Should I explore a merger? Things to consider
With financial pressures mounting, workforce challenges deepening, and the drive toward integrated neighbourhood models intensifying, many GP practices are asking the same question: should we explore a merger?
Mergers between practices — whether through full partnership consolidation, joint ventures, or federated working — can unlock economies of scale, resilience, and access to capital investment. However, they also carry significant legal, and operational implications that must be carefully evaluated before proceeding.
For GP practices, a merger is one of the most far-reaching strategic decisions partners can make. It affects partnership structures, property ownership, contracts, staffing, and patient lists. The partnership deed becomes the foundation for the merged entity, so understanding liabilities and governance arrangements is essential.
From an ICB perspective, supporting sustainable configurations of primary care is key to delivering integrated care and maintaining service continuity. Mergers can align with ICB estate strategies and workforce planning, but they also need to be lawful, compliant with GMS/PMS regulations, and properly authorised by NHS England where required.
Key considerations for 2026
The 2025/26 NHS planning framework places renewed emphasis on primary care sustainability and estates optimisation, both of which make mergers an increasingly practical option.
Recent guidance highlights:
- ICB discretion to approve merger proposals locally, replacing the more centralised approval model of previous years.
- Digital integration and estate rationalisation as key enablers for successful mergers, with funding potentially available through the Utilisation and Modernisation Fund, applying for which we discussed in another blog here!
- A push toward larger, multi-site partnerships or neighbourhood-scale practices to improve access, workforce flexibility, and business continuity.
These policy signals suggest that merger discussions are likely to become more common — but they should be underpinned by sound legal and governance preparation.
What does this mean?
For practice partners, this means assessing whether a merger aligns with long-term goals and values, not just short-term financial relief. You must be clear on what kind of merger you’re exploring — a full partnership amalgamation, a joint venture for specific services, or a shared administrative model — as the legal and tax consequences differ substantially.
For ICBs, it means developing transparent frameworks for assessing merger proposals, ensuring that patient safety, continuity, and value for money are preserved. A legally compliant and well-structured merger can help reduce duplication and improve care delivery — but rushed or poorly documented arrangements can expose both the new entity and commissioners to risk.
Below are some practical steps to take when one is considering a merger
- Start with due diligence – Review partnership deeds, property ownership, leases, NHS contracts, and outstanding liabilities.
- Engage early legal and financial advisers – Independent advice helps prevent disputes later and ensures proper structuring.
- Develop a shared vision – Align on culture, leadership, and service priorities before drafting the merger agreement.
- Consult stakeholders – Involve staff, patients, and ICB representatives early to maintain transparency and confidence.
- Plan governance carefully – Design robust decision-making and profit-sharing arrangements in the new partnership deed.
- Secure approvals – Obtain ICB and NHS England consent where required, ensuring compliance with GMS/PMS contractual terms.
A merger can be transformative when properly planned, offering stability, scale, and strategic opportunity. However, it remains a complex legal transaction — one that demands preparation, clear objectives, and professional advice to ensure that the promise of integration becomes a sustainable reality.
If you are considering a merger and would like expert legal advice to help you navigate what can often be a complex process, speak to DR Solicitors and find out how we can help you.
