Outgrown your GP premises , every room is booked. Your team has grown. Another clinic would help, but where would it go? If that sounds familiar, improving or expanding your GP premises may be on your wish list. Turning it into a fundable proposal takes more than showing that you need extra space. It means explaining what better space will make possible: better access, room for a wider team and more joined-up care close to home.

Build a stronger case for funding

Start with better care, not a bigger building

A growing patient list, new housing or a wider workforce can push an already busy building to its limits. Neighbourhood working may bring additional demands: somewhere for community colleagues to see patients, shared clinics or space for an integrated team to plan care. The useful question is not simply “How many more rooms do we need?” It is “Who will use them, what will they do differently and how will patients benefit?”

The answer may be reconfiguration rather than relocation. Improving existing rooms, extending a site or sharing facilities could be more practical than starting again. Agree the service and workforce needs with partners, then test the options. Co-location within general practice space should enable people to work together, not just put them under the same roof.

GP premises funding: where could support come from?

For practices in England, two pieces of NHS guidance help frame the conversation. NHS England’s neighbourhood health centre guidance explains how estate proposals should support service changes, integrated teams and care closer to home. Your business case needs that practical connection to local plans, not just references to policy. It does not mean every practice needs to become a neighbourhood health centre.

Alongside the NHS Premises Costs Directions, NHS England’s primary care capital grants policy sets out eligibility, application requirements and grant conditions. Some alterations and extensions may qualify for premises improvement grants. Commissioners can fund up to 100% of eligible improvement project costs where appropriate, subject to business case assessment and local prioritisation. Neither eligibility nor policy alignment guarantees funding.

Start with your integrated care board (ICB) to confirm the route, evidence requirements, eligible costs and approvals. Where mergers or reconfiguration are changing investment processes, priorities and project pipelines may still be under review. Establish who owns the process and what can progress now; do not assume an application window is open. New-build and relocation schemes may involve different capital, ownership, lease and reimbursement arrangements. Seek agreement before committing expenditure or starting works.

Could local housing growth support your case? The Community Infrastructure Levy (CIL) is a charge councils can choose to levy on development to fund infrastructure, including health facilities. If new housing is increasing demand on your practice, it may be worth exploring a contribution towards an eligible extension or new premises. Availability and allocation depend on local authority priorities, it is not a guaranteed pot for GP practices.

Speak to the council’s infrastructure or planning team and your ICB. Show the connection between housing growth, service pressures and the capacity your project would create. If funding sources are combined, explain what each will pay for, any remaining gap and how running costs will be covered.

What makes a convincing premises business case?

Evidence that makes the pressure visible. Patient-list trends, housing growth, room utilisation and gaps in provision turn everyday frustrations into a case decision-makers can assess. Include which partners need space, how often they would use it and how you will measure the benefits.

A service model behind the floor plan. More rooms do not automatically mean more appointments or better coordinated care. Show that the workforce, ongoing funding and working arrangements support your plans. Explain why the preferred option offers value and why alternatives fall short.

A clear view of the full commitment. Capital funding may not cover every cost. Check professional fees, fit-out, IT, maintenance, utilities, service charges and borrowing or lease commitments. Grants can also carry continued-use, repayment and premises reimbursement conditions. Take specialist legal, property and financial advice before entering binding commitments.

A realistic route to delivery. Surveys, planning permission, landlord consent, procurement and keeping services running all need attention. Set clear responsibilities and achievable milestones, allowing for different funders’ requirements and uncertain approval timescales. Be honest about risks and what depends on funding decisions.

At Scale: GP premises business-case and funding support

Building that case takes time most practice teams do not have. At Scale brings primary care knowledge, NHS and local government experience, and hands-on business case and bid development support. We work alongside you on premises improvement and expansion proposals, helping you navigate NHS capital funding applications and local processes—even where the route is still developing.

Find the starting point. Clarify your needs, test the options and explore funding routes, including NHS capital and CIL where relevant.
Bring the evidence together. Connect population, activity, workforce and space data with the benefits for patients and neighbourhood partners.
Develop the submission. Shape the project initiation document, business case or funding bid required locally, covering options, costs, benefits, risks and delivery.
Coordinate the input. Work with your team, partners and appointed estates, finance, legal and design specialists to identify gaps and keep the proposal moving.
Prepare for scrutiny. Check funder requirements, challenge assumptions and help you respond to commissioner or council questions.

Our role is to reduce the burden on your team and strengthen the proposal—not promise an award or remove funding delays. We complement, rather than replace, specialist legal, property and financial advice.

Do not wait for a funding deadline

You do not need a finished scheme to start a useful conversation. If your building is limiting what your practice can deliver, now is the time to understand the need, explore the options and find out which decisions come next. Even when funding is uncertain, preparation can move forward.

Ready to explore what better space could make possible? Book a premises discovery call with At Scale to clarify your needs, identify the business-case and funding questions, and agree practical next steps.

What to bring to your premises discovery call

Bring what you already have—not a finished business case. These details will help us get started:

Space challenges: what is not working, current room use and any available floor plans.
Demand: patient-list trends, known housing growth and services you cannot accommodate.
Neighbourhood plans: proposed services, partners and any co-location discussions.
Options and constraints: ideas explored, ownership, lease or landlord considerations.
Costs and funding: initial estimates, available funding, gaps and ICB or council feedback.
Priorities: your timescale, key contacts and questions for the call.

@mike_gill for more information and to book a call