When Partnerships Break Down: Navigating Primary Care Conflicts

Why Early Legal Advice is Your Best Investment

Partnership disputes in general practice rarely materialise overnight; they manifest over time, through various means including tensions around workload, commitment to the practice, money, differing views on the practice direction (stabilize, scale up by merger/acquisition, dispose, terminate NHS contract), patient safety concerns, poor professional practice behaviours, and so on. When left unaddressed, ‘annoying but tolerable irritations’ fester and escalate into a conflict that consumes time, causes stress and ultimately costs money because it threatens the viability of the practice itself. At DR Solicitors, we believe there is a more proactive approach which can be taken to mitigate these issues. Too often, practices reach out when relationships have already deteriorated and the only apparent option is formal litigation, when in fact resolving conflicts earlier can achieve more sustainable outcomes.

The Problem with Waiting before Taking Legal advice

There is a pervasive belief that instructing a solicitor should be a last resort. The concern, understandably, is cost. Legal fees can seem daunting so as a result, partners turn to sources of free advice including ChatGPT. While well-intentioned, these sources are unlikely to provide the specialist, healthcare advice needed to navigate a primary care partnership dispute.

When a dispute lingers on, relationships deteriorate, partner and staff morale plummets and good people leave. Before long, the practice has lost its resilience and it is unattractive to incoming partners. The good news? All of this damage can be avoided with the right, strategic legal advice at the start and sticking laser-focused to the goal.

Preparation Before the Meeting

When conflicts arise, the instinct is often to call an urgent practice meeting. This is rarely wise without preparation. Walking in without a clear agenda, defined objectives and an understanding of your legal position is a recipe for escalation.

Before any meeting, consider what outcome you actually want and take advice on your legal and commercial options at the outset. The right advice can hugely improve your negotiating leverage. Are you seeking to preserve the partnership, or is separation the best path? Do you want changes to working arrangements and profit shares? Next, understand your legal position. Review your Partnership Deed and the rights it creates. If you operate without a formal Deed, you are governed by the Partnership Act 1890, which may not reflect your intentions. Taking legal advice at this early stage is invaluable because a specialist solicitor can help you assess your position so you can approach negotiations with confidence and make informed, sensible decisions.

Every meeting should have a written agenda and clear minutes. Remember: everything you put in writing yourself is potentially disclosable; privileged communications with your solicitor remain confidential.

Choosing Your Dispute Resolution Route

If informal negotiation fails, you will need more structured processes. The three main options are mediation and, rarely, arbitration and court proceedings.

Mediation is a voluntary, confidential process where an impartial third party, known as a mediator, facilitates agreement and communication between parties, aiming to find a mutually agreeable solution for all. It is typically faster, less expensive and preserves relationships because it is collaborative rather than adversarial. Given there is no goodwill in a medical practice, if a dispute has reached this stage (most do not) the case is settled at mediation

Arbitration is more formal but the key positive (in comparison to the public courts or the Employment Tribunal) is that the arguments remain private. It is essentially a ‘private court’ where an arbitrator issues a binding decision. Most GP Partnership Deeds specify arbitration, and you can choose an arbitrator with healthcare expertise to fit the dispute. So you can appoint a healthcare surveyor to arbitrate a surgery valuation dispute or a healthcare accountant to arbitrate a financial dispute. But we work hard to settle a dispute before we get to this point because of the fact that there is no goodwill in an NHS practice so in most cases, the costs are prohibitive.

Court proceedings are heard in the High Court which is a public forum, and therefore the world can read about your dispute. It is slow because of the backlog in getting a hearing pencilled in, expensive and adversarial. It tends to destroy remaining relationships so in our view Court proceedings for a private GP partnership dispute should generally be a last resort.

Why Early Instructions to a Healthcare Lawyer can save Money

Instructing a specialist, primary care, dispute resolution solicitor early reduces your business risk and your costs. Early advice helps you avoid tactical errors: ill-advised emails and social media posts, verbal outbursts that are not thought through and most importantly, failing to follow the dispute resolution procedures set out in your Partnership Deed. You paid for a Partnership Deed so use it, and if you do not have a Partnership Deed in place then you clearly have a high risk appetite! Our team of highly skilled GP dispute resolution lawyers can quickly assess whether your GP or non-clinical partnership dispute is worth pursuing and identify the most appropriate route. Sometimes the best advice is to compromise early; sometimes it is to stand firm and hold out for a better deal.

Get in touch

Whether you are facing an emerging dispute, navigating a difficult partnership conversation, or simply want to review your Partnership Deed, our specialist team is here to help. The earlier you reach out, the more options you have and the lower your costs are likely to be. Contact our Primary Care team today here — the sooner we talk, the more we can do to help.