Becoming a GP Partner: Buying Into a GP Partnership and How to Fund It

What is a GP partner?

A GP partner is a GP who owns a share of the practice, usually as a member of a partnership. Rather than being paid a salary, partners share the practice’s profits under the partnership agreement, and they share responsibility for running it: the NHS contract, the staff, the premises, the finances and the practice’s liabilities.

Where the practice holds a General Medical Services (GMS) contract with NHS England, the partnership is the contractor. That is why joining or leaving a partnership involves contract and registration steps, not just an agreement between the doctors.

GP partner vs salaried GP

The choice between partnership and a salaried role is about more than pay. The main differences are:

• Status: a salaried GP is employed by the practice, while a partner is one of its owners.
• Income: a salaried GP is paid under an employment contract, while a partner’s income depends on the practice’s profits and their share of them. There is no fixed GP partner salary, and earnings vary between practices and from year to year.
• Responsibility: partners carry the business risks of the practice, including staff, premises and the contract, and take part in decisions about how it is run.
• Investment: partners are usually asked to contribute capital and, where the partners own the building, may be asked to buy into the premises.

The BMA’s guidance on GP partnership agreements notes that practices should decide whether a new partner reaches full parity of profit share immediately or over time, and that some practices soften capital requirements by letting the contribution be paid over a period. Ask how both will work in the practice you are joining.

How to become a GP partner

Partnership usually starts with a conversation with an existing practice, often one where you have worked as a salaried GP or locum. A typical route is:

1. Agree in principle with the partners, and ask whether there is a probationary period. The BMA says probation is common but not essential.
2. Review the partnership agreement. The BMA’s practical guide to taking on new GP partners calls it the most important document an incoming partner should be given.
3. Review the last three years of the partnership’s accounts, which the BMA says an incoming partner should have the opportunity to see.
4. Understand the premises arrangements: whether the building is leased or owned and, if owned, the share you will be asked to acquire, how it will be valued and when it completes.
5. Agree your capital contribution, profit share and start date, and line up any finance.
6. The practice gives notice of the partnership change to NHS England and deals with the CQC registration, and you sign the partnership agreement.

Take advice from a solicitor and an accountant who act for GP practices before you commit. The partnership agreement decides how and when your capital comes back, which affects how any loan should be structured.

Buying into a GP partnership: what you pay for

A GP partnership buy-in usually has two parts. The first is partnership capital: your contribution to the practice’s working capital, recorded in your capital account and normally returned to you when you leave under the terms of the agreement. The second, where the partners own the surgery, is a share of the premises, which may be held inside the partnership or separately.

Goodwill is different in general practice. In England, the Primary Medical Services (Prohibition on the Sale of Goodwill) Regulations 2019 prevent GMS contractors, and PMS and APMS contractors with a list of registered patients, from selling the goodwill of a medical practice. So buying into an NHS GP partnership is not normally a payment for NHS goodwill, unlike buying into a dental or veterinary practice. Your solicitor will confirm the position for the practice you are joining.

Our guide to partner capital loans explains capital accounts and current accounts in more detail.

The GMS contract when a partner joins or leaves

For a practice with a GMS contract, paragraph 59 of Schedule 3 to the GMS Contracts Regulations 2015 sets out how the contract is varied when the partnership changes. The contractor must give NHS England written notice of a change to the partnership’s membership, signed by each partner, specifying a date for the change at least 28 days after the notice is given. The regulations also set conditions that the partners in the new partnership must meet.

NHS England’s primary medical services policy and guidance manual also reminds GP performers to notify Primary Care Support England of changes relevant to their National Performers List entry. PMS and APMS contracts have their own terms, and Wales, Scotland and Northern Ireland have their own arrangements, so ask the practice and your solicitor how the change will be handled.

CQC registration when a partner joins

In England, GP practices are registered with the Care Quality Commission, and a partnership is registered as a provider. CQC’s guidance on making changes to partnerships says that partnerships registered since 4 February 2013 can normally add or remove partners without cancelling their original registration, using a variation application. Partnerships registered before that date must cancel their registration and apply to register the resulting new partnership as a new provider.

CQC publishes a separate add a partner application and advises applying only when you are ready for the change to take effect, because applications made too far in advance may be returned.

GP practices for sale and practice mergers

Because the goodwill of an NHS GP practice cannot be sold in England, NHS GP practices do not usually come up for sale in the way dental or veterinary practices do. Ownership changes more often through partners joining and retiring, and through practice mergers, where two partnerships combine. Private GP practices, which are outside NHS contracts, can be bought and sold, and are funded in a similar way to other private healthcare acquisitions.

Where partners own the surgery building, the property can change hands when partners retire or the practice merges. That is usually funded with practice premises finance, and a merger that needs funding can be structured through practice acquisition finance.

How a GP partnership buy-in is funded

A partner capital loan is normally made to you as an individual and repaid from your share of the profits, often with the funds paid directly to the practice. A premises share is usually funded separately, with secured lending if you are buying into the property. Lenders look at the practice’s accounts, the partnership agreement, the premises arrangements and your own position.

Interest on a loan used to buy into or contribute capital to a partnership can qualify for income tax relief in some circumstances. HMRC sets out the conditions in its manual on interest paid on a loan to buy into a partnership, so ask your accountant whether relief applies to you. Where the borrower is an individual, a sole trader or a small partnership, finance of £25,000 or less can be regulated consumer credit, and we will say at the outset if that applies.

See partner buy-in finance and GP and medical practice loans for the options.

For published rate ranges on partner buy-in loans, including those from lenders that fund GP practices, see practice purchase and buy-in finance costs.

How we can help

We arrange finance for GP partnership buy-ins, surgery premises and practice mergers. We search the market across the whole of the market, with access to 300+ lenders including specialist professions lenders, high-street and challenger banks, and present each case to the lenders most likely to suit it. Finance is subject to status, lender criteria and approval.

Talk to us once your offer of partnership is confirmed, so there is time to review the agreement and compare what is available. See how it works or get instant quotes.

Common questions

This guide is for general information only and should not be treated as legal, tax, accounting or financial advice. Funding availability and lender requirements depend on individual circumstances.