A GP partner’s long-term ill health does not automatically end their partnership, their GMS contract entitlement, or their employment-style protections, and treating it as though it does is one of the most common ways practices expose themselves to a disability discrimination claim. What actually happens depends on the terms of your partnership deed, the protections in the Equality Act 2010, and separately, the NHS Pension Scheme rules if the partner is applying for ill health retirement.
Sustained pressure on general practice means this scenario is no longer rare. A partner who has been signed off for months, or who is struggling to sustain full clinical sessions, puts the remaining partners in a genuinely difficult position: patient care and rota cover have to continue, income is affected, and yet the legal routes for managing the situation are narrower and more procedurally sensitive than many practices assume.
Why ill health is legally different from other partnership disputes
Most partnership disputes are, at root, a disagreement about conduct, direction or money. Ill health is different because the partner has not necessarily done anything wrong, and because a physical or mental health condition that has lasted, or is likely to last, 12 months or more will very often meet the legal definition of a disability under the Equality Act 2010. That triggers specific statutory protections that do not apply to a dispute about, say, working hours or profit share.
Under section 44 of the Equality Act 2010, a firm must not discriminate against a partner as to the terms on which they are a partner, by denying them access to benefits or opportunities, by expelling them, or by subjecting them to any other detriment, and a duty to make reasonable adjustments applies to the firm in the same way it would to an employer. This means an ill health partner cannot simply be compulsorily retired or expelled because their condition is inconvenient. Any decision has to be capable of justification as a proportionate means of achieving a legitimate aim if it is to withstand a discrimination challenge.
What your partnership deed should already provide for
A properly drafted deed will contain a specific long-term sickness or ill health clause, separate from the general expulsion clause, typically triggered after a defined period of absence, commonly around 12 consecutive months, or a cumulative period within a rolling three-year window, though there is no statutory template and the actual figure is whatever your deed provides for. Well-drafted clauses will also address:
- Continued profit share, or a reduced share, during the sickness period
- Whether the practice can require a medical examination by an independent occupational health provider
- The process and notice period for compulsory retirement once the trigger period is reached
- How the outgoing partner’s capital and goodwill are valued and paid out
Without express provisions covering this, the partners are left relying on the general law, which is considerably less predictable. Under section 35(b) of the Partnership Act 1890, a partner can apply to the court to dissolve the partnership where another partner has become “permanently incapable of performing his part of the partnership contract”, but this requires a court application, is slow, adversarial, and carries the same discrimination risk if not handled with care. This is precisely the scenario a partnership deed exists to avoid having to litigate. If your practice does not have a signed deed at all, the position is considerably worse again, as covered in our article on operating as a partnership at will.
The NHS Pension Scheme ill health retirement route
Where a partner’s condition means they cannot continue working, ill health retirement through the NHS Pension Scheme is often the practical route out, and it operates entirely separately from the partnership process. The NHS Business Services Authority (NHSBSA) administers two tiers of ill health pension. A Tier 1 award requires the member to be permanently unable to carry out the duties of their own role. A Tier 2 award requires that they also be permanently incapable of any regular employment of comparable hours, whether full or part time, because of the illness or injury. Tier 2 pays a materially enhanced benefit, and if a member later returns to work and their earnings in a tax year exceed the lower earnings limit, NHSBSA will substitute a Tier 1 award for the Tier 2 award going forward. GP partners apply to NHSBSA directly (via PCSE in England), and the application is independent of whatever the partnership deed’s own retirement process requires, though in practice the two processes usually run alongside each other.
| Tier | Qualifying test | Effect on award if member returns to work |
|---|---|---|
| Tier 1 | Permanently unable to carry out the duties of their own role | No automatic reduction tied to future earnings |
| Tier 2 | Meets Tier 1 test and is permanently incapable of any regular employment of comparable hours | Reverts to a Tier 1 award if earnings exceed the lower earnings limit in a tax year |
The GMS contract angle
A change in the partnership caused by one partner’s departure through ill health does not, by itself, put the GMS contract at risk. Regulation 15 of the National Health Service (General Medical Services Contracts) Regulations 2015 provides that the contract is treated as made with the partnership “as it is from time to time constituted”, meaning the reconstituted partnership generally continues to hold the contract. Commissioners have occasionally taken a stricter view of this than the regulations actually support, an issue examined in detail in the High Court’s 2024 decision in Bhat v NHS Litigation Authority, which we cover fully in our article on the Bhat case. If NHS England or your ICB suggests that a partner’s ill-health departure has itself terminated the contract, that position should be checked carefully rather than accepted at face value.
Where fitness to practise and GMC issues intersect
Occasionally, ill health, particularly where it affects clinical performance or judgement, becomes entangled with a GMC health or performance concern. These are separate legal processes with separate tests and timelines, and a GMC referral does not resolve, or replace, the partnership’s own obligations to the affected partner under the Equality Act 2010 and the deed. If your practice is dealing with both simultaneously, our article on what happens during a GMC investigation explains what to expect from that separate process.
Handling the departure fairly
Where a partner’s ill health ultimately means they cannot return to practise, the exit still needs to be handled through the deed’s proper process, valuation and notice provisions, applied consistently and without shortcuts, even where the underlying situation is sympathetic and the remaining partners are under real operational pressure. Rushing the process, or applying a mandatory retirement age informally rather than under an actual contractual power, carries its own risk, which we address separately in our article on whether a mandatory retirement age for GP partners is enforceable. Where the ill health issue has become genuinely intractable and the deed does not adequately address it, the wider dispute resolution options we set out in our guide to resolving a GP partnership dispute apply here too.
What This Means for Your Practice
Long-term partner ill health sits at the intersection of partnership law, disability discrimination law, NHS pension rules and the GMS contract, and treating it as a single, simple HR problem is where most practices go wrong. Review your deed’s sickness provisions before you need them, take independent occupational health advice before making any decision about a partner’s future, and keep the pension and partnership processes running in parallel rather than assuming one resolves the other.
If this affects your practice and you would like to talk it through, get in touch with our healthcare team or our employment specialists, call us on +44 207 566 1188, or email info@gurvelegal.com.
