RCGP Urges Support to Save Declining GP Partnership Model

The Royal College of General Practitioners (RCGP) has warned that GP partnerships are under threat, as the number of partners in England has dropped by 25% over the past decade.

In a new report, the college urged action to “break down barriers to partnership” and called for modernisation of the model to make it more attractive to younger doctors.

While the RCGP reaffirmed its support for the independent contractor model, it said there was “room for modernisation and innovation,” and backed “a mixed economy” of contractual models to deliver general practice.

Shift in Workforce

Between 2015 and 2025, the number of GP partners in England fell from 24,491 to 18,367. Over the same period, the number of salaried GPs rose by 81%, from 10,270 in September 2015 to 18,557 in December 2024.

As of June 2024, GP partners were a minority among fully qualified GPs for the first time.

The most significant drop in partnership was seen in younger doctors. Among GPs aged 30-34, numbers fell by 72.9%. The only age group to show growth was those aged 60-64, up by 19.5%.

Barriers to Partnership

Rising workload, administrative burdens, and concerns about financial risk were cited as major deterrents to partnership.

Professor Kamila Hawthorne, RCGP chair, said that many GPs were discouraged by the unlimited personal liability that comes with being a partner. She also pointed to the responsibilities of owning or leasing premises and managing staff, especially as patient demand increases. 

Exploring Alternatives

The RCGP report explored alternative business models that could support general practice, including limited companies, limited liability partnerships, and community benefit societies.

The college maintained that partnerships still offered flexibility and potential for innovation, particularly if financial and workload pressures could be reduced.

In 2024, more than half (55%) of RCGP members said they would be more likely to consider partnership if financial risks were lower.

A review by Lord Darzi highlighted the financial discipline of GP partnerships, noting that they could not run large deficits like other parts of the NHS.

Earlier this year, the Nuffield Trust described the current GP partnership model as “withering.” The health think tank warned that the government’s plans to improve GP access were at risk due to the fall in partner numbers.

Thea Stein, chief executive of the Nuffield Trust, told Medscape News UK: “It is hard to see partnership being the dominant model in the future.” She called for support where the model works well, but said new models must also be explored.

Hawthorne maintained that “there are elements of the traditional GP partnership that can be improved and modernised, while retaining its core strengths.” The GP partnership model has huge benefits for the NHS and for patients, she added.

Government Response

A Department of Health and Social Care spokesperson acknowledged the strengths of the partnership model, including efficiency, innovation, and continuity of care. “However, we also recognise that this is not the only model delivering general practice,” the spokesperson told Medscape News UK. 

“GP practices can choose to organise themselves in different ways and also provide good outcomes in terms of staff engagement and patient experience.”

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.