The Partnership Model

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The partnership model in general practice predates the NHS. Is now the time to change it?

The future of the GP partnership model (in place before the NHS’s creation) is uncertain. GP partner numbers have fallen, and fewer early career GPs now aspire to the role.  There is a shift towards salaried roles.  The author explores the reasons behind this shift, its implications and alternative business models.

What is GP Partnership?

GP partnerships are independent, autonomous businesses contracted by the NHS (via Integrated Care Boards) to deliver GP services. The GP partnership model is the main legal structure for the delivery of NHS general practice.
Partners are usually GPs but can include other professionals (e.g. practice nurses, practice managers).  They are self-employed, share profits (take a share of the surplus generated from practice income known as “gain share”) and take on unlimited liability (i.e. they are personally responsible for all financial liabilities such as losses and debts).

• GP partners are clinicians and business owners. They employ staff, manage the finance, estates and administration. 
• Each partnership has an internal ‘partnership agreement’, setting out terms and conditions, including each partner’s share of profits. Agreements vary between practices to meet the needs of the specific partnership.
• Types of GP contract:
  • GMS (General Medical Services) – the most common, nationally negotiated between DHSC, NHSE and GPC. 71% practices held GMS contracts in 2024. 
  • PMS (Personal Medical Services) – locally negotiated between commissioner and provider.  Flexibility to tailor provision to local need.
  • APMS (Alternative Provider Medical Services) – open to external providers including independent and community sectors and voluntary organisations. Locally negotiated, flexible. Not generally used by GP partnerships.

Find out more on our Partnership Model page.

Published: Jul 1, 2025