A GP Practice Manager’s guide to the basics of property ownership

Understanding how your GP surgery premises are owned is essential for effective practice management. Whether your building is owned by the partners, leased, or held by a third party, the structure of property ownership can have significant implications for funding, liability, succession planning, and the overall stability of the practice.

So here is a summary of the key concepts every GP practice manager should know.

1. Who Owns the Property?

GP surgeries can be:

Freehold-owned by the GP partners: The partners are the legal owners listed on the title register at HM Land Registry. They can sell, lease, or mortgage the property (subject to agreement between them).
Leased from a third-party or some GP partners / former partners: The practice operates under a lease agreement, typically paying rent and service charges.

Knowing the ownership model is key to understanding responsibilities and rights.

2. Legal vs Beneficial Ownership

Legal ownership is what’s shown at the Land Registry.
Beneficial ownership refers to who actually benefits financially from the property (e.g., rental income or sale proceeds).

It’s important these align with what’s stated in your partnership agreement—if a partner leaves or joins, the ownership structure should be reviewed and updated accordingly.

3. Implications of Ownership

NHS Reimbursement: Premises funding may differ depending on whether the practice owns or leases the surgery. Owners may receive cost rent or notional rent, while leaseholders claim actual rent reimbursement.
Liability: Property owners are responsible for building insurance, maintenance, and compliance with regulations. Leased premises may pass some or all of these responsibilities to tenants via lease terms.
Succession Planning: If a partner retires and their name remains on the property title, it can delay sales, refinancing, or funding. Updating the register and partnership agreement is crucial.

4. Common Issues

Outdated title registrations (e.g. retired partners still listed).
No formal declaration of trust, leading to confusion over shares in the property.
No written lease where the practice is informally occupying space.
Misalignment between ownership and NHS funding, causing shortfalls.

5. What Should Practice Managers Do?

Check the Land Registry title – Know who is listed as legal owner.
Review your partnership agreement – Does it reflect the current ownership and the Partnership’s requirements?
Take legal advice when partners join or leave, or when refinancing or leasing.

Conclusion

Property ownership is more than a legal technicality—it underpins the financial and operational health of your practice. A clear understanding of who owns your surgery, and how, helps you avoid costly issues and plan confidently for the future.

If in doubt, please contact Victoria Walker in our Primary Care team. It's a small step that could save your practice major complications later on.