As general practice continues to evolve, some GP-led organisations are exploring alternative corporate structures to support service delivery, community engagement and long-term sustainability. One option that is sometimes considered is converting an existing private limited company (Ltd) into a Community Interest Company (CIC).
While both structures are companies limited by shares or guarantee and offer limited liability protection, there are important differences in governance, ownership, financial flexibility and future strategic options. Before making any decision to change corporate structure, GP shareholders should fully understand the implications.
A limited company is established primarily to benefit its shareholders. Directors have a duty to promote the success of the company for the benefit of its members, and profits can generally be distributed to shareholders through dividends.
The advantages include:
For organisations operating healthcare services, the Ltd model can provide significant flexibility when responding to commissioning opportunities and changing market conditions.
A CIC is a special type of company designed to operate for the benefit of the community rather than primarily for private profit.
Whilst a CIC can trade, employ staff and generate surpluses, it is subject to additional regulation and operates under an “asset lock” which restricts the distribution of assets and profits.
The key principle is that the organisation exists to deliver community benefit rather than shareholder return.
Perhaps the most important question for existing GP shareholders is:
What happens to shareholder value?
When moving from a traditional limited company structure to a CIC, shareholders need to understand that future opportunities to extract value from the company may be significantly restricted.
Questions to consider include:
These issues should be examined carefully with specialist legal and financial advice.
One of the defining features of a CIC is the asset lock.
This means company assets must be used primarily for community benefit. Assets generally cannot be distributed freely to shareholders, and upon dissolution any remaining assets must normally be transferred to another asset-locked organisation or community benefit body.
For organisations that have accumulated assets, reserves or property over many years, this is a significant consideration.
A CIC may become eligible for certain grants, social investment opportunities or funding streams that are less accessible to conventional commercial companies.
Potential advantages can include:
However, this should be balanced against the reduced flexibility associated with shareholder returns and capital investment.
A CIC is regulated by the Office of the Regulator of Community Interest Companies in addition to Companies House requirements.
This creates additional obligations, including:
Directors should be comfortable with a more formal requirement to demonstrate social impact.
Shareholders should consider the long-term strategic implications of conversion.
Questions may include:
Whilst CICs can operate commercially, some strategic options become more constrained when compared with a traditional limited company structure.
For some healthcare organisations, a CIC structure may be viewed positively by patients, partners and commissioners because of its explicit commitment to community benefit.
Potential advantages may include:
However, commissioners generally commission services based on quality, value and capability rather than company structure alone. Organisations should therefore avoid assuming that CIC status automatically creates commissioning advantages.
Before considering any conversion, shareholders should be able to answer the following:
✅ Why are we considering becoming a CIC?
✅ What specific benefits do we expect to achieve?
✅ What effect will the change have on shareholder rights and value?
✅ How will future profits and reserves be managed?
✅ What restrictions will apply under the asset lock?
✅ How might the change affect future business opportunities?
✅ Have we obtained independent legal, tax and accounting advice?
Converting from a limited company to a Community Interest Company is a significant strategic decision rather than simply an administrative change. Whilst CIC status can strengthen an organisation’s social purpose and community credentials, it also introduces new governance requirements and restrictions around assets, profit distribution and shareholder value.
GP shareholders should ensure they fully understand both the opportunities and the long-term consequences before pursuing any change in corporate structure. Independent legal, financial and tax advice should always be obtained before making a final decision.
The Deprivation of Liberty Safeguards (DoLS) are a key part of the Mental Capacity Act 2005 (MCA) and provide legal protection for individuals who lack the mental capacity to consent to arrangements made for their care or treatment, where those arrangements may amount to a deprivation of their liberty.
The safeguards exist to ensure that restrictions placed upon a person’s freedom are applied only when they are:
DoLS most commonly apply to people living in care homes or receiving care in hospitals, particularly those with conditions such as dementia, learning disabilities, severe mental illness, or acquired brain injuries that affect their ability to make decisions about their care and residence.
For healthcare professionals, including GPs, an understanding of DoLS is important as patients and their families may seek advice regarding capacity assessments, restrictive care arrangements, or the legal processes surrounding deprivation of liberty. GPs may also be asked to contribute relevant medical information to assessments undertaken by local authorities.
