How sustainable is the GP partnership model?

Since 2016, The King’s Fund has conducted annual surveys to understand GP trainees' future career plans. The most recent survey of GP trainees offers a revealing snapshot of how future GPs perceive their career paths. Against the backdrop of ongoing collective strike action and calls for reform, these insights raise pertinent questions about the sustainability of the GP partnership model – a structure once seen as the backbone of primary care in the UK.

A striking finding from the survey is the decline in interest among trainees in pursuing GP partnerships as a long-term career goal. In 2019, 41% of trainees viewed partnership as their primary aspiration for ten years post-qualification, but by 2024 this had fallen to just 31%. Balancing these financial risks with the pressures of running a practice is dissuading new doctors from pursuing partnership roles.

The growing number of trainees expressing uncertainty about their future (46% in 2024 compared with 32% in 2019) underscores this shift. This ambivalence could be linked to increasing job demands, financial pressures and the perceived burdens associated with partnership roles. 

The data reveals that responsibility for practice workload remains the top deterrent for trainees considering partnership, a concern that has grown from 56% in 2019 to 64% in 2024. The financial commitment required also stands as a significant barrier, cited by 60% of trainees. This shift aligns with the broader economic environment affecting GP partners. The proposed hike in National Insurance contributions from April 2025 is likely to compound anxieties over financial security for the GPs of the near future.

Balancing these financial risks with the pressures of running a practice is dissuading new doctors from pursuing partnership roles.

GP trainees' shifting preferences for part-time work reflect a deeper desire for better work–life balance. The number of trainees planning to work part time immediately after qualifying has risen slightly, from 42% in 2019 to 48% in 2024, while long-term certainty about any clinical role has dropped markedly, from 79% to 60%. This change suggests that the intensity and demands of full-time roles, especially within partnerships, are discouraging commitments to such paths.

Administrative workload has emerged as a growing concern, cited by 75% of trainees in 2024 compared with 49% in 2019. This spike highlights the strain posed by the expanding non-clinical responsibilities that come with GP partnership, an issue corroborated by The King’s Fund report on making care closer to home a reality. The report emphasises that reducing administrative burdens and investing in support structures are key to sustaining a resilient primary care workforce.

A notable finding from 2024 is the rise in trainees considering options outside NHS general practice. Interest in private clinical work has climbed to 37%, while 42% are contemplating working abroad – a marked increase from 18% in 2019. The proportion of trainees considering alternative business ventures has also risen, from 10% to 24%. Additionally, there has been a significant drop in the number of trainees citing a lack of interest in business matters as a deterrent to becoming a partner. When combined, these findings emphasise that a lack of interest in medical leadership, business and innovation among trainees is not an issue. Rather, there is a lack of faith in the current structure and system being able to provide these opportunities and so trainees are seeking to pursue them elsewhere.

The context in which these survey results are situated is critical. The current wave of collective strike action among NHS staff, including doctors advocating for better pay and conditions, has underscored the systemic challenges facing the profession. The King’s Fund has repeatedly highlighted the urgent need for comprehensive workforce planning and policies that prioritise staff wellbeing. The sustainability of the GP partnership model depends on addressing these issues, from ensuring competitive compensation to reducing the administrative burden and providing pathways that make partnership roles attractive.

The data from the 2024 GP trainee survey paints a picture of a workforce that is increasingly cautious about long-term commitments to partnership roles. To maintain the sustainability of primary care, policy-makers and NHS leaders must respond by creating conditions that support, retain and incentivise new generations of GPs. Addressing workload intensity, reducing administrative burdens, fostering clinical innovation and leadership interests, and ensuring competitive compensation are crucial for sustaining the attractiveness of partnerships and securing the future of general practice.