to work in.
Only 50% of respondents to the survey said their premises are suitable for present use, while 83% believe they cannot meet future demand. More than 80% reported not having enough space for additional staff, and nearly three-quarters said they cannot provide training facilities for new GPs.
In addition, it shows funding is falling seriously short. Since 2022, 42% of applications for funds to make improvements have been rejected, even though most requested less than £150,000.
Practices also reported serious concerns over longstanding disputes over inaccurate charges from DHSC-owned companies, NHS Property Services (NHSPS) and Community Health Partnerships (CHP), with examples like being charged for lift maintenance when the practice does not even have a lift. Over half of NHSPS tenants and a third of CHP tenants, who responded to the survey, say these disputes are threatening their sustainability, and worryingly, many GPs have even considered handing back their contracts as a result.
Dr Gaurav Gupta, BMA General Practitioners Committee England premises policy lead, said: ‘This survey shows a system at breaking point. Patients deserve to be seen in safe, modern surgeries that allow GPs and their teams to focus on what matters most, but instead they are being cared for in buildings that are simply not fit for purpose and were never designed to meet modern health needs.
‘Staff have told us about working out of converted containers, in cramped rooms, and kitchens that can barely fit one person, which makes it hard to provide the safe, confidential, and dignified care that patients deserve. Many surgeries cannot house additional GPs and other staff, meaning patients face longer waits and fewer services close to home - directly undermining the Government's 10-Year Plan, which places neighbourhood health services at its core.'
‘Training new GPs is almost impossible when practices have no space for them, threatening the future supply of family doctors. At the same time, practices are being drained by unfair and inaccurate service charges, forced to spend precious time disputing bills rather than focusing on patient care.
‘This is not just about bricks and mortar, this is ultimately about patient care. We urgently need substantial investment to modernise GP surgeries, clear action to free up space by removing paper records, and resolution of service charge disputes that have gone on for years.'
In response, a spokesperson for NHS Property Services, said: ‘We acknowledge the publication of the BMA's Premises Survey results and welcome the findings, which we are currently analysing in more detail. We are pleased to see some improvements in our performance areas since the last survey in 2019. However, we are aware that there is always more to do and remain committed to supporting our primary care colleagues facing financial challenges.
‘This is illustrated in our improved billing and charging processes, which we have been refining since 2021, following the introduction of our standard occupancy documentation programme. This initiative, alongside our Annual Billing Schedule check-ins, enable practices to review and understand their charges in detail and we encourage any practice with concerns to contact us so we can review their circumstances and provide support and clarification.'
The spokesperson added: ‘We remain focused on offering our expertise to help our NHS colleagues create neighbourhood health services, enabling them to focus on delivering excellent patient care.'
A spokesperson for Community Health Partnerships said: 'We welcome feedback from our tenants and have an active programme to maintain and improve tenant satisfaction, including our service on financial queries.
'We recognise the financial challenges and constraints across the healthcare sector and are committed to providing transparency on charges. We issue all tenants with annual budget information, including a breakdown of tenancy charges and explanatory materials. The annual budget statement shows all costs reasonably incurred in operating the building. Where GP tenants have questions and queries about their bills, we encourage them to contact us so that we can respond quickly.
'Tenants of LIFT buildings are charged in line with national policy. The charges are calculated on a cost recovery basis in line with the terms of the lease or the percentage of space occupied. This means that service charges reflect the actual costs of providing services such as cleaning, utilities, and maintenance.'