Many clinicians will be aware that the Liberty Protection Safeguards (LPS) were introduced through the Mental Capacity (Amendment) Act 2019 with the intention of replacing the existing DoLS framework. However, the implementation of LPS has been repeatedly delayed and, at present, DoLS remains the legal mechanism in England and Wales for authorising deprivation of liberty in hospitals and care homes.
Practices are encouraged to remain familiar with the current DoLS process and associated responsibilities until further national guidance is issued regarding the future implementation of LPS.
Further information, guidance, and useful resources can be found on the Doncaster LMC website:
👉 View the Doncaster LMC DoLS Resource Page
Additional national guidance is available via the Department of Health and Social Care’s DoLS Code of Practice and other supporting resources for healthcare professionals.
Although responsibility for DoLS authorisations rests with supervisory bodies, practices are increasingly involved in supporting patients who lack capacity, responding to requests for medical evidence, and advising families navigating complex care arrangements. Maintaining awareness of the current legal framework helps ensure patients’ rights are protected while supporting safe and lawful care planning.
Primary Care Support England (PCSE) has published its latest monthly update for GP practices, containing several important reminders and actions relating to GP pensions and medical records management.
The October update highlights key developments that practices should be aware of as we move towards the end of the financial year and continue to navigate ongoing administrative requirements across primary care.
The latest bulletin includes important pension-related guidance aimed at supporting both practices and sessional clinicians.
Supporting Locum GPs to Meet NHS Pension Deadlines
Practices are encouraged to be aware of forthcoming NHS Pension Scheme deadlines and to support locum colleagues where required. Accurate and timely pension administration remains essential to ensure pensionable service and contributions are correctly recorded, helping to avoid delays or difficulties for clinicians later in their careers.
Preparing for the 2025/26 Pensions End of Year Process
PCSE has also provided guidance to help practices prepare for the annual pensions reconciliation and end-of-year process. Early preparation can help minimise administrative burden, reduce errors, and avoid last-minute issues that could affect pension records or submissions.
The update also includes information regarding the management and accessibility of patient records.
Accessing Hospital Records
Practices may find the guidance on accessing hospital records particularly useful, as timely access to secondary care information continues to be an important factor in supporting safe, coordinated patient care. The update provides clarification and practical information to assist practices in understanding the current processes and available routes for obtaining relevant hospital information where appropriate.
👉 Read the full PCSE GP Practice Update (October 2026):
PCSE GP Practice Update – October 2026
On 5th October, RDaSH commenced a community stoma care service as part of the Community Bladder and Bowel Service (previously known as the specialist continence service). This new service is designed to improve patient outcomes whilst reducing GP workload associated with routine stoma care.
The service will provide
Therefore, from the 5th of October, Doncaster GPs are requested to stand down the prescribing of stoma products and instead redirect patients to the RDaSH service via 03000 218996.
There may be patients who have routinely ordered their prescriptions via their Dispensing Appliance Contractor (DAC) which may require a backfilled prescription. The DACs have however been informed of the change in prescribing responsibility and have been informed that prescriptions requested after 5th October should be sought from RDaSH who will be working to complete a review of the patient.
As with any new service mobilisation, there may be an unsteady period of time as the service becomes embedded as business as usual, please contact RDaSH directly or Kim Bottomley at the ICB (kim.bottomely@nhs.net) if you have any concerns or queries. RDaSH will also be attending TARGET sessions for an opportunity to provide more details and to answer any questions.
This change has been discussed with and agreed by Doncaster LMC and your support with establishing this as a successful service for our patients is very much appreciated.
NICE has published updates to its guidance on the management of type 2 diabetes in adults, revising recommendations for several medicines to support consistent clinical decision-making and improve access to clinically effective and cost-effective treatment options across the NHS.
As part of its ongoing programme of reviewing medicines throughout their lifecycle, NICE has updated four technology appraisals relating to type 2 diabetes treatments. In addition, guidance relating to four further medicines is being withdrawn where it is no longer required, helping to streamline recommendations and reduce duplication across the NICE guidance portfolio.
The changes are intended to support clinicians in making evidence-based prescribing decisions while ensuring patients continue to have access to therapies that offer good clinical value and represent an effective use of NHS resources.
