There is no best way to work as a GP; there are three different bargains, and the right one depends on which risks you can carry and which rewards you actually value. What follows is the honest side-by-side, written for 2026's market, where the old assumptions, locum premium, partnership burden, salaried safety, all need updating.
The three bargains in one paragraph each
Salaried: you trade autonomy for security. A contract of employment, ideally on the BMA model terms, brings defined sessions, paid annual, sick and study leave, employer pension contributions, employment rights, and predictable income; it also brings the practice's workload weather, limited control over how the job is shaped, and a ceiling on earnings that partnership does not have. In the current market, salaried is where policy is pushing employment, the 2026/27 reimbursement schemes fund exactly these posts, which is quietly improving availability.
Locum: you trade security for flexibility, and in 2026 the trade has worsened. Full control of when and where you work, variety, and historically a rate premium; against that, no paid leave of any kind, income volatility, self-managed tax, pension administration via the locum forms, self-arranged cover for the gaps, and exposure to exactly what has happened: when practice finances tightened, flexible spend was cut first, and BMA surveying found most sessional GPs reporting falling rates and many unable to fill their diaries. Locum work remains an excellent bargain for those with scarce skills, strong local networks or a need for genuine flexibility; it is no longer a reliably liquid default.
Partnership: you trade risk for ownership. Profit share rather than salary, typically the highest long-run earnings of the three when the practice is healthy; a genuine say in how the practice runs; and, with it, unlimited-liability-flavoured exposure to the business, premises questions, staff employment, cashflow (sharpened by reimbursement-model funding, where practices spend first and claim back), and the management workload that is the job's real second half. The steady loss of partners nationally, over 6,500 FTE since 2015, reflects those burdens; the counterpoint is that succession-hungry practices make partnership more accessible now than at any point in a generation, sometimes remarkably quickly for those who want it.
The dimensions that decide it
Income: partnership highest and most variable; salaried predictable within the pay range; locum entirely rate-and-diary dependent, currently softened. Pension: salaried and partners accrue through the scheme with employer contributions structurally handled; locums can pension GP work but carry the administration and annualisation quirks. Leave: salaried holds paid annual, sick and study leave; partners take leave the practice can absorb; locums fund every day off themselves, which is the most underpriced difference of the three. Indemnity: state-backed schemes cover the clinical core for NHS work across all three; check what sits outside it for your role mix. Admin: partners carry the business; salaried carry the clinical admin of their sessions; locums carry a small business of one, invoicing, bookings, records, forms. Employment rights and security: salaried strongest, partnership is ownership not employment, locums have neither and price accordingly. Mortgages and life admin: salaried simplest, partners well-served once accounts mature, locums need history and paperwork. Career development and autonomy: partnership maximal on both; salaried depends heavily on the practice; locum offers breadth of exposure but must self-fund development and can drift without structure, which is where deliberate CPD systems matter most.
Choosing, and re-choosing
The stage-of-life reading is more useful than any ranking: early post-CCT years often suit salaried, income floor, pension, learning a patch, with sessions of locum for breadth; established GPs with capital appetite and a practice they believe in take partnership; portfolio and caring-responsibility years lean locum or reduced salaried. Nothing is permanent: the modal GP career now moves between these bargains several times, and the skill is renegotiating deliberately rather than drifting. Whichever you hold, keep the professional infrastructure portable, your evidence, your CPD, your appraisal readiness travel with you, not with the contract; our toolkit for the post-CCT years is at /blog/newly-qualified-gp-toolkit-first-year-after-cct.
Frequently asked questions
Is the locum premium gone for good?
Rates compressed because flexible spend was cut first; if practice funding stabilises hiring, scarcity can return locally, and OOH and hard-to-recruit areas already pay it. Treat the premium as cyclical and local, not abolished, and never as a plan's foundation.
How quickly can a newly qualified GP realistically become a partner?
Faster than folklore suggests: succession pressure means motivated candidates are seeing partnership conversations within a year or two in many areas. The due diligence, accounts, premises, culture, matters far more than the wait.
Can the three be mixed rather than chosen?
Commonly, and often optimally: a salaried core with locum sessions on top, or partnership with an OOH thread, captures security and flexibility at once. The constraint is administrative, each stream carries its own pension, tax and appraisal-evidence overhead, so mix deliberately, not accidentally.