What does it cost to open a GP surgery?
The short version
- There is no single cost to open a GP surgery; it depends most on whether you own or lease the building and how much fit-out the space needs.
- The main line items are premises, fit-out and equipment, clinical IT and several months of working capital before income settles.
- A leased, lightly fitted practice can open for a five-figure sum; buying and fitting out a building runs into six figures.
- Working capital is the figure most often underestimated, because NHS income arrives in arrears while costs start on day one.
- We arrange the finance behind new practices and fit-outs, but we are an arranger and introducer, not a lender.
When people ask how much it costs to open a GP surgery, they usually want a single number, and the honest answer is that the number is built from a handful of parts that vary enormously. A practice taking a fitted suite on a lease faces a very different bill from one buying and converting a building. What does not vary is the list of things you have to pay for.
This page sets out those parts so you can build a realistic budget, and explains how each is usually financed. We arrange that finance, so this reflects what lenders support in practice.
The main costs of opening a practice
Opening a GP surgery is really five budgets stacked together. Get each one roughly right and you have a defensible plan; miss one, almost always the working capital, and an otherwise sound practice runs into trouble in its first year.
| Cost | What it covers | How it is usually funded |
|---|---|---|
| Premises | Buying or leasing the building | Commercial mortgage if buying; deposit and rent if leasing |
| Fit-out | Consulting rooms, reception, clinical waste, compliance | Term loan or part of the property facility |
| Equipment | Clinical equipment, furniture, signage | Asset finance or term loan |
| Clinical IT | Clinical system, hardware, connectivity | Term loan or cash |
| Working capital | Wages and costs before NHS income settles | Working capital facility or partner funds |
If you are buying rather than leasing the building, the premises line is the largest by far, and it is financed differently from the rest. Our piece on buying your own surgery premises covers that side in full, and you can model the cost with our commercial mortgage repayment calculator.
How much does it cost to run a GP surgery?
Opening is a one-off; running is forever, and the running costs are what determine whether the practice stands up. The biggest is staff, by a wide margin, followed by premises costs (rent or mortgage, rates, utilities and maintenance), clinical supplies and indemnity, and IT.
The cost that catches new practices out is not on the opening budget at all. It is the gap between paying staff on day one and NHS income arriving in arrears. Working capital bridges that gap.
Because NHS income arrives after the costs have been incurred, the practice needs enough working capital to carry several months of outgoings before the cash flow settles. Underestimating that figure is the single most common reason a viable new practice struggles early.
Financing the fit-out and equipment
The fit-out and equipment do not have to be funded from the same facility as the building. Spreading them across the right products keeps the cash demand manageable and matches the cost of each item to its useful life.
Premises
A commercial mortgage if you buy, supported by the NHS notional rent; rent and a deposit if you lease.
Fit-out
A term loan over a sensible period, or folded into the property facility where the lender allows.
Equipment and IT
Asset finance or a shorter term loan, so the repayment period matches the life of the kit.
Working capital
A working capital facility or partner funds to carry the early months before NHS income settles.
Our GP surgery finance page sets out the products we arrange and how we stage them so a new practice is not over-borrowed on day one.
NHS practice versus private GP
A private GP practice and an NHS practice are different businesses with different cost profiles. The private model has no NHS notional rent to help with premises, and no NHS income arriving in arrears, but also no NHS contract underpinning the list. That changes both the opening budget and how a lender views the case.
Whether NHS or private, the discipline is the same: cost each line honestly, fund it with the right product, and carry enough working capital. Where the models diverge is risk, and that is where a lender focuses. To understand the income side before you commit, read are GP surgeries profitable.
Building a budget that a lender will back
A lender backs a plan, not a hope. The new practices that secure finance are the ones that present a clear, costed budget with each line matched to a sensible funding source and a realistic working capital cushion. That is as much a presentation task as a financial one, and it is where a broker earns their place.
We have seen the same practice plan rejected by one lender and approved by another, on the strength of nothing more than how the working capital was justified. How you present the case matters as much as the numbers in it.
For the broader context, our pillar on financing a GP surgery connects opening costs to buying in and buying premises, and our guide to notional rent reimbursement explains the income that supports a premises loan.