As many practices and Landlords are aware, the District Valuer’s proposals on rent reimbursement are only initial assessments and can be appealed and negotiated. If you are unsure about this, either concerning Notional Rent reimbursement or reimbursement of a rent under a lease agreement, our Healthcare team can assist you.

Even at appeal, there can be occasions where the gap is just too wide, and agreement cannot be reached with the District Valuer. What happens then? There are various stages of appeal with the ultimate step being NHS Resolution.

NHS Resolution Process

The NHS have an appeal process known as NHS Resolution, in which any unagreed cases will progress to if negotiations are unsuccessful following the initial appeal stages and Local Dispute Resolution.  An application can be made after a year of no progress or movement (from the date on the letter reporting the Current Market Rent assessment to the practice from NHSE).  The National Health Service (General Medical Services Contracts) Regulations 2015, provide full details of the process and steps for Local Dispute Resolution Procedure (LDRP). Once this process has been followed and exhausted, the case will then be allocated to an ‘NHS Advisor’ for review.

Timeframes for appeals

Up until recently, the timeframe to conclude an NHS appeal has been three years from the date of the letter providing the initial assessment. Whilst this may seem like a long time, it is possible that an appeal can take this long to progress and conclude due to understaffing and long delays at ICBs (Integrated Care Boards)  and with District Valuer services (whilst unusual and in the minority). The NHS have recently amended their guidelines, effective from January 2024, to state that for an appeal to be approved by NHS Resolution, it must be sent to them within 3 years from the date the CMR letter was issued to the practice.

Whilst we don’t anticipate that this will cause an issue for the majority of reviews and appeals, there are instances where this could be problematic and prompt action will need to be taken to protect your right to appeal.

What to do if your letter is three years outstanding

In the event that your notification letter is now three years outstanding, and agreement has not been reached, we recommend that a formal application to NHS Resolution is lodged straight away, to protect yourselves from the potential risk of the NHS closing your case due to the amendment to the three-year rule. In addition, we would recommend moving your first stage appeal to LDRP, which in certain circumstances may extend your 3-year period.

Some ICBs are now using the deadline to close older cases that have been at appeal stages for some time. However, where considerable delays to the process have been caused by lack of engagement from the ICB or the District Valuer involved, we do not consider it reasonable to close down the right to progress an appeal. As a result, we would recommend all practices take advice in this respect as soon as possible.


Further advice on NHS primary care appeals

If you have any queries regarding NHS Resolutions and appeals for your primary care practice, then please feel free to get in touch with us at or 01727 844555 and we will aim to help wherever we can.

Picture of Paula Mace, Head of Healthcare at Aitchison Raffety

Paula Mace – Director of Healthcare