Practice manager Mike Neville explains how non-GP partners can benefit practices
As the healthcare landscape evolves, the question of whether non-GP professionals should become partners in GP practices has become increasingly pertinent. It is a complex question that does not have one single answer.
I have been a partner in my practice for almost a decade. Recently, I met up with my best man. Although not in healthcare himself, he is the son of a GP so has some concept of how general practice works. However, he could not fathom why it would be beneficial for a partnership to have a non-GP. Our conversation was not only cathartic for me, but also gave him an appreciation of why non-GP partners were beneficial on multiple levels.
There are many things to consider whether a non-GP should be considered as a viable option; or indeed why a non-GP should aspire to become a partner in practice.
Benefits to the organisation
We know that general practice functions differently to secondary care: the buck stops with us and there is nobody to bail us out if things go wrong. So from a business perspective, it is entirely reasonable to consider what advantages having a non-GP partner will bring to the organisation.
- Diverse perspectives. Incorporating non-GP partners fosters a collaborative environment where people’s different experiences and backgrounds contribute to innovative problem solving and decision making.
- A stronger partnership. With more partners, there is a decreased likelihood of the ‘last man standing’ situation.
- Improved efficiency. With their specialised skills, non-GP partners can streamline administrative processes, optimise workflows, and enhance practice productivity.
Benefits to the individual
Conversely, any individual considering entering into a GP partnership will want to know what is in store for them. The benefits listed below are the same for any GP also becoming a partner.
- Financial benefits. Profit sharing, equity building and tax efficiency of not being employed.
- Influence and control of the organisation’s overall strategy. Partners have the final say in major decisions, control of practice policies, and service provision.
- Professional development including leadership opportunities. As a partner, the non-GP can take on leadership roles within the practice, enhancing their professional profile. This may also benefit external leadership opportunities (e.g. LMC, ICB, or with their professional body.)
- Job security. Partners have more job security than employees because they have a vested interest in the success of the practice. As a partner, the non-GP is investing both in their own future, as well as the practice’s, offering long term career stability.
- Networking and collaboration. The non-GP partner will work with other partners and key stakeholders. The non-GP can foster a collaborative environment, leading to better patient care and practice efficiency.
- Personal satisfaction due to a sense of ownership and impact on the success of the practice.
Challenges for the organisation
Of course, it’s not all fun and games working in general practice and that applies to practice management too. When considering whether or not to have a non-GP partner, organisations should be clear about potential challenges they might face.
- Regulatory hurdles. Regulatory frameworks traditionally presented obstacles to the inclusion of non-GP partners, requiring careful navigation to ensure compliance with legal and professional standards. However, since the 2022 introduction of a recognised regulatory body – Institute of General Practice Managements (IGPM) professional accreditation framework – this has now become a moot point (assuming that that individual is accredited and on the professional register.)
- Role clarity. Clear delineation of roles and responsibilities is essential to prevent conflicts and ensure effective collaboration among all partners within the practice.
- Practice insurance. Whilst a GP partner currently secures 100% indemnity insurance in respect of clinical claims, a non-GP partner would risk being sued if their responsibilities are not adequately documented. Therefore, the practice needs to ensure it is adequately insured.
Challenges for the individual
Taking on a partner role at a surgery is also not without risks for the individual, and for non-GPs there may be more considerations to bear in mind before taking on the role.
- Personal liability. A full non-GP partner would assume unlimited liability for the debts and liabilities of the practice.
- Employment rights. These do not apply to profit-sharing partners because they are independent contractors – not employees. So any partnership agreements should have considerations for parental or sickness leave as an example.
- Tax. As a profit-sharing partner, a non-GP partner is classed as self-employed so has responsibility for paying their own tax and national insurance contributions.
- Pension. As a non-GP partner is not an employee, they are responsible for both employee pension contributions, as well as employer contributions
- Surgery premises. Although not necessary, premises buy-in has its own complexities so the individual should consult with a mortgage advisor.
- Partnership deed/agreement. This would need to be amended to include the non-GP partner. The obligations clauses should ring-fence their exposure to non-clinical issues and responsibilities. They may also consider adding an indemnity from the other clinical partners, in respect of all other third-party claims.
- Ring fenced liabilities. As a non-GP partner has no background or medical training, a partnership may wish to consider limiting their liability to non-clinical areas, such as finance, HR, premises management, IM&T, and data management.
While the integration of non-GP partners in GP practices presents both opportunities and challenges, it ultimately holds the potential to enrich patient care, optimise practice operations, and foster a culture of collaboration and innovation.
With almost ten years as a non-GP partner, I may be forgiven for potentially having a bias towards the positives. But that is not to say that I do not recognise the challenges experienced along the way both for me and my partner in partnership.
I recognise that not all non-GPs are suitable for a partnership role, however that is equally true for GPs too. Some partnerships may wish to offer partnership to a non-GP, but that individual may not want to be a partner for some of the reasons suggested.
It doesn’t matter what their background and experience is, as long as each individual brings something to the partnership and enhances the experience of the organisation from the perspective of the partnership, the staff and the patients also. Something my best man now has an appreciation of.
Mike Neville is a Managing Partner in Manchester and is the Institute of General Practice Management’s national lead for England North. You can follow him on X (formerly known as Twitter) @miken231
