England General practitioner General Practitioners Committee

Last updated:

GP networks and federations

More and more practices are beginning to explore entering some sort of collaborative arrangement with other practices in their area. These partnerships come by many names (i.e. federations, networks, alliances etc.) and can be formal or informal entities with a set of common objectives or purposes.

There are two main approaches to how GP networks opt to deliver economies 'at scale'. The main difference between them is the extent to which individual practices retain or lose their autonomy, thereby affecting the employment arrangements for salaried GPs employed by these structures.

 

  • Super partnership

    Several partnerships merge to form a super partnership covering multiple sites across a wide area. The super partnership operates much like a regular partnership at a larger scale. Usually, a partnership agreement between the partners of the practices is sufficient for a merger to take place, thereby merged practices can hold G/PMS or APMS contracts, but this may eventually be in addition to another structure, e.g. a company limited by shares etc.

  • Federations

    Similarly, a federation is a group of practices that come together, to share responsibility for a range of functions, which may include developing, providing or subcontracting services, training and education, back office functions, safety and clinical governance. The collaboration may be informal or formalised as a legal entity which can hold contracts. The table below provides a list of structures for how a formalised legal entity could look like and what the implications would be for a salaried GP.

    Table 1: collaboration structures and contractual implications for employers and employees

    Super partnership

    Employer's contract status Can hold G/PMS and APMS.
    Pension status Eligible for NHS Pension Scheme if holding G/PMS/APMS.
    Model contract status for salaried GP Contractually bound to offer terms no less favourable if G/PMS.
    Recommended if APMS.

    Company limited by shares

    Employer's contract status Can hold G/PMS/APMS in its own right.
    Member practices retain individual contracts.
    Pension status Eligible for NHS Pension Scheme if holding G/PMS/APMS contract.
    Model contract status for salaried GP Contractually bound to offer terms no less favourable if G/PMS.
    Recommended if APMS.

    Company limited by guarantee

    Employer's contract status Only APMS contract in its own right.
    Individual practices retain contracts.
    Pension status Eligible for NHS Pension Scheme as an independent provider if holding APMS.
    Model contract status for salaried GP If employed by the Company limited by guarantee, then model contract recommended.
    If employed by individual practice which holds G/PMS contract, then bound to offer model contract.

    Limited Liability Partnership (LLP)

    Employer's contract status Can only hold APMS in its own right, but individual practices retain individual contracts.
    Pension status Eligible for NHS Pensions Scheme as an independent provider if holding an APMS contract.
    Model contract status for salaried GP If employed by the LLP, then model contract recommended.
    If employed by individual practice which holds G/PMS contract, then bound to offer model contract.

    Community Interest Companies (CICs)

    Employer's contract status Can hold G/PMS/APMS contracts in its own right.
    Pension status Eligible for NHS Pensions Scheme as an independent provider if holding an APMS contract.
    Model contract status for salaried GP Contractually bound to offer terms no less favourable if G/PMS.
    Recommended if APMS.
  • Checklist

    We have compiled a checklist of questions you should be asking if your practice is considering entering a super partnership or federation.

    View the checklist

    Read further information on the collaborative GP networks and their legal structures.