BMA pushes for new legal structure to limit GP partner liability

The BMA is pushing for GP partners to be able to enter limited liability partnerships as part of a new national contract with the Government. 

In guidance shared with GPs last month, the BMA’s GP Committee for England argued that the ‘ability to limit liability’ for GP partners must be a ‘central tenet of a new contract’ in order to mitigate personal risk. 

In 2018, the GP Partnership Review recommended that the Government introduce this flexibility to incentivise more GPs into partnership. 

When asked whether the new Labour Government is considering this change, the Department of Health and Social Care (DHSC) told Pulse that it is ‘determined to fix problems in general practice’ but did not address partner liability.

One ICB has taken on board LMC concerns about the risk of unlimited liability under the current GMS contract, and made commitments in its recent primary care strategy to address this. 

Buckinghamshire, Oxfordshire and Berkshire West (BOB) ICB said it wants to ‘consider flexibilities around contracts’ in primary care to ‘enable risk sharing’, and gave the example of GPs holding their core contracts in limited companies. 

Since ICBs do not dictate the terms of GMS contracts, BOB ICB told Pulse it will ‘try to influence the debate in this field with regional and national colleagues’. 

The GPCE has repeatedly called for an overhaul of the current GP contract, and widespread frustration with the lack of investment in the 2024/25 contract has led to a ballot for collective action.

GPCE deputy chair Dr David Wrigley told Pulse that the issue of unlimited liability ‘shows the urgent need for a new GP contract to be negotiated nationally by GPC England with the new Government’.

He said GPs need a ‘solid commitment’ from the DHSC ‘to begin that work’. 

In response to BOB ICB’s plans to explore GP partners holding their contract in limited companies, Dr Wrigley pointed out that this ‘already possible’ under the current regulations.

He continued: ‘What we’d rather see is for GP contractors and partners to be allowed to use limited liability partnerships (LLPs). This would remove the jeopardy of the unlimited personal financial risks they currently face. 

‘That would lead to more GPs joining or forming partnerships with other GPs, independently contract with the NHS and setting down roots in local communities for the long-term.’

Under the current GMS contract, all partners are ‘jointly and severally’ liable for any losses, meaning each could be liable for the entire value of any debt. 

In its guidance, the GPCE said this is ‘not palatable for future generations’ and ‘not sustainable for current partnerships’.

Instead, the committee is pushing for LLPs, which are separate legal entities which operate as a hybrid between a limited company and a traditional partnership. 

Under this arrangement, there is ‘no individual responsibility for each other’s actions’ and members ‘cannot lose more than they invest’. 

The current GPCE position is that national regulations should be ‘amended’ to allow GPs in LLPs to hold the core contract. 

However, the committee warned that regulations would also need to allow LLP members to contribute to the NHS pension scheme, which is not currently possible. 

Larger practices that are ‘expanding’ or ‘developing specialist practice areas’ would be most likely to benefit from LLPs, according to external advice the BMA received. 

Last year, the Institute for Government (IfG) made a similar recommendation, arguing that a move towards LLPs or companies would make GP partnership more attractive. 

The NHS Confederation has also called on the Government to make this change, which would help to ‘limit GP partners’ liability’ and ‘modernise’ the partnership offer.

A DHSC spokesperson said: ‘This government is determined to fix problems in general practice, which is critical to making the NHS fit for the future.

‘We will increase the proportion of resources going into primary care over time and help address the issues GPs face.

‘We will also make the future of general practice sustainable by ensuring we train thousands more GPs and shift the focus of care out of hospitals and into the community.’