Career development - Where have all the partnerships gone?

Dr David Wrigley explains how to find and successfully form that elusive partnership.

Looking in any of the job advertisements of medical publications makes you think 'What on earth has happened to all the partnership ads?' They are few and far between in recent years.


If a practice has a vacancy, point out the benefits of taking on a new partner, such as your commitment to the practice

What happened?
Going back eight years when I was on my VTS, morale among GPs was very low.

Work was being piled on GPs by the government with no extra resources to do that work. Out of hours was becoming onerous as each practice had to take part in their share of the rota.

GPs were fed up and some retired early or were burnt out and could not continue. Overall practice income depended on the number of partners, therefore it was vital to replace a retiring partner in order to maintain income.

However, as general practice was unpopular, if a partnership was advertised quite often only one or two applied. This was unsustainable and the BMA and government recognised this.

The new GP contract was negotiated because of this crisis. No longer was the income of the practice dependent on the number of partners. No longer was out-of-hours work the responsibility of each GP.

Income rose due to the quality framework and general practice once again became very popular.

The knock-on effect
Because of these changes, employing a salaried GP has become an option for practices. It was not necessary to replace a retiring partner with a partner, as practice income was no longer dependent on that.

Practice income came from offering services and the quality framework topped that up. Many practices chose to replace a partner with a salaried GP.

This has meant that fewer partnerships are now on offer and when one is advertised sometimes there are over 100 applicants. Many GPs now wish to join a partnership, share the management work and take on the attached risks.

The GPC has been aware of this problem for years and has looked at how to make practices aware of the need to take on partners.

The BMA does not want general practice to become a salaried service where GPs are employed by PCTs.

Learning points

Things you must do before you sign the dotted line ...

1. Redraft the partnership agreement.

2. Obtain independent advice on three years of practice accounts.

3. Ensure you are happy to commit yourself to that practice and the area.

4. Make sure you think you will get on with and enjoy working with your new partners and the healthcare team.

Being a partner
The beauty of being a partner is that you are an independent contractor. You are self-employed. This has downsides in that you do not get sick pay or maternity leave automatically granted to you.

You also share in the risks of running a business and sometimes need to invest a significant amount of money to 'buy into' the partnership.

However, you have the freedom of being self-employed and flexibility in how you work.

As long as your practice runs well, provides a good service and you co-operate with your partners, you can choose how you spend your working day.

If you need to start surgery after the morning school run then that can be accommodated. If you need to have a few hours off every Wednesday afternoon then that is possible.

There is no boss watching over your shoulder telling you what to do - although you do have to keep your practice manager happy, as they are crucial to the running of the practice.

Seeking a partnership
As I have said, there are not many partnerships advertised. It might be worth asking around local practices as to whether they have a partner retiring or leaving in the near future.

Some will happily advise you if this is the case. Ask your trainer if they know of any forthcoming retirements or vacancies - they will know all the local GPs very well.

It is worth ringing your LMC as it occasionally advertises partnerships or knows when they are available.

Your local postgraduate education centre sometimes has a job advert board to look at.

Ask your friends or GP locums if they know of any partnerships coming up.

There are now a few websites that advertise jobs and these are worth registering with.

If a practice has a vacancy then it might be worth pointing out the benefits of taking on a new partner. These include:

  • The knowledge that the doctor is fully committed to the practice, usually for the rest of their career, and will settle in the area.
  • The new partner will inject capital into the partnership.
  • The new partner will be dynamic, hard working and bring new ideas and work streams to the practice.
  • As a partner you don't have a 'clocking off' mentality. You get on with the work and finish when all the day's work is done.
  • The new partner will take on part of the management of the practice and spread the workload.

A practice will be looking for a hard-working GP. They will be interested in you as a person, rather than the number of research papers you have written.

Nowadays, nMRCGP is compulsory. If you have gained other competencies or certificates in your training then mention them, but they are not crucial.

If you are looking for a partnership then I wish you all the best in your search.

I have certainly heard many GPs say in recent months that they will now be taking on partners in the future and not salaried GPs.

  • Dr Wrigley is a GP in Carnforth, Lancashire and member of the GPC
  • This topic falls under section 4.1 of the GP curriculum 'Management in Primary Care',


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