By Alex Taylor, Director of Estates - Operose Health
For generations, owning or leasing surgery premises has been one of the defining characteristics of general practice. GP Partners have invested in their buildings, developed them over many years and created healthcare facilities that have become central to their local communities.
For many, those premises have represented independence, stability and a valuable long-term investment.
Today, however, the role that surgery premises play within general practice is changing.
Across England, GP Partnerships are balancing increasing patient demand, workforce shortages and growing operational complexity alongside ageing buildings, lease obligations, statutory compliance and the prospect of significant capital investment. Increasingly, surgery premises are becoming one of the most complex and uncertain aspects of running a practice.
The question many GP Partners are now asking isn't simply whether their building is fit for purpose.
It's whether the traditional model of GP Partners carrying long-term property liabilities remains the right solution for the future.
More than bricks and mortar
Property has often been viewed as an operational issue.
In reality, it has become a strategic one.
The buildings from which healthcare is delivered directly influence patient access, workforce capacity, service integration and the ability of practices to respond to changing healthcare needs.
Modern healthcare estates also require increasingly specialist management. Compliance with statutory requirements, lifecycle maintenance, capital investment planning and landlord obligations all demand time, expertise and resource that many GP Partnerships were never intended to provide.
These responsibilities are entirely manageable in isolation.
The challenge is that they now sit alongside the ever-growing demands of delivering primary care itself.
As a result, many GP Partners are finding themselves balancing two very different roles: clinical leaders on one hand, and long-term property owners and estate managers on the other.
A changing conversation
Over recent years, I've noticed a shift in the conversations we're having with GP Partners.
Historically, discussions centred around improving premises or securing funding for extensions.
Increasingly, they focus on something different.
Risk.
One GP Partner described it to me like this:
"Managing the building and holding the lease had gradually become one of the most stressful parts of being a GP Partner. Between maintenance issues, lease obligations and trying to plan for succession, it often felt like we were spending as much time worrying about the premises as we were focusing on patient care."
Another reflected on the growing uncertainty surrounding long-term investment.
"Our surgery premises had become a growing source of uncertainty. We knew significant investment would eventually be needed, but with recruitment challenges and changing partnership dynamics, it was becoming increasingly difficult to manage that risk with confidence."
A fellow GP Partner added something that has stayed with me:
"There was so much uncertainty around future GP contracts and partnership viability that when our lease came up for renewal, we didn't want to commit for five years, let alone twenty."
These aren't isolated views.
They're part of a wider conversation taking place across primary care.
Rethinking responsibility
This isn't an argument against GP Partners owning their premises.
For many practices, existing ownership arrangements continue to work well and will remain the right model for years to come.
However, I do believe practices are beginning to ask a different question.
Rather than asking "Who owns the building?", they're asking:
"Who is best placed to carry the long-term responsibility that comes with it?"
For some practices, the answer may still be the existing partnership.
For others, particularly where succession planning is becoming a priority, different models are beginning to emerge.
Some GP owners are choosing to retain ownership of their premises as a long-term investment while transferring responsibility for operating, repairing and managing the building through a long-term lease to a larger provider.
Others are working with specialist healthcare property investors, enabling the property to be sold while ensuring the surgery continues to operate from the same premises under a secure occupational arrangement.
The common thread isn't ownership.
It's reducing the personal operational and financial liabilities that have traditionally sat with individual GP Partners.
Looking ahead
General practice has always evolved to meet changing patient needs.
The way primary care estates are managed will inevitably continue to evolve too.
For some practices, that evolution will involve continued ownership by GP Partners.
For others, it may mean recognising that the responsibilities associated with surgery premises have grown beyond what individual partnerships were ever designed to manage alone.
What seems increasingly clear is that the future of primary care isn't simply about who delivers care.
It's also about who carries responsibility for the buildings from which that care is delivered.
For decades, that responsibility has largely rested with GP Partners.
Increasingly, practices are asking whether that remains the right model for the future, and whether transferring those responsibilities to organisations with the scale, expertise and long-term commitment to manage them might ultimately provide greater resilience for practices, and greater continuity for patients.
Are you a GP Partner looking at the future of your practice or planning your succession?
