General Medical Services contract

GMS is the UK wide contract between general practices and primary care organisations to deliver primary care services to their local communities. This page outlines the main areas of the contract, the key changes introduced in 2006/07 and current activity.

Where we are

NHS Employers and the BMA's General Practitioners Committee have reached a settlement on the key changes to the GMS contract for 2008/09. The main changes are:

• a new Extended Opening Hours Access Directed Enhanced Service (DES) in England - general practices are being asked to provide around 3 hours extra appointment time per average practice a week, at times that suit the needs of their patients. The Department of Health has issued more detailed guidance on this DES to Primary Care Trusts and Strategic Health Authorities
• 1.5% investment - this will be used to fund new services for patients and it has been agreed that this investment in England will be allocated as follows:
  • firstly to meet the cost of any 2008/09 inflation uplift as determined by the Government following the Doctors' and Dentists' Review Body (DDRB) recommendation. The Government has accepted the DDRB's recommended uplift of 2.7% to be applied to the global sum payments only, which will be mainly offset by savings in the Correction Factor Payments. The overall increase in cost to the GMS contract is likely to be 0.2 per cent.
  • the remaining 1.5% will be invested in clinical areas (potentially up to £50m in England). The detail of this is currently being discussed with the GPC
  • any outstanding money would then be offered through PCTs in England for local agreement with practices, to provide additional services to improve access and responsiveness
• Quality and Outcomes Framework (QOF) - a number of small changes are being made to the QOF. These include amendments to the indicators to ensure that they reflect the latest in clinical evidence and the removal of 58.5 QOF points to fund easier access to an appointment with a GP and to booking an appointment more than 2 days ahead. There will be a new national patient experience survey which will measure these improvements. We have produced detailed guidance document with the GPC that outlines all the changes, this is available online only.
• IM&T DES - practice eligibility to receive one-off payments will continue for England for a further year until 31 March 2009

We are now working with the GPC to finalise the outstanding details of the contract.