General Practice in England

Published Wednesday, September 9, 2015

This briefing paper provides general background for Members and their staff on NHS primary medical services provided by GPs in England. It gives an overview of commissioning arrangements as well as information on changes to GP contracts and funding.

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It is estimated that around 90 per cent of patient interaction with the NHS is with primary care services, including GP practices, dental services and community pharmacies.[1]

The majority of GP services are independently contracted from NHS England. There are a number of different ways that funding can be allocated to GP practices, and different contracting methods.

The majority of GP practices use the nationally negotiated core GP contract: the General Medical Services (GMS) contract. Changes were made to the GMS contract for 2015/16 as a result of negotiations between NHS Employers and the BMA’s General Practitioners Committee. Key changes in the 2015/16 contract include:

  1. The named GP requirement is extended to all patients. This is a contractual requirement and builds on the 2014-2015 agreement to provide a named and accountable GP for over 75s.
  2. GMS practices must publish on their website by 31 March 2016 the mean net earnings of the partners, salaried GPs and locum staff.
  3. Practices must expand and improve the provision of online services, including access to medical records online and online booking of appointments.
  4. Changes to the Quality and Outcomes Framework (QOF) for 2015-2016.

NHS England’s Five Year Forward View, published on 23 October 2014 stated that NHS England will be investing ‘a much higher proportion’ of its budget on GP services. Funding has subsequently been committed, including £550 million announced in March 2015 to improve access to GPs, modernise GP surgeries and improve out-of-hospital care:

  1. The funding will come from:
  2. £100 million addition to the existing £50 million Prime Minister’s Challenge fund
  3. £250 million infrastructure fund for new buildings, treatment rooms and IT
  4. £200 million transformation fund for 29 pilots to integrate services offered by hospitals, GPs, and care homes[2]

In May 2015, the Prime Minister gave a speech setting out plans for a 7-day NHS, which included improving access to GP services. He set a commitment that by the end of the 2015/16 financial year, 18 million patients will have access to a GP at mornings, evenings and weekends, which will be extended to everyone by the end of the 2015 Parliament.

In June 2015, the Health Secretary set out a new deal for GPs, including commitments to increase the primary care workforce, support 7 day access to the NHS, and reduce bureaucracy to allow GPs more clinical time with patients.

In September 2015, the Health Select Committee launched an enquiry into Primary Care, which will examine areas including: the quality and standards of care for patients; demand and access (including out of hours access and proposals for 7 day access); funding (including local and national distribution of resourcing); and commissioning.

This briefing paper provides general background for Members and their staff on NHS primary medical services provided by GPs in England. It gives an overview of commissioning arrangements as well as information on changes to GP contracts and funding.

[1]     Health and Social Care Information Centre, Primary Care

[2]     Gov.uk, GP evening and weekend appointments to increase, 28 March 2015

Commons Briefing papers CBP-7194

Authors: Elizabeth Parkin; Tom Powell

Topics: Health services, Health staff and professions

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