For decades, the GP partnership model has been the backbone of general practice. It’s what has kept family doctors rooted in their communities - offering continuity, local knowledge, and genuine ownership of patient care.

But with the NHS 10-Year Plan pushing for more integrated “neighbourhood” services, and with fewer doctors choosing to become partners, it’s fair to ask: is the model still fit for purpose?

Why the Partnership Model Still Matters

At its best, partnership offers something unique: independence, flexibility, and a real sense of belonging. Partners can shape how their practice runs, decide what services to offer, and tailor care to their patients rather than working to a script.

That freedom brings accountability too. As Lord Darzi put it, GP partners have “the best financial discipline in the NHS”, because it’s their business. And evidence backs that up: practices with more GP partners tend to see better patient satisfaction and outcomes.

Why Fewer GPs Are Becoming Partners

Despite the positives, fewer GPs are stepping up to partnership. Over the past decade, the number of GP partners in England has greatly dropped, while salaried roles have risen sharply.

Why? The most common reasons we hear include:

• Personal liability – Partners are personally responsible for the business, including debts and leases. That unlimited liability can feel daunting.
• Premises ownership – Taking on a share of the surgery building or a long lease can tie partners in for years, sometimes in ways that aren’t well understood.
• Workload and management – Running a small business means HR issues, CQC compliance, and financial pressures, all while delivering patient care.

For many doctors, particularly those early in their careers or with family commitments, that level of responsibility can be a hard sell.

Does It Need to Be All or Nothing?

The partnership model doesn’t have to be abandoned - but it probably does need to adapt.

Some practices are already looking at ways to share the load, whether through merging with others, joining federations, or reviewing how liability is structured.

A Limited Liability Partnership (LLP) could be a good option for GP practices, as it can reduce personal financial risk, however, currently an LLP cannot hold a GMS contract. There have been rumours for years that this could become a possibility but still no certainty on this.

The key is to look at options that preserve what’s good about partnership - freedom to shape how a practice runs, patient continuity and flexibility in how care is delivered, while recognising that today’s workforce has different expectations.

Practical Steps for Practices

If you’re a current or prospective partner, a few practical steps can make the model more sustainable:

• Review your partnership agreement. Make sure it’s up to date, clearly sets out decision-making processes, and covers key areas like leave, retirement and dispute resolution.
• Revisit premises arrangements. Understand your exposure under leases or ownership structures, and consider whether changes could share or limit risk.
• Clarify roles and expectations. A clear division of responsibilities - clinical, managerial, and financial - can prevent friction later.
• Plan for succession. Agreeing how new partners will join, and how retiring partners will leave, can avoid problems down the line.

Partnerships that are clear, fair and legally sound tend to weather challenges far better.

The Model Is Worth Saving - But It Must Evolve

The GP partnership model still offers something no salaried system has quite managed to replicate: a structure that still allows GPs to build trusted, long-term relationships with their patients.

But for it to thrive, it has to work for today’s GPs as well as yesterday’s. That means rethinking how risk, workload, and reward are shared, and being open to legal and structural change where it makes sense.

Partnership has been the heartbeat of general practice for 75 years. With the right support, it can stay that way.

How I Can Help

I regularly advise GP partners and practices on all aspects of their partnership arrangements – from reviewing or updating agreements to advising on partner admissions, retirements and disputes. I also help practices explore practical ways to reduce risk and ensure their partnership model remains workable for the future.

If you’d like to talk through your situation in confidence, please get in touch. 

Contact our Primary Care team on care@porterdodson.co.uk