GP Surgery & Medical Practice Finance
Specialist property and business finance for NHS GP practices and private medical businesses.
GP Surgery & Medical Practice Finance
GP practices, both NHS contract holders and private medical businesses, occupy a uniquely advantageous position in the commercial mortgage market. The strength and predictability of NHS income makes GP surgery premises finance one of the most competitively priced commercial mortgage products available. Yet most practices do not know this market exists and default to their clearing bank for advice.
Doulton Bridging Finance specialises in property and business finance for GP practices, medical centres, and private healthcare businesses. We access a specialist healthcare lender panel that understands GMS/PMS contracts, Care Quality Commission registration, and the specific dynamics of NHS income in a way that generalist commercial mortgage brokers cannot.
Who this is for
- GP partnerships or LLPs seeking to purchase their surgery premises from an NHS property company or private landlord
- GP practices refinancing an existing commercial mortgage to access better rates or release equity
- GPs acquiring additional premises for branch surgeries or expansion
- Healthcare developers building or converting premises for let to NHS-contracted practices
- Private medical practices, dental, physiotherapy, aesthetic medicine, mental health, purchasing or refinancing their premises
- GP practices needing bridging finance to acquire premises quickly ahead of long-term mortgage completion
Why GP surgery finance is different
NHS GMS (General Medical Services) and PMS (Personal Medical Services) contracts provide a guaranteed, government-backed income stream, the most secure covenant available to a commercial mortgage lender. Specialist healthcare lenders recognise this and price GP surgery mortgages significantly more competitively than standard commercial property, often achieving rates comparable to strong residential investment mortgages.
Most GP practices are unaware of this competitive market because their clearing bank, which does not have a specialist healthcare lending arm, cannot offer these rates.
Mortgage products available
- GP surgery owner-occupier mortgage
- The most common product. The practice partnership or LLP purchases the freehold or long leasehold of its surgery premises. NHS contract income is used as the primary income assessment. LTVs to 70% are available; some specialist lenders go to 75% for practices with long-established, high-list-size contracts.
- Medical centre investment mortgage
- For investors or property companies purchasing a surgery or medical centre for let to an NHS-contracted practice. Assessed on the lease terms, tenant covenant (the practice), and income. Long-term NHS leases with RPI-linked rent reviews are highly lender-friendly.
- GP surgery bridging loan
- When a practice needs to complete on a premises purchase quickly, typically when a landlord offers a time-limited opportunity, or when the practice needs to vacate its existing premises before permanent mortgage finance is in place, specialist bridging is available. Rates from 0.65% pm.
- NHS premises improvement loan
- Finance for extending, adapting, or improving surgery premises, including conversion of adjacent properties, accessibility works, and energy efficiency improvements. Can be structured alongside the premises mortgage or as a standalone facility.
- Private medical practice mortgage
- For dental practices, physiotherapy clinics, aesthetic medicine, mental health practices, and similar private healthcare businesses. Underwritten on the private practice income alongside the property security. Lenders experienced in CQC-regulated environments are essential.
What lenders assess for GP surgery finance
- NHS contract type and duration
- GMS contracts (indefinite) are most lender-friendly. PMS and APMS contracts have end dates that affect lender appetite. The contract holder must be a GP qualified partner, not a locum. Lenders require a copy of the current NHS contract.
- List size and QOF performance
- Larger list sizes create higher NHS income. QOF (Quality and Outcomes Framework) achievement affects practice income, high QOF scores demonstrate clinical quality and income consistency. Lenders view declining list sizes or poor QOF as a risk signal.
- Practice income and profitability
- 3 years of practice accounts are typically required, alongside NHS payment schedules. Lenders assess income stability, profit per partner, and the practice's debt service capacity.
- CQC registration
- CQC registration is mandatory for NHS-contracted practices. An 'Outstanding' or 'Good' CQC rating is a positive indicator for specialist healthcare lenders. 'Requires Improvement' or 'Inadequate' ratings require careful presentation, our brokers will advise on the best approach.
- Practice structure
- Partnership agreements, LLP deeds, and corporate structure all affect how the mortgage is structured. Multiple partners may all need to be party to the mortgage, or a GP property holding company can be established. Our brokers advise on the most appropriate structure before application.
- Existing liabilities
- Any existing debt (NHS premises improvement loans, previous commercial mortgages, personal debt of partners) is assessed alongside the new application. High partner personal debt can affect affordability.
Case study: GP partnership purchases surgery from NHS Property Services
- Practice
- Four-partner GP practice, Surrey. 11,400 patients, GMS contract.
- Situation
- NHS Property Services offered the practice the opportunity to purchase their surgery freehold at a fixed price. The practice had 60 days to complete or the property would go to open market.
- Property value
- £2,540,000 (independent RICS valuation)
- NHS offered price
- £2,150,000, 15% below market value
- Bridging loan arranged
- £1,460,000 (68% LTV on NHS price), completed in 18 working days
- Long-term mortgage
- £1,720,000 NHS specialist mortgage arranged during bridging term, 25 years, competitive fixed rate, cleared bridging at month 4
The practice secured the freehold at below-market value. The monthly mortgage payment (£7,100) is materially below the previous annual rent (£124,000 / £10,333 pm), delivering a significant long-term cost saving and a balance sheet asset acquired.
Frequently asked questions
Can a GP partnership take out a commercial mortgage?
Yes. A GP partnership is a standard legal entity for borrowing purposes. Most specialist healthcare lenders are comfortable with traditional partnerships, LLPs, and limited company structures for GP surgery ownership. For partnerships with multiple partners, all partners typically need to be party to the mortgage, though some lenders accept a designated borrower with partner guarantees.
Does NHS income count as business income for mortgage purposes?
Yes, NHS GMS/PMS income is typically the primary income stream assessed by specialist healthcare lenders. It is treated as recurring, contractual income (similar to a long-term commercial lease) rather than business profit, because the government contract provides a guaranteed minimum income regardless of practice performance. This is why GP surgery mortgages can achieve competitive rates despite the practice being a small business.
What happens to the mortgage if a partner retires or leaves?
Partner changes are a normal part of GP practice ownership. Most specialist healthcare mortgage lenders have clear procedures for partner substitution, a new partner joins the mortgage and the departing partner is released from their personal liability. This is typically handled via a deed of variation rather than a full mortgage redemption and re-application.
Can I get a mortgage on a surgery I am currently renting from NHS Property Services?
Yes. NHS Property Services periodically offers sitting tenant practices the opportunity to purchase their surgery at a discounted price. These opportunities are time-sensitive, NHS PS typically gives 60-90 days to complete. A specialist bridging loan can fund the purchase within the deadline while the long-term mortgage is being arranged. Our brokers have experience with NHS PS transactions and can move quickly.
Are private dentists and non-NHS practices eligible?
Yes. Private dental, physiotherapy, aesthetic medicine, and other private healthcare practices can access commercial mortgages for premises purchase. The underwriting uses the private practice's income (accounts, contracts with private insurers) rather than NHS income. CQC registration is required for regulated activities. Our panel includes specialist lenders experienced in private healthcare.
Get an indicative quote
Tell us your scenario and we will come back the same working day with indicative terms and a lender shortlist.
Speak to our healthcare finance team
Our healthcare finance brokers understand NHS contracts, CQC registration, and the GP partnership structure. Tell us your scenario, practice list size, property value, and timeline, and we will come back the same working day with indicative terms.