RCGP calls on Government to ‘break down barriers’ to GP partnership

The RCGP has called on the Government to take action to ‘break down barriers’ to GP partnership, amid concern that a recent decline in partner numbers could destabilise the model entirely.

In a new report published today, the college said it has been considering the future of the partnership model, as GP partner numbers have fallen ‘by 25% over the past decade’.

It stressed that the model ‘has the potential’ to offer the flexibility many younger GPs are seeking, if ‘key pressures’ such as workload and liability are addressed.

Addressing issues that are ‘discouraging’ GPs from taking on partnership ‘should be a priority’ for the Government, the college said, including:

• The risks of holding unlimited personal liability
• Concerns around becoming the ‘last partner standing’
• The financial burden and associated risks associated with owning or leasing premises, and feasibility of buying into property for early career GPs
• Complexity of HR and other management responsibilities related to running a business, employing staff and managing workloads, and premises.

The report said: ‘We are now at a point where we are seeing a declining number of GP partners, with an increasing number of newly-qualified GPs not wishing to enter into the traditional partnership model, due to concerns about financial risk and overburdening bureaucracy associated with running a practice.

‘This poses a real possibility of an environment in which there are too few GP partners available to support a partnership approach to delivering general practice.

‘These are areas where targeted action from governments and system partners could make a meaningful difference.

‘In 2024, 55% of RCGP members said that reduced financial risk would make becoming a GP partner more attractive.’

It mentioned the Darzi review which found that the health service is in a ‘critical condition’ but can be saved, with increased general practice funding. The review also argued that GPs ‘have the best financial discipline’ in the health service family as they cannot run up large deficits in the belief that they will be bailed out.

The RCGP said that different ways of approaching the partnership model should be ‘carefully scrutinised’ by the college, the Government and the BMA, as well as ‘piloted and evaluated before wider roll-out’. 

And key principles should be safeguarded ‘while considering any alternative approaches’, including:

• Practices should retain relative autonomy, with an agreed budget, in decisions relating to the organisation and delivery of patient care, with the ability to act as powerful independent advocates for patients, and the flexibility to innovate
• Patients should remain connected to and have a personal relationship with their neighbourhood GP practice, with at-scale working being ‘behind the scenes’
• Practices should be physically connected with and accountable to a community
• Practices should continue to be supported to deliver continuity of care

The report also summarised some of the different models currently being explored across the UK, including associate and super partnerships, GP federations and community interest companies.

It added: ‘Some of these structures are well established while others are more novel and remain in development.

‘Each model offers different strengths and limitations, which we have considered in relation to our principles to support the GP partnership model, whilst acknowledging that local context is essential in determining the suitability of any approach.’

RCGP chair Professor Kamila Hawthorne said: ‘We know there are elements of the traditional GP partnership that can be improved and modernised, while retaining its core strengths.

‘Members tell us they are concerned about the unlimited personal liability exposure involved with being a GP partner, the financial risks associated with owning or leasing premises, and the burden of management responsibilities related to running a business and employing staff – particularly at a time when the number of patients needing care is soaring. 

‘The RCGP wants to safeguard the future of general practice – and that means looking at ways to remove these barriers to partnership that members tell us about, while also being open to exploring alternative ways of approaching partnership.’

Earlier this year, primary care minister Stephen Kinnock committed to a future for the GP partnership model.

Speaking at Pulse Live, he said that although partnership is ‘not always the model that works best’, the Government is ‘not in the business of trying to micromanage what works best at a local level’.

Prior to Labour coming into power, health secretary Wes Streeting had expressed doubt concerning the future of the GP partnership model, arguing the ‘murky’ GP contract should be ‘ripped up’. However, he has since said he wants to ‘engage’ GPs in the discussion.

Pulse has contacted the Department of Health and Social Care for comment.