What is the process of a notional rent review?

All owner-occupied GP Practices in the UK receive reimbursement from the NHS for occupying space within their premises. This rent is reviewed every three years by a surveyor (District Valuer) on behalf of the NHS and can be challenged/appealed to ensure it is in line with the current market and the practice aren’t getting underfunded.

Every practice will have their own triennial review cycle which is based on when the practice first opened its doors. The rent review cycle may be changed (with prior approval from the NHS) should the practice make significant physical changes to the surgery premises (i.e. improvements or extension) or, if the usage or parts of the surgery change (i.e. NHS services no longer provide from a room as it is now rented out to a third party such as a pharmacy, dentist etc).

What is the Notional Rent Review Process?

  1. Notional Rent review becomes due
  2. NHS issue the CMR1 (Prem1 in Scotland and Wales) forms to the practice
  3. Practice complete and submit the CMR1 forms to the NHS
  4. NHS instruct a District Valuer (Health Board Surveyor, in Wales)
  5. District Valuer visits and inspects the practice
  6. District Valuer issues his report to the NHS
  7. NHS send a copy of the District Valuers report to the practice

The NHS/Health Board are responsible for commencing the 3-yearly review of the Notional Rent of a practice. They will instigate this process by issuing the practice with the CMR1 forms (Prem1 forms in Wales and Scotland). These are in Excel format and will ask questions about the premises including room usages and whether any changes have been made since their previous review. These forms should ideally be issued by the NHS 2-3 months prior to a review becoming due. However, it is very rarely done on time and often practices can be waiting months to receive their forms.

Once the surgery is in receipt of the forms, it is their responsibility to fill them in to the best of their knowledge and submit them back to the NHS in order for a District Valuer to be appointed to undertake the Notional Rent assessment.

The District Valuer will then generally arrange for a visit to the premises to inspect and ensure no changes have been made since the previous review. After the District Valuer has been to the practice they will write up their report and issue it to the NHS for their approval. Please note that following the coronavirus pandemic District Valuers have not been inspecting surgery premises (unless absolutely necessary) but have been preparing Notional Rent assessments on a “desktop” basis. This process is being reviewed by the DVS monthly.

Following the NHS approval of the District Valuer’s opinion of CMR value they will issue the CMR6 letter (or Notional Rent determination letter) to the practice. The surgery then has the opportunity to get a second opinion (usually from an independent surveyor) to ensure the value is in line with the current market and they aren’t getting underfunded.

In Wales, the Health Board Valuer contacts the Surgery direct with their opinion of Notional Rent, and the Surgery can then immediately seek independent advice as to whether to challenge that opinion.

How do you challenge the Notional Rent determination?

  1. Get in touch with an independent surveyor
  2. Surveyor should undertake a free initial assessment to determine whether it is worth further investigation
  3. Surveyor will arrange to inspect the practice (if appropriate)
  4. Surveyor will complete their CMR valuation
  5. Practice will contact the NHS to instigate an appeal (if appropriate)
  6. NHS to instruct a District Valuer to negotiate with the practice’s surveyor
  7. DV and Surveyor negotiate and agree a fair market rent
  8. NHS issue amended DV report (CMR7) for practice acceptance

We can undertake a free initial assessment to ensure the practice aren’t getting underfunded. All we would need is a copy of the last notional rent notification letter they received.

Following the free assessment, we will make a decision whether it is worth further investigation and an inspection to the practice and if we believe you are losing out, we can contact the NHS to instigate a challenge and enter negotiations with them to increase your reimbursement.

Why choose BW Healthcare Surveyors?

BW Healthcare Surveyors team have considerable experience helping GP Practices with their notional rent challenges. We pride ourselves on our no-nonsense approach and highly competitive fee structures. We will manage the whole process from start to finish and keep you up to date with our progress on a regular basis.

  • 89% of surgeries we have inspected over the last 5 years have been losing out on valuable income because their reimbursement is too low.
  • We are the Top ranked primary care surveying firm in the UK according to Practice Index.
  • We have 10 specialist primary care surveyors with over 100 years combined experience supporting GP practices with all their premises requirements.
  • Our specialist team have already provided help and support to over 1,000 GP practices
  • We are SafeContractor accredited, and a Code of Practice approved supplier.
  • We have fantastic working relationships with other agents, ICB’s and NHS Premises teams to ensure a speedy and hassle-free rent review process.

Should you have any questions or queries regards any of the above or would like to discuss your circumstances with one of our expert advisors, please don’t hesitate to get in touch on 0114 4420098 and we would be more than happy to help.


Sue Pyatt

Excellent service throughout, constant updates and feedback from yourselves.

Sue Pyatt, Practice Manager

Francis Mulhern

They were extremely easy to deal with, informative, focussed and efficient.

Francis Mulhern, Bretton Medical Practice Peterborough

Adnan Mohammad

Efficient company that that has a competitive fee and get the job done.

Dr Adnan Mohammad, GP Partner, Newsome Surgery, Yorkshire

Jill Foster

BW Healthcare has that special personal touch.

Jill Foster, Practice Manager, Beacon Primary Care, Lancashire