The role of the DV

The role of the DV is to ensure value for money is achieved by publicly-funded bodies including the NHS.

DVs work for the Valuation Office Agency, an Executive Agency of the Inland Revenue.

DVs become involved in primary care premises at the invitation of PCTs or PCOs; for new developments this will usually be at the planning stage.

They must assess the CMV of any site for development. The CMV is the value of the site on the open market assuming it is available for development for any purpose for which planning permission might reasonably be forthcoming. PCTs require DVs to assess the likely CMR on the part of the building already agreed by the PCT and the practice to be used to deliver GMS, before giving outline approval for the new provision, extension or refurbishment of those premises. In all cases PCTs need to have the DV's assessment of CMR before they can reimburse notional or actual rents to GPs. The DV is also required when existing premises need to be reassessed for CMR. This happens at varying intervals depending on whether the reimbursement is notional, actual or cost rent. The DV's role in assessing CMR applies to GMS premises. It does not necessarily apply to premises within PMS contracts, where rents may be agreed with other suitably qualified valuers without reference to the DV. These valuations should be analogous to GMS.

The DV assessment

The DV's assessment is given to the PCT. The DV should be prepared to negotiate with practitioners or their advisors to reach agreement on CMR or the proportion of rateable value of practice accommodation to be recommended to the PCT. GPs have a right of appeal to the Secretary of State if dissatisfied with the assessment.

The DV may advise on other PCT issues

The DV is also able to provide advice on a range of issues such as interest rates, premises size and lease terms; PCTs can, however, seek advice from other suitably qualified professionals on these issues. Issues facing the DV
The development of new primary care premises, as envisaged in the 'NHS Plan', together with the new GMS contract, has highlighted some difficulties in the role of the DV. These can be summarised as:

• The need to find local premises against which to compare new developments in order to assess CMR. This is increasingly difficult given the specialised nature of many new primary care premises.
• DVs are adjudicating on what is and is not GMS. This is not their role and PCTs need to be clear, when they ask for the advice of DVs, what they want to fund and by which route.
• Certain advice and services that the DV offers can be accessed equally well from other sources.

Common faults found on inspection by the DV

• No low height section to reception desk for wheelchair users.
• Inadequate or no provision of acoustic seals where speech privacy is required e.g. consultation/examination rooms, interview rooms and treatment rooms.
• Wash basins provided are not clinical wash basins; elbow taps in clinical rooms missing or short lever alternative substituted; sinks in such rooms to have no plug or overflow.
• Inadequate fitted cupboards/units to treatment rooms.
• No coved skirting to vinyl floor coverings in treatment rooms.
• No provision for private interview room at reception with a secondary means of escape for staff into a staffed area.
• No provision for confidential communications with reception staff by telephone or in person.
• Inadequate provision for storage and disposal of clinical waste.
• Inadequate security provision for drugs, records, prescription pads and doctors' statements.
• Inadequate lighting, heating and ventilation.
• Examination lamps missing.
• Inadequate provision/poor design of staff refreshment facilities.