management
refurbishments
There is a lot to be said for giving a surgery a quick lick of paint. The premises will feel brighter
practice” in favour of “more modern, developed premises and facilities”. This means creating welcoming reception areas with natural light and doing away with the onerous bullet-proof glass shields sometimes found between patient and receptionist. Accessibility is also important. “GP practices should always look at their surgeries through the eyes of their patients,” recommends Johnson. “Walk around the premises, both inside and out, looking for any faults or issues, e.g. cracks in the walls, leaky roof, damp or peeling paint. Make a record of what you see. Do this every month and act on your findings.” Any seemingly small structural fault, she warns, can send GP practices spiralling towards a major financial liability. She recommends surgeries have a full condition survey or property audit by a specialist every few years and don’t forget to ask your patients how they think you could improve.
FINDING THE ENERGY
Monitoring your energy usage is important not only for the earth, but your bottom line too. It should also be a motivation when refurbishing a surgery. Obtaining an Energy Performance Certificate (EPC) is the first step to assessing the energy efficiency of your practice, which is now a legal requirement if you’re renting, selling or building a GP surgery. GP Surveyors recommends simple measures like checking weather-stripping on doors and windows and sealing any cracks. “Insulate your loft, ensure you have double glazing and get cavity insulation,” says Johnson, particularly if you’re one of the many surgeries occupying an old house. “It really does make a difference.” Last, but not least, turn off the lights in rooms not in use and take advantage of daylight – which can be a win/ win situation, making patients happier too.
MONEY TALKS
When going for a refurb, it has to make business sense. “Although thought must be given from the financial point of view, practice developments should predominantly be made from a business point of view,” advises Watson, “not in order to minimise tax burdens or such like.” Furthermore, Johnson reminds: “Any improvement works can enhance the capital value of a surgery and have a positive impact on National Rent Reimbursement if approval has been sought from the PCT/
health board beforehand.” Bryan Wootten of Wootten Dean Chartered Surveyors recommends speaking to the PCT (or NHSCB) first to find out the likely increase in reimbursement rent resulting from the refurbishment. “Whilst such a proposal is inevitably led by the practice’s desire to improve facilities for patients,” he explains, “it is also important to know whether the cost will be justified.” One of the biggest issues for practices can be sourcing the funding in the first place. “Traditionally refurbs and smaller extensions have been supported in part by the trusts via improvement grants,” continues Wootten. “Whilst the practices receive abated reimbursement rent over the next 10 years as part of this arrangement, improvement grants have given many practices valuable financial support and a useful incentive to progress premises refurbishments.” However, he warns, this financial support has been significantly interrupted over recent months with the organisational changes and budget constraints of the new NHS – and it is reasonable to expect this to continue for the next six months at least. As an alternative, practices can turn to the high street banks for funding. “Whilst this type of funding is probably less accessible than it was five years ago, banks do have funding specifically to support small businesses,” says Wootten. The Government’s Funding for Lending Scheme can also be accessed through banks.
Before you start on any project, it’s important to have a watertight plan. “Look at all the current guidance and recommendations and start by writing a list of everything you need to be compliant [on] and everything you would like to improve as a nice to have,” Brady tells clients considering refurbishments. Make sure you do a background check on any company you decide to partner with and don’t be afraid to ask if you can visit a site they’ve already completed. “A positive working relationship during renovations is important, as is a proven track record,” says Brady, of developing GP practices. It’s especially important to get someone reliant in as it can impact on rent reimbursement. Feeling slightly overwhelmed about where to start? “There is a lot to be said for giving a surgery a quick lick of paint,” Johnson reassures. “The premises will feel brighter and cleaner, and your staff and patients will really notice the difference.”
february 2013 39
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