Type 2 diabetes management continues to evolve rapidly, particularly with the increasing use of newer therapies that deliver benefits beyond glycaemic control, including reductions in cardiovascular risk, improvements in weight management and protection against renal disease in appropriate patient groups.
Practices should be aware that updates to NICE recommendations may influence:
Clinicians involved in diabetes care are encouraged to familiarise themselves with the revised guidance and consider any implications for existing prescribing practices and future treatment decisions.
The review forms part of NICE’s wider commitment to ensuring guidance reflects the latest clinical evidence while supporting sustainable NHS spending. By reviewing technology appraisals and retiring outdated guidance where appropriate, NICE aims to provide clearer and more accessible recommendations for frontline clinicians.
Given the prevalence of type 2 diabetes within primary care, these updates are likely to be relevant to GPs, nurse practitioners, clinical pharmacists, diabetes leads and medicines optimisation teams.
Practices can access the full guidance and review the updated recommendations via the NICE website:
NHS England has published amendments to the General Medical Services (GMS) Statement of Financial Entitlements (SFE), introducing a number of important changes to the Practice-Level GP Reimbursement Scheme and wider contractual arrangements for the 2026/27 financial year.
The amendments are intended to provide practices with greater flexibility in accessing workforce funding, support the recruitment and retention of GPs, and maximise the use of available reimbursement opportunities to increase clinical capacity within primary care.
Practices are now able to submit claims for eligible GP locum costs incurred between 1 October 2026 and 31 March 2027 under the Practice-Level GP Reimbursement Scheme.
This change provides additional flexibility for practices managing workforce pressures, sickness absence, recruitment challenges, or temporary increases in demand during the winter period. Practices intending to utilise locum support should familiarise themselves with the eligibility criteria and claims process to ensure funding can be accessed where available.
The amended SFE allows GP practices to transfer all or part of their funding entitlement to another GP practice.
This new provision is designed to support collaborative working arrangements and may be particularly relevant where practices are working together at Primary Care Network (PCN) level, sharing workforce resources, or developing innovative approaches to increasing local GP capacity.
Practices considering such arrangements should ensure that any transfers are appropriately documented and comply with the relevant scheme requirements.
The reimbursement scheme continues to support the employment of additional GPs, with practices able to claim funding for eligible newly appointed GPs employed between 24 February 2026 and 31 March 2027.
This measure forms part of wider efforts to improve access to general practice by increasing the number of GP sessions available to patients and supporting practices in expanding their clinical workforce.
Practices planning recruitment activity should review the eligibility requirements and funding arrangements to ensure opportunities available through the scheme are fully utilised.
Further amendments allow practices to claim a higher hourly reimbursement rate for additional GP sessions delivered by existing salaried GPs and agreed during the period between 30 April 2026 and 24 June 2026.
The change recognises the contribution made by practices and salaried GPs in increasing clinical activity and capacity during this period and provides additional financial support for qualifying sessions.
The amendment also formalises changes to the Quality and Outcomes Framework (QOF), introducing improvement thresholds for childhood immunisation indicators as outlined in the 2026/27 QOF guidance.
The move towards improvement thresholds aims to recognise and reward practices making measurable progress in immunisation uptake, particularly in areas with historically lower vaccination rates or populations facing significant health inequalities. Practices should review the updated QOF requirements to understand how these changes may affect performance monitoring and achievement during the current financial year.
Further Information
NHS England has introduced a new national referral pathway for adult gender services, bringing together referrals into a single, nationally managed waiting list. The new system is designed to provide a more consistent approach to referrals and ensure patients can access NHS Adult Gender Services through a standardised process, regardless of where they live in England.
The new arrangements are managed through the NHS Gender National Referral Support Service (GNRSS), which now oversees referrals and waiting list management for adult gender services across England.
As part of the changes, a single national referral form has replaced all previous referral forms used by individual adult gender services.
The form is available through:
The introduction of a standardised referral process aims to simplify referrals for healthcare professionals and improve consistency across the country.
Adults aged 18 years and over who are registered with a GP in England and experiencing symptoms of gender incongruence or gender dysphoria may be referred to NHS Adult Gender Services.
