Smaller GP practices that appoint a manager partner are significantly less likely to close or merge, the first study of its kind has found.
The University of Manchester and Calgary researchers publish their study today in the Journal of Health Economics amid a backdrop of dwindling numbers of GPs practice owners-known as partners.
That, say the researchers, puts the managerial and financial burden of operating a practice on increasingly smaller numbers of GPs, with a heightened consequential risk of burnout and stress.
It is funded by the National Institute for Health and Care Research (NIHR) Policy Research Unit (PRU) in Health and Social Care Systems and Commissioning.
Practices in the UK are generally owned and operated by one or more self-employed independent contractors referred to as partners.
Under most general practice contracts with the NHS, there must be at least one General Practitioner (GP) partner at a practice; however, not all partners need to be GPs.
One potential way to provide a sustainable alternative structure for general practice they say, could be non-clinical ownership with practice managers as partners.
The managers, responsible for administration, HR, and financial management, typically handle the business and operational aspects of the practice and do not usually have medical training.
By 2022, the number of practices reporting they had a manager partner had grown to 335, from 0 in 2015, serving 7% of patients registered at general practices in England.
Based on analysis of data from England’s 37,660 practice-years from 5,026 general practices between 2015 and 2023, the researchers use a range of sources to investigate the impact of non-clinical ownership stakes on key primary care outcomes.
They found that appointing a manager partner leads to significant increases in full-time equivalent (FTE) direct patient care staff, excluding GPs and nurses, as well as administrative staff numbers and total patient list size.
Practices that appoint a manager partner were found to be more sustainable because they were less likely to subsequently merge or close.
There were no significant impacts on numbers of GP or nurse staff, GP turnover, quality of care, patients’ satisfaction and access. And income from reimbursement for non-core services, such as local or direct enhanced service, quality outcome framework payments, and medication administration payments, were higher following appointment of a practice manager as a partner.
“The University of Manchester is a public research university in Manchester, England. The main campus is south of Manchester City Centre on Oxford Road.”
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