The GP partnership model
For many years, becoming a partner was the main goal for most GPs. Yet in recent times, the role of the GP partner has become more challenging - and the partnership model less popular.
There are still plenty of reasons and opportunities to pursue this career route though. And there are fresh attempts to breathe new life into the partnership model.
Under the 2020/21 General Medical Services contract deal for England, NHS England and the British Medical Association (BMA) agreed to provide a £20,000 ‘golden hello’ for GPs taking on partnership roles for the first time.
In this brief guide, we’ll look at some of the considerations behind moving to partnership. We’ll also show you how to buy into a GP practice if you decide it’s right for you.
Benefits of being a GP partner
Making the step up to partner can be a real boost for your career. It’s a chance to develop a work life that spans clinical, management and financial roles.
That’s not the only reason why some doctors choose to become an equity partner. Other benefits include:
- Autonomy: The chance to set your own working day or week in agreement with your other partners.
- Community: A GP surgery is a pillar of a local community. Being a partner can give you a highly rewarding sense of responsibility to your area.
- Income: While profits vary from practice to practice and from year to year, GP partners can often earn more than salaried GPs.
Finding a partnership
If you’re keen to explore the option of GP partnership, there are various ways you can find an opportunity. A vacancy may arise in your practice or through networking with other local GPs.
There’s also a range of specialist jobs boards you could try, such as:
When you’ve found a vacancy you’re interested in, you need to assess whether the practice is the right fit for you.
Examining the practice
There’s a lot to think about when you’re mulling over a partnership opportunity. For starters, you need to think about the personal elements of the move. Can you lay down roots in the local area? Is it right for your family?
You’ll also need to assess the business side of things and do your due diligence on the practice.
The priority is to learn the state of the practice’s financial health, and to understand more about the services it does (and can) offer. The first thing to know is which of the three main NHS contracts the practice works under:
- Most practices in England are moving towards direct funding through the Primary Care Network (PCN). These practices work within a GP network to provide services alongside clinical pharmacists, district nurses, physios, podiatrists, social care, the voluntary sector and more.
- The General Medical Service Contract (GMS) is nationally led and gives core funding for the costs of running a practice, including some essential GP services.
- The Personal Medical Services (PMS) is seen as a more flexible contract than the GMS. It allows GPs to enter into contracts with the regional NHS England or the local Clinical Commissioning Group (CCG) to provide services to meet local primary care needs.
You also need to know if any extra clinical or ancillary services are offered as part of day-to-day operations. If so, do these services generate income for the practice?
Other things to consider
Here are some more factors to weigh up as you assess a practice:
- Is it a happy and cohesive team? Is there a high staff turnover?
- Can you work with the partners and are they of a like mind? Are they open to new ideas and opinions?
- Has the vacancy come after a partner has retired? Or are there other reasons why they left?
- Will the other partners’ positions affect you as (potentially) the most junior partner?
- Does the practice provide the chance for you to pursue areas of interest? Will you be able to develop new services?
The answers to these queries will help you decide if this partnership is the one for you. If it is, this may be the time to engage a lawyer and accountant to help you move forward.
Be sure to choose those with experience and understanding of medical partnerships. Buying into a GP surgery can be complex, and you’ll need the right help to minimise delays and overcome obstacles.
The partnership agreement
To get a true financial picture of the practice, ask to see at least the last three years of accounts. This will show whether the practice is profitable and help you work out your likely drawings as part of the profit share.
You should also request a copy of the partnership agreement or deed. This will help you learn more about the relationship between partners, and other key matters like:
- Each partner’s duties and responsibilities
- How decisions are made and how disputes are settled
- Outline of authority
- Profit share agreements and capital and income distribution
- Holiday and sick pay entitlements for partners
- Policy on the resignation, retirement or expulsion of a partner
Be clear about the percentage of the partnership being offered. Also be sure to check on any probationary period for new partners, which is often between one and three years.
This may limit your influence in key decision making until you are a full partner. It may also dictate when you will receive full profit share.
Who owns the building?
Another key issue which can cause problems is understanding who owns the surgery building. It is not unusual for the building to be owned by one or more of the partners who receive rent. Or, it may be owned by the partnership or leased from a private landlord.
More thoughts around this (and other aspects of moving to partnership) can be found in the full version of this guide. You can get a copy by emailing us on firstname.lastname@example.org.
Remember, as a partner, you will be personally liable if issues arise. That’s why it’s vital to be clear on roles, responsibilities and rental agreements - to avoid any disputes which can be stressful and costly to resolve.