Practices should be aware that a diagnosis of a mental health condition does not automatically prevent access to gender services. Individuals with conditions such as bipolar disorder, schizophrenia, or other significant mental health diagnoses may still be referred and assessed. However, NHS England advises that any significant mental health symptoms should be appropriately managed to support engagement with the assessment process.
Similarly, where patients have drug or alcohol dependency issues, these should be addressed and stabilised before attendance at appointments with an NHS Adult Gender Service.
Under the revised arrangements, referrals do not need to be made exclusively by GPs.
Referrals can be made by:
This broader referral eligibility may help improve patient access and reduce unnecessary delays in the referral process.
General practices are likely to see an increasing number of enquiries relating to gender incongruence and gender dysphoria. Clinicians and practice teams should familiarise themselves with the new national referral pathway and referral requirements to ensure patients are directed appropriately.
The introduction of a single national waiting list and referral process should reduce variation between services and provide clearer information for both patients and healthcare professionals regarding access to specialist assessment and support.
Further guidance for healthcare professionals and patients, including referral information and frequently asked questions, is available from the National Referral Support Service:
👉 National Referral Support Service for Adult Gender Services
Practices that engage GP locums are being reminded of the importance of promptly reviewing and approving Locum A forms submitted through PCSE Online, as delays can have a direct impact on a locum GP’s ability to pension their work.
Under current NHS Pension Scheme arrangements, a locum GP must have an approved Locum A form from each practice where work was undertaken before they can complete their Locum B form and submit their pension contributions. Where approvals are delayed, locums may be prevented from completing the necessary pension administration within the required timeframe.
The NHS Pension Scheme operates within strict regulations. Importantly, a period of freelance GP locum work that ended more than 10 weeks previously cannot be pensioned. This makes the timely processing of Locum A forms essential.
While the responsibility for submitting pension paperwork ultimately rests with the locum GP, practices play a critical role in enabling the process. Delays in practice approval can contribute to missed deadlines, potentially affecting a locum’s pension record and future benefits.
Prompt review and approval of Locum A forms is therefore not only good administrative practice but also an important way in which practices can support the wider GP workforce.
To review, approve or reject Locum A forms within PCSE Online, staff members must be assigned the “GPP – Locum Applications” role by the Practice User Administrator.
Practices are encouraged to review their current user permissions and ensure that appropriate staff members have access to this functionality. Without the correct permissions in place, Locum A forms may remain unprocessed, creating unnecessary delays for both practices and locum GPs.
As a matter of good practice, practices should consider assigning the relevant role to more than one member of staff.
Having multiple authorised users can help maintain continuity during periods of:
This simple step can help ensure pension administration continues smoothly and that locum forms are not left awaiting approval for extended periods.
Practice managers and administrators may wish to:
With workforce pressures continuing across primary care, supporting locum GPs to maintain accurate pension records is a straightforward but important contribution practices can make to the sustainability of the wider GP workforce.
Further guidance on assigning user roles and managing access is available through the PCSE User Management Guide. Additional support regarding the approval of Locum A forms can also be found on the PCSE website and through PCSE’s online training resources.
Practices are reminded of the availability of the Doncaster Minor Eye Conditions Service (MECS), which provides patients with timely access to assessment and management for a range of acute eye conditions within community optometry settings.
The service is designed to ensure that patients with appropriate eye-related symptoms can receive specialist assessment closer to home, often reducing the need for GP appointments, hospital referrals, or attendance at urgent and emergency care services.
MECS offers an important alternative pathway for patients presenting with minor eye problems, helping them access the right care from clinicians with specialist expertise in eye health.
GP practices have two options when directing patients to the service:
A list of local MECS providers and contact details is available to practices and should be used to identify the most appropriate service location for the patient.
Patients can also access information and book appointments through the service website:
MECS practitioners assess and manage a range of minor eye conditions, which may include:
Service eligibility and referral criteria should always be checked against current local guidance.
The continued use of MECS can provide several benefits, including:
As pressures across primary care continue, effective use of community services such as MECS can play an important role in ensuring patients receive timely care while helping practices manage demand appropriately.
Practice teams are encouraged to familiarise themselves with the local MECS pathway and consider signposting suitable patients directly to participating providers where appropriate. Ensuring patients are directed to the most appropriate service first time can improve outcomes and help reduce delays in accessing specialist eye care.
