Dr Michelle Drage, chief executive of Londonwide LMCs, said the current model of partnership 'does not seem to be providing them [sessionals] with the autonomy they are looking for.'

The emergence of federated and networked practices in London mean there will be more opportunities for different types of career, she said.

One model involves salaried GPs becoming stakeholders and running one of a group of practices without investing in property and infrastructure.

‘We are looking at how we can create opportunities with the benefits of being in a partnership without the millstone round their necks of having to own all the infrastructure,' said Dr Drage.

Londonwide LMCs are also developing a range of services to help small practices federate to avoid pressure from PCTs in London.