GP Super Partnerships

Super partnerships: a new era for general practice

General practice is under unprecedented and sustained pressure. Financial constraints, rising workloads, and evolving NHS commissioning models are prompting many GPs to rethink the size and structure of their practices. The traditional model of small partnerships of up to six partners is increasingly seen as unsustainable.

The rise of super partnerships

In response, a new model is emerging: the super partnership. These are large-scale mergers of GP practices, often involving 10 to 20 practices or more. While mergers of one or two practices were once the norm, the formation of Our Health Partnership (OHP) in Birmingham—uniting 38 practices and serving nearly 300,000 patients—has redefined the scale and ambition of what’s possible.

Other super partnerships are following suit. The Suffolk GP Federation, for example, comprises 57 practices and a patient population of 540,000, positioning it to become one of the largest GP partnerships in the UK.

Why super partnerships work

Super partnerships offer a compelling blend of scale and local autonomy. They enable practices to:

  • Collaborate with local health and social care providers to deliver integrated, community-based care
  • Centralise administrative, regulatory, and management functions—freeing up clinicians to focus on patient care
  • Strengthen resilience against competitive pressures and reduce the risk of practice closures
  • Create new career development opportunities for staff and partners

Our role in supporting super partnerships

We worked closely with the leadership of OHP to develop a secure and innovative legal framework that balanced the benefits of scale with the need for local autonomy. Each practice retained control over its day-to-day operations while contributing to a unified partnership structure. Crucially, existing partnership agreements were preserved and adapted—not discarded—ensuring continuity and confidence for all partners.

Key considerations for merging practices

A successful super partnership depends on careful planning and shared commitment. Key principles include:

  • Vision: A clear, shared purpose is essential—typically focused on improving patient care, operational efficiency, and long-term sustainability.
  • Commitment: Early agreement on democratic governance and delegated decision-making is vital. While individual influence may diminish, many partners find renewed freedom to focus on clinical work.
  • Autonomy: While some control is necessarily centralised, practices can retain significant autonomy over local matters.
  • Contractual Flexibility: Merging GMS/PMS contracts is not required at the outset. Practices can maintain separate contracts and align them over time.
  • Staff Engagement: Transparent communication and a compelling vision can turn uncertainty into opportunity, energising staff and unlocking new roles.
  • NHS Pension Scheme: Structuring the merger to preserve NHSPS access is critical and requires specialist legal input.

Looking ahead

Super partnerships are not a one-size-fits-all solution, but they offer a powerful model for practices seeking to thrive in a changing NHS landscape. With the right legal, operational, and cultural foundations, they can deliver real benefits for patients, partners, and the wider health system.

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