Does GP partnership still make sense?

The right GP partnership can provide a professionally rewarding and profitable career choice. Dr Tommy Perkins, GP partner and co-founder of Medics Money, highlights what GPs should consider when looking for a good partnership.

Dr Tommy Perkins, co-founder of Medics Money

GP partnership has become a less popular option for GPs in recent years. Since 2015 the number of full-time equivalent GP partners has dropped 21.6%, according to NHS figures.

Finding the right partnership

Each of us has different priorities in what we want from a GP partnership, and it should not just be about the financial benefits. For example, cycling to work is important to me to maintain my physical and mental health so I only considered partnerships that I can cycle to.

But each of us is different and the right cultural fit for me may be very different from you. That’s why either prior experience of working at the practice or a mutual assessment period prior to joining the partnership is vital.

Whilst our preferences for cultural fit may be unique, joining a partnership is a big financial commitment and the financial health of a GP partnership should be a major determinant in deciding whether to join, irrespective of whether you can cycle there.

How can I tell if a practice is high earning?

If you are thinking of joining a partnership it is vital to get a copy of the recent accounts. The accounts are the vital signs of the financial health of the practice.

You are expert in analysing your patient’s vital signs like blood pressure and blood tests to reach a diagnosis. However it’s likely that GP training taught you absolutely nothing about analysing the vital signs of a GP business and diagnosing if the business is well or unwell.

While I would always recommend going over the accounts with an experienced medical accountant, there are some red flags warning signs that you can look for yourself.

Red flags in the accounts

Brackets mean a negative number
Brackets on a set of accounts are used to denote a negative number. Not always a problem – but if the bottom line has brackets, that is an issue! So, if you see brackets, have a closer look.

A list of partners
The list of partners can be telling. For example, have there been recent changes? If so, have these been cases of normal retirement, or is it an indication of unhappiness within the practice? Try to find out more about the history of the practice and reasons for partnership changes. What other planned changes are there?

Accounts finalised late
If the practice year end is March and it takes until the following January to finalise the accounts – why? Perhaps there is a problem with partners disagreeing with figures or a problem with timely supply of financial information. If financial information is not being collected and flowing easily through the practice this may be a sign of trouble.

Other resources to analyse the accounts include this article on the Medics Money website by my colleague Ed, who is a GP and chartered accountant.

How to find a high-earning practice

Partly due to the way funding is allocated to GP practices, certain types of practices can earn more. These include:

  • Dispensing practices with a high list size and with a well-organised dispensary
  • Practices with high disease prevalence and high levels of enhanced services
  • Practices with a very high ratio of low paid salaried doctors to partners (although it is unlikely that such practices will offer any partnerships)
  • Practices with very high levels of patients per doctor (but this is probably through need rather than choice and unlikely to be sustainable unless additional resources are brought in, which will reduce profits per partner)

Below is a list of the attributes of high-earning practices:

  • Stable partnership (low turnover of partners)
  • Partners work as team and trust each other, plan ahead and meet regularly
  • Partners have similar philosophies in terms of the dichotomy between money and patient care
  • Proactive rather than reactive teams
  • Good managers of time
  • Well-organised GPs with strong staff teams and good skills mix amongst them
  • GPs who delegate well to paramedics, nurses, health visitors etc
  • GPs who work long hours, have low deputising costs and a high level of non-NHS earnings

Financial incentives to become a partner

There are currently some financial incentives to attract new GP partners. These include a £20,000 'golden hello' and a £3,000 training fund to support development. More information on who can claim can be found here.

Further resources from Medics Money

Medics Money empowers doctors to make better financial decisions and you can find details of our New to GP Partnership training course to support new partners here. The course teaches new GP partners everything they need to know to thrive in their new role and for eligible partners it is fully funded by the NHS.

We recently recorded a podcast that discusses everything a GP should consider before joining a partnership. We talk about parity, property ownership, pensions and much more. Listen here.

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