GP Partnership Mediation: Not Just for Repairing Relationships

Mediation is not only about reconciliation

When GP partnership relationships break down, mediation is often misunderstood as a process aimed only at reconciliation. In reality, GP partnership mediation is not simply about helping partners find a way to continue working together. It can also provide a practical, confidential, and cost-effective route to ending a business relationship cleanly - particularly where an exit from the partnership is the most realistic and constructive outcome.

There is a common myth that mediation is only useful when GP partners want to repair a damaged working relationship and continue in business together. This is one of several common misconceptions about mediation that can prevent parties from considering it when it may offer a practical route forward. As a mediator, I often hear ‘We don’t need a mediation as we can’t continue working together, so we are going to use our green socks clause instead,’ or more recently - when being invited onto a podcast to talk about the benefits of mediation - ‘It’s good to let GPs know that there is an alternative to divorce.’

Like in the situation of divorce between married couples, mediation can be just as valuable when the relationship is irreparable and can achieve a quick and cheap clean-break, benefitting all, including of course patients and staff of the partnership.

Not every GP partnership dispute can, or should, result in reconciliation. Sometimes the most sensible outcome is a clean and orderly exit for one or more partners, allowing both the individual and the remaining partnership to move forward without prolonged uncertainty, escalating costs, the fear of future legal claims, or further damage to the practice.

When separation is the most constructive outcome

A common reason for an irreparable business relationship is when partners find they have a completely different approach to running the business, often stemming from a clash of values - for example, a partner focused on profitability and another focused on improving patient care, regardless of what cost that may put on the practice. Neither is right or wrong - they are simply different points of view - but importantly neither partner is likely to wake up one day and take a different approach to life.

Achieving a quick, clean separation is particularly important in general practice, where partnership disputes can rapidly affect decision-making, staff morale, patient services, CQC ratings, profits, and the day-to-day running of the practice.

How GP partnership mediation supports a negotiated exit

Mediation provides a structured, confidential, and without prejudice process for working through a solution. The legal ‘safety’ of the mediation can give partners the courage to talk openly about how the situation is untenable and someone is regrettably going to have to leave. It gives the partners a forum to clarify what each side needs, identify the practical and financial barriers to an exit, and negotiate terms that are workable for everyone involved.

Creative solutions for notice periods, negative equity, debts that haven’t yet crystallised (such as disputes with NHSPS landlords), capital accounts, restrictive covenants on where outgoing partners can work, premises value, and financial settlements can be discussed and refined - without the fear of any of that being seen as an admission of liability - as what happens in a mediation can’t be spoken about or be used in an ongoing/future claim.

Mediation compared with formal legal routes

Compared with formal legal proceedings, mediation can also be quicker, less expensive, and less disruptive. It allows the partners to retain more control over the outcome, rather than handing the dispute over to a court, arbitrator, or drawn-out correspondence between solicitors.

The risks of relying on a green socks clause

With the example of using a green socks clause to retire a partner, this can take some time - there may be processes the partnership must follow first (perhaps a series of meetings that must be scheduled at least a month apart) and then a very rigid procedure of sending information to the retired partner must be followed (and is usually done by a solicitor). We have explored separately why a green socks clause can provide an important non-fault exit route, as well as the legal, procedural and reputational risks involved in using one.

Even then after those associated costs and time, the outgoing partner can challenge what has happened, by stating that the process wasn't validly executed, or by claiming that they have been discriminated against based on a protected characteristic of theirs. This can clearly cost many tens of thousands of pounds to fight (on both sides) and leaves a state of chaos in the meantime with the outgoing partner continuing to turn up to the practice claiming they have a right to be there and to continue working.

It is clear, therefore, why mediation is an appealing alternative - sitting down in a room and attempting to negotiate a clean break without months of uncertainty, stress, and legal costs on all sides.

When the partnership agreement provides no clear exit

Some partnership agreements don’t have the option at all to formally expel a partner except if they have breached terms of the partnership agreement (which of course can always be challenged). This illustrates why a carefully drafted GP partnership agreement needs to anticipate not only misconduct, but also the possibility that the business relationship may simply become unworkable. Those partnerships have even fewer alternatives to a negotiated settlement through mediation than those that do have a green socks clause.

A clean exit can be a successful mediation outcome

Mediation therefore should not be seen as a last attempt to save a partnership that has already broken down. In many cases, its greatest value is in helping GP partners separate with clarity, dignity, and commercial common sense. Where the alternative may be months of uncertainty, legal correspondence, escalating costs, and disruption to the practice, mediation offers a way to reach a negotiated exit that protects the individuals involved, the remaining partnership, the staff team and, ultimately, the patients.

General Practice Mediation supports GP partners in negotiating confidential and commercially workable exits, whether the relationship might still be repaired or separation has become the more realistic outcome.