For further information and booking details, please visit:
Significant reforms to UK employment law are now being introduced through the Employment Rights Act 2025, with changes being implemented in stages throughout 2026 and 2027. These reforms affect employers across all sectors, including general practice, and will require practices to review employment policies, contractual arrangements and workforce management processes.
The changes are wide-ranging, covering areas such as family leave, statutory sick pay, workplace protections, trade union rights, dismissal procedures and flexible working arrangements.
Practice partners, managers and HR leads are encouraged to familiarise themselves with the reforms and assess the potential impact on their organisation.
Further information is available via the Government’s guidance for employers and workers: 👉 New Employment Rights: Guidance for Businesses and Workers
A number of important reforms came into effect in April 2026, including:
These changes have immediate implications for practice employment policies and staff management procedures.
Further reforms introduced in August include:
From 1 October 2026, the time limit for most employment tribunal claims has increased from three months to six months.
This means practices may need to retain employment records and documentation for longer periods and should ensure robust processes are in place to support the management of employee grievances, disciplinary matters and workplace disputes.
A number of significant workplace protections come into force from 30 October 2026, including:
Practices should review workplace policies, reporting procedures and staff training arrangements to ensure compliance with these strengthened obligations.
Further employment reforms are scheduled for implementation during 2027 and are likely to have a significant impact on workforce management.
Key measures include:
Additional measures expected during 2027 include:
Whilst some of these reforms may have limited day-to-day impact, others represent significant changes to employer obligations and employee rights. Practices should take the opportunity to review:
Given the breadth of these changes, practices may wish to seek advice from their HR provider or employment law adviser to ensure they remain compliant as further provisions come into force.
The Employment Rights Act 2025 represents one of the most significant reforms to workplace legislation for many years. With changes continuing to be introduced throughout 2026 and 2027, practices should keep abreast of developments and take a proactive approach to reviewing their employment arrangements.
Doncaster LMC is been a member of the LMC Buying Groups Federation.
Buying Group membership entitles practices to discounts on products and services provided by the Buying Group’s suppliers.
Membership is free and there is no obligation on practices to use all the suppliers. However, practices can save thousands of pounds a year just by switching to Buying Group suppliers. To view the pricing and discounts on offer you need to register for access to the Buying Group’s online portal: https://buying.plexusportal.co.uk/Register.
What is the purpose of the Buying Group and how does it work?
The sole purpose of the Buying Group is to save its member practices money by negotiating discounts on goods and services which practices regularly purchase. The Buying Group team negotiate with suppliers, after which they identify ‘approved’ suppliers, who guarantee to give you significant discounts over what you would otherwise pay for their services, in return for the Buying Group’s endorsement and help in making you aware of what they offer.
Does it cost us anything to be part of the group?
No, membership is free and members are free to use as many discounts as they wish.
Is there any obligation to take up the deals offered?
No. Each practice is free to take up or decline any of the deals the Buying Group have negotiated. If you wish to take advantage of any of the offers in question, you will be given contact details, and all communications take place between you and the individual supplier*.
*The Buying Group accepts no liability for any contract willingly entered into by a practice with an approved supplier. Practices are advised to check that the terms of any contract with suppliers are consistent with those the Buying Group have negotiated and are advised to inform the Buying Group team of any discrepancy. The Buying Group do not, however, accept any responsibility for any member practices’ failure to check the terms of the relevant contract and the principle of caveat emptor (buyer beware) applies in all cases. Your rights as a consumer under the Consumer Protection Act are unaffected. With respect to any services to which the provisions of the Financial Services Act 2000 might apply practices are advised to seek independent financial advice as may be appropriate.
What happens to my details?
When a practice signs up for Buying Group membership, they will keep your basic contact details (practice address) on a secure system. On the membership application form, they also ask you how they can use your personal data (i.e. your email address) but even if you do sign up to receive their emails you can stop them at any time by clicking the unsubscribe button.
What if I am not happy with the quality of goods and services supplied?
Always let the Buying Group know if you encounter any problems getting what you want, and they will endeavour to sort it out.
Contact the Buying Group
The Buying Group is managed by Plexus Support Services Ltd:
Tel: 0115 979 6910
Email: info@plexussupport.co.uk
Website: https://www.plexussupport.co.uk
