When GP partners hear the word “mediation”, many assume it means being pushed into a compromise, sitting in a confrontational meeting, or having decisions imposed on them. 

In reality, mediation in GP partnerships is very different and is far more measured, flexible and supportive than that, and crucially it happens at the pace and in the way that best suits the people involved. 

This blog explains what actually happens in a GP partnership mediation, step by step, to help reduce fear, correct common misconceptions and help partners understand what to expect. 

First things first: what mediation is (and isn’t)

Mediation is a confidential, voluntary process designed to help GP partners have constructive conversations and reach their own solutions.

It is:

• Not litigation

• Not about deciding who is “right” or “wrong”

• Not about imposing outcomes

• Not reported to NHS England, the ICB or the CQC (unless a legal change is required and parties consent to this as part of the agreed outcome)

The mediator does not take sides or make decisions. Their role is to support meaningful dialogue, help clarify issues and assist the partners in finding a way forward that works for the practice. 

Step 1: Preparation and understanding the dispute

Before any meetings take place, the mediator will need: 

• Details of the dispute

• Who the parties are

• A broad understanding of the background and current situation

At this stage, the focus is not on legal arguments or formal positions. It is about understanding what has happened, where things have become stuck, and what the parties are hoping mediation might achieve. 

Step 2: Individual meetings with each party

The mediation process usually begins with separate, confidential meetings with each GP partner (either in person or via Teams). 

These meetings are a key part of the process and serve several purposes:

• Introductions and explanation of how mediation works including the setting of ground rules

• Clear discussion of confidentiality and the mediator’s neutral role

• An opportunity for each party to explain the situation from their perspective

• Exploration of what matters to them: their concerns, priorities and interests

• Discussion about whether mediation is the right way forward and, if so, how best to proceed. 

For many GP partners, this is often the first time they have been able to speak openly about the situation without fear of judgment or escalation. 

Importantly, mediation only continues with the agreement of all parties.

Step 3: Deciding how the mediation should progress

Following the individual meetings, the mediator will consider, with the parties, the best way to move forward.

This might involve: 

• A joint facilitated meeting

• Shuttle mediation (where parties remain in separate rooms)

• Or a combination of both. 

While bringing everyone together is often the most effective way to rebuild dialogue, it is only done where it is safe and constructive to do so. 

Step 4: The joint facilitated meeting (where appropriate)

If a joint meeting is agreed, the mediator will facilitate a structured discussion where: 

• Each party has the opportunity to air their views

• Issues are clarified and reframed where necessary

• Communication is managed to avoid blame or escalation

• Common ground begins to emerge

This stage is not about winning arguments. It is about understanding, rebuilding communication, and creating the conditions needed to move towards agreement.

Step 5: Working through the issues and developing a plan. 

Once the key issues are identified, the focus shifts to problem-solving. 

This often involves:

• Working through practical and interpersonal issues together

• Exploring different options and solutions

• Agreeing a joint plan of action

• Holding side meetings if helpful to unblock sticking points. 

The solutions are decided by the partners themselves, not imposed by the mediator. 

Step 6: Building and reality-testing the agreement 

As proposals take shape, the mediator will help the parties: 

• Reality-test options (“Will this actually work in practice?”)

• Consider risks, unintended consequences and future scenarios

• Discuss contingencies if things do not go to plan

• Decide who else (if anyone) needs to see the agreement

This stage is crucial in GP partnerships, where agreements need to be workable within the realities of clinical commitments, finances, staffing and regulatory pressures. 

Step 7: Recording the outcome

If agreement is reached, the mediator will:

• Write up the terms as a good faith agreement
  
  
• Provide a copy to all parties

This can then be taken forward as needed, for example, to be reflected in partnership documentation or acted upon operationally.

Even where full agreement is not reached, the process often brings clarity, narrows the issues, and significantly improves communication.

Why this approach works particularly well for GP partnerships

GP partnerships are unique. They involve:

• Long-standing professional relationships

• Shared responsibility for patients and staff

• Financial and emotional investment

• External scrutiny and regulatory pressure

This style of mediation recognises that reality. It prioritises:

• Safety and trust

• Open, honest dialogue

• Flexibility in process

• Practical, sustainable outcomes

For many practices, mediation provides a way forward that protects both the business and the people within it.

Final thoughts

Most GP partners don’t come to mediation because they want conflict. They come because they want a way forward.

Understanding what actually happens in mediation often removes the biggest barrier to taking that first step.

If a partnership is struggling, mediation is not a sign of failure, it’s often the most practical, professional response to a difficult situation.

If you want to find out more about our mediation services, please get in touch.  

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