GMS Contract

This page summarises the key GMS contract changes from 2003 to 2014, starting with the first three-year GMS contract which was introduced in 2003/04.

Any agreed contract changes are underpinned by a Statement of Financial Entitlements (SFE) which are all available on the Department of Health’s website.

Contract changes 2017/2018

On 2 February 2017, the GPC announced changes to the GMS contract in England for 2017/18.

The changes include:

  • The Avoiding Unplanned Admissions directed enhanced service (DES) will be discontinued from 31 March this year. £156.7million will be added to the global sum.
  • Full reimbursement of practices’ total CQC fees for 2017/18.
  • £30m has been secured to cover rises this year in indemnity cover costs relating to GMS services. This will be paid to practices on a per patient basis – it will not be weighted.
  • Funding of expenses has been agreed which should deliver a pay uplift of 1%, to be added to the global sum. This includes £2m recurrently to account for increased practice workload relating to records transfer by primary care support services, £3.8m to recognise increased superannuation costs of 0.08% as a result of changes to the NHS pension scheme and £1.5m to pay for completion of the workforce census.
  • Improvements to GP sickness cover reimbursement.
  • Maternity payments no longer subject to a pro-rata reimbursement.
  • The sum paid per health check in the Learning Disabilities DES to increase from £116 to £140.
  • A new initiative agreed to replace the GP Retainer Scheme with greater funding and some key changes.
  • New conditions that mean practices which regularly close for half a day, on a weekly basis, will not ordinarily qualify to deliver the Extended Hours DES, although there is provision for exceptions, such as at some branch sites. No changes will be made to the qualifying criteria of the DES until October.
    More information can be found here.

Contract changes 2015/16

On 30 September 2014, NHS Employers and the General Practitioners Committee of the BMA announced changes to the GMS contract in England for 2015/16.
The focus of the changes is on a named, accountable GP for all patients, publication of GPs’ average net earnings and commitment to expand and improve the provision of online services.
To view the changes, click here

Contract changes 2014/15

On 15 November 2013, NHS Employers and the GPC announced changes to the GMS contract in England for 2014/15.

The focus of the changes were on reducing unplanned admissions/accident and emergency attendances and reducing the number of indicators in the quality and outcomes framework (QOF) to allow GPs more time to spend with their patients.

A guidance document is available to download here.

The changes include the following:

  • The introduction of a new “enhanced service” (ES) to improve services for patients with complex health and care needs, who may be at high risk of unplanned admission to hospital.
  • Reducing the size of the QOF by 341 points, with the GMS element of the 238 points being reinvested into global sum, 100 points into the new ES and 3 points into the learning disabilities ES.
  • Changes to seniority payments – no new entrants as from 1 April 2014 and payments to cease on 31 March 2020 for those already in receipt of payments.
  • That every person aged 75 and over will be assigned a named accountable GP, who will ensure that patients receive coordinated care.
  • A commitment to monitor the quality of out-of-hours GP services provided by third parties.
  • The Introduction of the Friends and Family test from December 2014.
  • From October 2014, allowing GP practices to register patients from outside their practice boundaries.
  • The introduction of new IT systems including the ability for patients to book appointments online and access their own records.
  • Developing proposals to publish the NHS earnings of GPs.
  • Changes to ES for patient participation, extended hours access, dementia, alcohol and learning disabilities, with the patient online and remote care monitoring ESs ceasing as of 31 March 2014.

Contract changes 2013/14

Changes included an increase in global sum of 1.47%, the phasing out of MPIG over a seven year period, changes to QOF, vaccination and immunisation and four new enhanced services. This was announced by DH following a consultation process.

Contract changes 2012/13

Changes included an overall uplift on 0.5%; changes to QOF including new indicators; extension of two clinical DESs and the extended hours DES for a year.

Contract changes 2011/12

Changes included an increase in pay in 2011/12; 0.5% uplift; changes to QOF; extension of clinical and non-clinical DESs; and a new Patient Participation DES.

Contract changes 2010/11

These changes continue existing arrangements for the Extended Hours Access Scheme Directed Enhanced Service (DES) and the four clinical DESs in England. There were no changes to the Quality and Outcomes Framework (QOF) as part of a wider agreement on a new DES for the swine flu vaccination programme.

Contract changes 2009/10

In 2009/10 the agreed changes gave a fairer distribution of resources across practices, to ensure that the contract rewards practices that continue to develop services to meet patient needs.

Contract changes 2008/09

These changes included an additional 1.5 per cent investment in new patient services and small changes to QOF, to ensure that it reflected the latest clinical evidence.

Contract changes 2006/07

In 2006/07, the key changes included strengthening and improving the QOF, and new investment in enhanced services. In England there was a new Extended Hours Access Scheme DES and a new independent patient experience survey.

The new GMS contract 2003/04

The new General Medical (GMS) contract saw the introduction of a practice-based contract, with an unprecedented scale of investment in general medical services. From 1 April 2004, the’ blue book’ – which outlined the new three year contract – was implemented throughout the UK.