Health & Social Care

We worked as a team with other third party professionals to secure sufficient funding, agree building contracts, create new partnership agreements and complete a successful build.

St Paul's Medical Centre, Cheltenham, Gloucestershire is now a thriving hub, providing a wide range of medical care, alternative therapies, a pharmacy and mobility centre. The centre houses 5 GP practices, opticians, chiropractors and acupuncturists, and the NHS use the centre for chiropody, phlebotomy, physiotherapy, dental access and minor surgery.

The individual surgeries were mostly practising out of buildings that were not fit for purpose and no longer adequate for their needs. Being able to provide patients with the best level of care possible is one of the most important objectives for any GP. A vital factor in achieving this goal is having the right resources and facilities to be able to grow and develop new services as patient numbers increase and as patients grow older. Developing a future proof surgery could be the answer, in terms of providing high quality care as well as safeguarding patient's and GP's future security. Better space, bigger space, more accessible space gives you the opportunity to provide better healthcare and a wider variety of services, all compliant with CQC standards. 

Our team of healthcare experts have supported a number of GPs looking to create a 'Super Surgery' or needing to move to bigger premises to improve the services they provide. At St Paul's Medical Centre, the team oversaw the amalgamation of the five different surgeries, assisting with the whole development from the outset. Working as a team with other third party professionals they secured sufficient funding, agreed building contracts, created new partnership agreements and completed a successful build.

Getting Started

Before you start making detailed plans, one of the most important things to consider about your surgery development is getting the right team in place to support you from the outset.

Having the right team on board who are well experienced within the sector and already have established relationships with third parties, can ensure the project runs as smoothly as possible, whilst keeping that risk to a minimum.

There are many early decisions to make such as finding and buying the perfect plot, and deciding to end own or rent the property, but two of the crucial aspects to get right from the very beginning are negotiating the correct financial deal with the bank and ensuring the structure of the new development will provide Partners with the minimum level of individual risk. Then there are searches and surveys, planning applications, the preparation and awarding of construction tender documents, and the design of the new surgery, all of which take time to do properly.

"For all of this to happen seamlessly you need to work with a team who can provide support in finance, legal, construction and corporate structure matters, as well as find a build team who know what they are doing. We would also suggest that it is important to be in control of your own build, rather than at the mercy of a developer, so you can take ownership of the plans and any alterations you may need." says Jo Bewley, Partner at BPE and one of the lead members of the Healthcare team.

Challenges

Every project will inevitably present challenges at some stage and there are bound to be pitfalls along the way, but an experienced team will often spot these before they turn into bigger complications.

One of the main challenges to look out for is keeping on budget and not over spending, especially when complications arise.

"Although it is crucial to bring a strong team in from the beginning, be mindful that a team with experience will have an appreciation of a standard timeline of events and realise that not everything has to be dealt with and billed for upfront. Costs can be staggered throughout the entirety of the project, making it easier for you to keep to budget and control your outgoings." explains Jo.

Mistakes are often made by failing to secure third party occupiers early on in the process and by failing to appreciate the significance of potential money pits.

Results/The Future

Although a big step to take, owning your surgery gives GPs financial security with a guaranteed pension fund and increased revenue streams. It also allows your practice to grow so that you can increase patient numbers without decreasing the level of service provided. A surgery, owned by you, provides patients with better future security, as well as giving you the opportunity to provide enhanced healthcare and a wider variety of services.  

If you are thinking of developing your surgery and have any questions for the healthcare team, please do not hesitate to contact Jo Bewley on jo.bewley@bpe.co.uk or 01242 248445.

We have supported Keith Coghill in a complex £10m deal which included buying an ex-care home out of administration.

Our Healthcare team played a vital role in the lead up to construction starting on Tewkesbury's new £5 million super surgery this October.

The team worked alongside Dr Sanjay Shyamapant, of the Church Street practice, right from the outset and were key in assisting the GP's purchase the site from the NHS.

As well supporting the GP's through the negotiations with Gloucestershire Care Services NHS Trust, which owned the land, our Healthcare team also advised on the new corporate structure for the purchase, as well as terms for the financial package from Barclays.

The new super surgery will be located at the old hospital site in Tewkesbury and sees Church Street and The Mythe practices coming together under one roof, along with a Lloyds Pharmacy, training rooms and additional space for NHS outpatient clinics.

"We've been working with BPE Solicitors for the past 4 years on this project," said Dr Sanjay. "Throughout the entire time they have been extremely supportive, accessible at all times and a fount of knowledge during a process that, at times, has been extremely frustrating."

Both Church Street and The Mythe practices desperately need to move to new premises. The surgeries are currently located across three sites in Tewkesbury in old, ill-equipped buildings that are no longer able to cater for their growing patient numbers.

"Building your own surgery, whether it's a Super Surgery or simply a better space than you have now, gives both GP's and their patients future security," said Jo Bewley, Partner in BPE Solicitors' Healthcare team. 

Better space, bigger space and more accessible space gives GP's the opportunity to provide better healthcare and a wider variety of services to a growing population, all compliant with CQC standards. Alongside this, owning your surgery gives you and your colleagues financial security with a guaranteed pension fund and increased revenue streams.

We will continue to work alongside the GP's assisting with the construction element of the build and finalising occupational leases. 

The firm has worked alongside key professionals on a number of super surgery projects and knows how to avoid the pitfalls. 

"We're with you right from the start, from finding the right plot and helping you buy it, to creating new partnerships and company formation, building contracts, funding negotiations and construction agreements." says Jo Bewley.

Construction work on the new super surgery is due to start in October this year.

Thinking of building a super surgery?  Here's how we can help.

• Finding the right site
• Purchasing the land: title investigation, searches, enquiries, negotiation of contract and transfer
• Bank/PCT funding
• Due diligence on purchase of land
• Secure terms and commitment from third party occupiers (pharmacy/dentist/PCT)
• Planning applications
• Completion and post completion matters
• Creating a Special Purpose Vehicle which will own the property.
• New partnership agreements, termination of existing partnerships/practices
• PCT contracts
• Ongoing pension provisions
• Employee changes (TUPE, restructuring & redundancy)
• Tax structuring
• Land contamination issues
• Site waste management & energy performance
• Professional appointments, project managers, quantity surveyors, engineers, architects
• Project administration and management
• Performance of professional team
• Defect reviews upon completion
• Post completion analysis
• Maintenance agreements/long term service agreements
• Asset and facilities management agreements