Chemistry is key for successful practice mergers

June 22, 2016

By Phil Harnby, manager at RMT Healthcare, the specialist medical division of Newcastle-based RMT Accountants & Business Advisors


Formal mergers between GP practices have become an increasingly regular occurrence over the last few years, and it’s a trend that has been driven by a range of different clinical and management factors.

Having greater numbers of clinical staff available can make it easier to manage local health needs and deliver new services, while having larger patient lists increases the amount of revenues that can be earned.

Sharing facilities may enable practices to use space more efficiently, and can facilitate new opportunities for additional revenue generation through the sale of surplus premises or leasing space to third parties, such as pharmacies.

The risks and rewards of introducing new service offerings can be shared across the bigger organisation, rather than by a smaller single practice, and options for funding premises improvements may also become wider.

Succession planning can become clearer with greater numbers of doctors, new career-development options can be provided for younger GPs which might not be available in smaller practices, and staff and/or functions may also be shared across practices.

All of these reasons provide compelling arguments for bringing practices together, but during the process of making mergers happen, and getting the backing required from the likes of NHS England and the local Clinical Commissioning Group, it must never be forgotten that GP practices are made up of people.

We’ve seen a number of potential practice mergers that looked good on paper fail to get over the line due to differences of opinion or a lack of chemistry between the two sets of partners and staff involved.

Clear and early communication between all parties at partner level is the absolute key to making mergers work, and for identifying issues that might slow or block it altogether.

At the start of the process, the two practice teams should sit down and discuss what are their ‘red lines,’ the key issues over which agreement needs to be reached to give the merger a chance of going through.

These could be anything from the amount of holidays that partners can take or the way in which GP remuneration is organised through to the roles that other staff have and issues of leadership amongst the merged team, but if there’s clarity and open discussion from the beginning, the risk of something arising that derails the whole merger process is significantly reduced.

Staff at the two practices need to be informed of their employers’ plans once things begin to fall into place, and to then be kept informed as work on the merger progresses, as this could give the respective workforces a chance to find out more about each other and how their prospective new co-workers operate.

Finally, appointing a project manager for the merger, whether an existing employee or an outside party like a lawyer or accountant, is absolutely essential in ensuring that responsibility for driving the project forward on schedule sits in an agreed place, and that it doesn’t get put on the back burner due to other clinical or administrative demands.

Taking a properly planned approach can ensure practice mergers bring the positive outcomes that all parties want when they embark on the process, but making sure it’s focused as much on your people as on your clinical and structural needs is essential to give yourselves the best chance of success.

For further information please contact Phil Harnby on 0191 256 9500 or email


Our key focus is outstanding client service. We are always on the look out for high quality team members in the following areas…

If you would like to be part of a progressive, growing practice please upload your CV here.

  • Accepted file types: pdf, doc, png.
  • This field is for validation purposes and should be left unchanged.