Becoming a GP partner

‘Drawings’ rather than a ‘salary’

Partners will usually get ‘drawings’ from the practice, rather than a monthly salary.

Like a salary, you are still paid monthly and your pension contributions are deducted at source.

Unlike a salary, your tax, National Insurance and student loan deductions aren’t yet deducted.

You’ll need to be disciplined in saving part of your pay each month to cover these payments, made twice a year in January and July, with help from your accountant. How much you ‘draw’ is usually agreed between the Partners and Accountant.

Some practices will fluctuate their drawings from month to month, whilst others will pay a fixed amount. At the end of the year when your ‘Partnership Profits’ are known (i.e. how much your income is), there may be one-off balancing payments made either once or twice a year (sometimes called a ‘divvy’).

This will be an adjustment payment that balances the difference between what has been drawn and the actual figure.

Parity

Given the costs involved in taking on a new partner (e.g. writing a new partnership agreement), sometimes there will be an element of ‘parity’ when you join a partnership.

This basically means the partnership will pay you less (say 90%) for a period of time (say one year) in order to have money available for any costs required to bring you onboard.

Some practices will give you full parity from day one (i.e. no reduction in your partnership profits), others may ask for two years. There is an element of negotiation to be had, but be realistic. It is commonplace for new partners to earn less than others for some period of time.

Partnership agreement

The partnership equivalent to a contract of employment is a ‘partnership agreement’. This can be a lengthy document which explains the responsibilities of a partner and what would happen if there are any disputes.

It is not a legal requirement to have one, but if a practice does not have one in place, the partnership will be governed by the Partnership Act 1890 and outcomes from disputes may not be what partners would particularly want.

A good partnership agreement, reviewed regularly, is key!

Will you have to pay the joint partnership?

Yes and no. The partners are not allowed to ‘sell’ you a share of a partnership (i.e. the goodwill of the practice cannot be sold) - however they may ask you to pay into the following:

• The practice ‘capital account’ – each practice will have a bank account which has a ‘float’. This is to help them manage day-to-day cash flow, as the CCG may pay them one day, but a certain bill may need to be paid the day before. The amount in the capital account can vary from practice to practice, and will usually depend on how many sessions you are going to work as to what your share would be. You could just pay the money (e.g. £5,000) to the practice on day one (you will get the money back when you leave), but it's more common for the new partner to accept a slightly lower level of drawings for a period of time in order to pay into the capital account and build up their share gradually (e.g. over one year).
• The practice building – sometimes the partners own the practice building. Sometimes they don’t. If they do, they may give you the opportunity of buying into the building (potentially paying off a retiring partner). This can be a huge cost and so it is not for everyone. Fortunately it is optional. Most new partners will buy into the practice building if they have the option, but not straight away. They may do it after one or two years of being a partner (to ensure it is the right place for them). More often than not, the new partner will take out a commercial loan to buy into the building. Fortunately, the owners of the building (i.e. the partners) will receive rent from the NHS (sometimes called ‘notional rent’) which will help towards any loan repayments.

Are you committed to the practice for the long-term?

Not necessarily, but it will depend on what is agreed in the partnership agreement. Some practices will want a partner to give three months’ notice to leave, others will want six or twelve months. You should not enter a partnership if you expect it to only be a short-term thing, but if you do want to leave in the future, you can.

So, is it worth it?

Yes, there is an increased administrative burden, and you may have a more onerous clinical responsibility for your patients, but the financial benefits and ability to make real changes to benefit your patients can make this an appealing opportunity.

Partnership is not for everyone, so there is no ‘right or wrong answer’ as to whether you should become a partner or not. Usually when GPs understand the differences between partnership and being a salaried GP or locum, the ‘step up’ in responsibility doesn’t seem quite as daunting.