Buying your first GP practice

From salaried GP or partner to practice owner

For most GPs, becoming a practice owner is the single biggest financial and operational decision of their career. It's also one that fewer and fewer doctors are stepping into — the average age of GP partners is rising, and the number of fully partner-led practices has fallen steadily over the last decade. That creates opportunity for the minority of clinicians who do want to own.

This guide covers what to think about if you're considering buying your first GP practice in the UK or Ireland — whether that's a partner buyout, a whole-practice acquisition, or a first step into building a group.

Understand what you are actually buying

A GP practice is not a single homogeneous asset. In the UK, you are typically buying an economic interest in a partnership that holds a GMS, PMS or APMS contract with the NHS, plus premises (freehold or leasehold), plus goodwill and sometimes a service company. In Ireland you are buying a going-concern practice that holds a GMS contract with the HSE and a private patient book.

The mechanics of how the contract transfers, how premises are held, how the partnership deed is structured, and how patient lists are treated all matter far more than the headline price. Two practices with identical revenue can be very different businesses.

Know what you are looking for

Before you start viewing practices, get clear on the profile you want:

• Location — urban or rural, list demographics, PCN or primary care network alignment
• List size — a 5,000-patient single-handed practice is a very different business from a 15,000-patient four-partner practice
• Contract type — GMS (Global Sum + Enhanced Services), PMS, APMS, or in Ireland GMS + STCs + Enhanced Contracts
• Partnership appetite — do you want to take on clinical partners, work with salaried GPs, or bring in a locum rota?
• Premises — freehold ownership (with Notional Rent) vs leasehold, and any NHSPS or community landlord considerations

Understanding valuations

GP practice valuations are typically expressed as a multiple of adjusted EBITDA (or "super profit" in single-practice transactions). What counts as adjusted matters a lot: partner drawings, locum cover, one-off QOF catch-ups, non-recurring Enhanced Services, and related-party payments (for example rent paid to a partner-owned property company) all need to be normalised.

Single-practice multiples in the UK and Ireland typically sit in a 4–7x range for stable, profitable practices. Platforms that roll several practices together have generally traded closer to ~10x EBITDA, with outlier European comparables reaching higher where scale and institutional readiness are genuinely differentiated. We cover this gap in more detail in our guide to GP practice valuations.

Funding the purchase

Most first-time buyers fund a GP acquisition through a blend of senior bank debt and personal equity. A healthcare-specialist lender will look hard at the stability of capitation income, the QOF profile, and any Enhanced Services element, and then size debt based on DSCR against EBITDA (not net profit).

Typical structures include:

• Senior debt — usually over 10–15 years, secured against the practice interest and any owned premises
• Premises loan — separate freehold finance where the building is part of the deal
• Vendor finance — retiring partners or selling principals sometimes defer a portion of consideration
• Personal equity — typically 10–20% of enterprise value on single-practice deals

Your funding structure shapes your cashflow from day one. See our guide to funding considerations for GP acquisitions for a deeper walk-through.

Due diligence — what to check

Once you have agreed heads of terms, the diligence work begins. Key areas go well beyond the accounts:

• Contract and list — is the GMS/PMS/APMS contract clean, is the list regularly cleansed, and what is the active vs registered ratio?
• QOF achievement — is the practice consistently at or near maximum points, and is that sustainable?
• Enhanced and Local Services — what income is contractually recurring vs annually renewable?
• Partnership deed — retirement provisions, profit-sharing ratios, and consent rights
• Premises — lease length, Current Market Rent reviews, dilapidations, and any NHSPS disputes
• Workforce — retention of key salaried GPs, practice nurses, and the Practice Manager through transaction
• Regulatory — CQC rating history, HIQA position in Ireland, complaints, and any significant events

The cost of proper diligence is a fraction of the cost of discovering a CQC issue, a sticky partnership deed or an imminent premises rent review after completion.

Structuring the deal

How the deal is structured matters as much as the price. Common levers include:

• Phased partner retirement — common where one partner is retiring and the incoming buyer wants continuity of care
• Earn-outs — tying a portion of consideration to future list retention, QOF points or revenue
• Seller clinical tie-in — vendor continues as a salaried GP or partner for 2–5 years
• Property treatment — retain in a separate property company, sell to the operating company, or sale-and-leaseback
• Asset vs share purchase — different tax treatment, different risk profile

Surround yourself with the right team

The transaction will be smoother and the outcome better with a specialist team: a primary care-literate solicitor, an accountant who understands GP partnership accounts, and an adviser who can spot what a generalist will miss. Sector knowledge materially changes outcomes in contract transfer, partnership deed and premises work.

Getting started

The best first step is simply to start the conversation. Understand what is realistic for your budget, get a feel for what is on the market, and build a picture of a good practice profile before you need to move quickly on a deal. The buyers who end up with the best practices typically started preparing six to twelve months before they actually transacted.