Hawthorne et al
1 make a strong case for preserving and evolving the GP partnership model, highlighting its value in continuity, localism, and professional autonomy. While they note alternative organisational structures such as limited liability partnerships and federated models, we suggest there is another under-recognised option worthy of inclusion in this debate — the cooperative model.
In a cooperative, ownership and control are shared democratically among members, who may be GPs, other staff, and sometimes patients. Surpluses are reinvested in the service or directed to priorities agreed by members, aligning governance, staff wellbeing, and community health outcomes.
Applied to general practice, the cooperative model can retain the key strengths of the partnership model:
continuity and localism through rooted, accountable community connections;
autonomy in decision making, with shared risk among a broader membership; and
financial sustainability, with surpluses used for service improvement rather than external shareholders.
Crucially, this approach can also address current deterrents to partnership. Structures such as cooperative societies or community-benefit societies can limit personal liability, removing a significant barrier to ownership while retaining clinical and organisational control.
Although rare in UK general practice, this model is not theoretical. Newfield Medical Group in Dundee operates as a GP cooperative jointly owned by GPs and staff, delivering high-quality primary care while maintaining strong local identity. Beyond patient care, it supports a unique education model — a student-led clinic embedded within the practice. As described elsewhere by Leslie and McConville,2 this initiative provides immersive, supervised clinical experience for medical students, enhancing engagement for both learners and educators, and demonstrates how cooperative structures can foster innovation in workforce development as well as service delivery.
- © British Journal of General Practice 2025
