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Renaissance for GP partnerships

Fiona Barr asks if recruiting a partner is a more attractive proposition because of the coming reforms

Dr Drage: being a partner 'is a good thing. It provides more career development and opens up a market which has been shut for a long time' (Photograph: Londonwide LMCs)
Dr Drage: being a partner 'is a good thing. It provides more career development and opens up a market which has been shut for a long time' (Photograph: Londonwide LMCs)

The statistics have yet to prove it but accountants, GPs and LMCs are reporting the signs of a renaissance of the partner.

Dr Michelle Drage, chief executive of Londonwide LMCs, says: 'It's anecdotal but people are talking about partnerships in a way that they have not done for some time. We don't have data to quantify that yet because it takes time to work its way through.'

The 10 years from 1998 saw salaried GP numbers grow by 705 per cent so that by 2008 a fifth of GPs were salaried. However, at the beginning of 2009 the BMA reported that the trend towards a decreasing number of partners and a significantly increased number of salaried GPs had been arrested and figures for the whole of 2009, the latest the BMA has available, confirm that.

Dr Stefan Cembrowicz, a GP appraiser in Bristol, reports that the practices he visits are beginning to change their stance. He says: 'I get the impression that after a period where nobody got offered a partnership when somebody retired, some partnership vacancies are starting to arise.'

Dr Cembrowicz believes the government's overhaul of the NHS may be playing a part.

He adds: 'With commissioning lying ahead, people who take strategic responsibility and have specific skills in a particular area look like attractive partners.'

Partner versus salaried
Dr Louise Skioldebrand and her partners at Stow Health Centre in Suffolk have just gone through the debate themselves as a partner retired. They opted to recruit a salaried GP but Dr Skioldebrand says her experience as a GP appraiser suggests that other practices are not following suit.

She says: 'I have heard of more partner jobs coming up recently.' Dr Skioldebrand adds that premises could be one issue prompting practices to recruit partners.

She says: 'Some partners are realising that they need some junior-ish partners to buy in to their practices.'

The offer to buy in to practice premises will not appeal to all GPs. Graeme Jump, a solicitor with Mace and Jones in Manchester, says premises costs continue to be a deterrent.

'You have a got a generation of partners who bought into their premises and are now looking to take their equity in the building.

But young GPs who probably have a mortgage themselves don't want to commit to additional debt of what could be anything from £30,000 to £100,000,' he says.

Some practices are also struggling to recruit salaried GPs and Mike Burdett, in charge of GP recruitment for Your World Recruitment agency, believes many GPs are preferring to work as locums in these uncertain times rather than commit to a salaried job.

Unfilled vacancy
In Suffolk, Dr Skiolebrand says previous openings for salaried GPs were more successful than the latest drive which left the practice still looking to fill its vacancy.

'We don't know if we would have got a lot more applicants if we'd advertised for a partner,' she says, adding that the partnership decided against employing another partner because it already has seven partners and felt that was enough managers.

Laurence Slavin, partner with GP accountancy firm Ramsay Brown and Partners, says the size of current partnerships can be a factor. His firm represents more than 500 practices nationwide and also reports a halt in the trend towards ever increasing numbers of salaried GPs.

'Practices have reached a point where they can't get rid of any more partners. For instance, if they have gone down to being a three partner practice they feel they cannot drop further to become a two-partner practice,' he says.

Like Dr Cembrowicz, Mr Slavin believes that partnerships are also anxious about the future - both with the advent of commissioning and what he predicts will be an increasing attack on GP income.

He adds: 'GPs are making long-term decisions now to take people who will give them a bit more and also, if they have somebody good, they want to make sure they grab them with a partnership.'

Salaried GP more costly
Hard finance may also drive a move towards more partnership jobs if practices see their income falling and fear it may be more expensive to pay a salaried GP than to split the profits with a partner.

Mr Slavin believes few practices have reached these kind of decisions yet but argues that, if each GP is earning less than £10,000 for a weekly session, then the practice is not any better off with a salaried GP.

Dr Richard Fieldhouse, chief executive officer of the National Association of Sessional GPs, also cites the forthcoming overhaul of the NHS as a factor.

'My gut feeling is that if I was a partner, whereas before I would have felt quite happy to cut a partner, I would now be wanting to build a more substantial team around me and recruit another partner,' he says.

However he warned that while GP partner vacancies may increase there may not be hundreds of young GPs queuing up to fill them.

He adds: 'In our locum chambers we have had nine partners resign from their practices in the last year to join us and eight of those nine were under 45.'

Dr Drage believes there are plenty of entrepreneurial young GPs who want to become partners. She hopes any sign of more partnerships is also a result of practices responding to the LMCs' message that recruiting partners is the best protection against the encroachment of private sector competitors.

She says: 'It's absolutely a good thing. It provides more career development than just going in and doing a surgery and it opens up a market which has been shut for a long time.'

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