Focus on how to access information

February 2004 (updated August 2006)

This guidance note has been produced by the General Practitioners Committee (GPC) to help GPs and Local Medical Committees (LMCs) manoeuvre around the new contract documents and information sources more easily. It is one of a series of guidance notes on the new contract and will be updated as new documents are produced. Although this 'focus on ...' is England specific, much of the information it covers is relevant UK-wide. Separate 'focus on ...' documents are also available for Northern Ireland, Scotland and Wales.

NB. Some of the URLs within this document may be subject to change: the version available online will be revised regularly and should therefore be fully up to date.

The main documents
- Pre-ballot
1. New General Medical Services (GMS) contract 2003 ‘Investing in General Practice’
The main contract document (“blue book”) sent to all GPs throughout the UK in February/March 2003.

2. Letter on the Minimum Practice Income Guarantee (MPIG)
A copy of this joint letter, from the GPC and NHS Confederation, was sent to all UK GPs on 17 April 2003. Read the letter on the MPIG website.

3. New GMS contract 2003 ‘Investing in general practice’ – supporting documentation
The second “blue book” sent to all GPs throughout the UK in May 2003

The supporting documentation was sent with a second joint letter clarifying any final issues.

The above 3 documents make up the bulk of the pre-ballot documentation.

- Post-ballot/implementation phase
4. NHS (GMS contracts) regulations
The GMS Contract Regulations (SI 2004/291) are available on the Her Majesty's Stationery Office (HMSO) website .

5. Standard GMS contract
The standard contract can be found on the Department of Health's website .

This link also contains all historic documents.

6. GMS Statement of financial entitlements for 2004/2005 (SFE)
The SFE takes the form Legal Directions and replaces the Statement of Fees and Allowances (‘Red Book’). It sets out in detail the way in which payments will be calculated and made to practices - part 4 of the SFE details those payments that have been directly transferred from the ‘Red Book’.

The SFE can be found on the Department of Health's website. This link also contains all historic documents.

7. Delivering investment in general practice; implementing the new GMS contract (“Guidance”)
Published online by the Department of Health (DoH) in December 2003, this document provides detailed guidance on the above 3 documents.

The guidance can found on the Department of Health website .

The guidance was drafted by the DoH and agreed between the GPC, the NHS Confederation and the DoH. It is not a “stand-alone” document and must be read in conjunction with the source legal documents, ie the regulations, the standard contract and the SFE.

8. GMS Transitional and Consequential Provisions Order 2004
Details of the transitional arrangements are available from HMSO (SI 2004/0433) .

9. GMS and PMS Transitional and Consequential Provisions Order 2004
The second transitional order (SI 2004/0865), which also covers transitional arrangements for PMS pilot agreements, can be found online .

10. Primary Medical Services (Sale of Goodwill and Restrictions on Sub-contracting) Regulations 2004
A letter to the profession from the Chairman of the GPC, dated 25 March 2004, regarding the partial end to the ban on the sale of goodwill in England.

The Goodwill Regulations (SI 2004/0906) can be found online through HMSO .

11. Primary Medical Services (Directed Enhanced Services) (England) Directions 2004 ["DES directions"]
The DES directions place new legal duty on Primary Care Trusts (PCTs) to implement the six schemes. Applying to both GMS and PMS, the DES directions can be found on the DoH's website

12. NHS (Performers List) Regulations 2004
The Performers list (SI 2004/0585) replaces the former principal and supplementary lists for both GMS and PMS doctors. Some 'frequently asked questions' are available on the DoH website

The DoH issued guidance, primarily for PCTs, in August, 'Primary Medical Performers Lists: Delivering Quality in Primary Care'. It advises on the management of primary medical performers lists, including admission of doctors to the lists, conditional admission of doctors to the lists, suspension, contingent removal of doctors from the lists, and doctors' disqualification for inclusion in any list.

The final list regulations can be found online through HMSO .

13. NHS (GMS Contracts)(Prescription of Drugs etc) Regulations 2004
The Prescription regulations reaffirm the drug restrictions on the NHS (previously schedule 10 of the drug tariff), are available from HMSO (SI 2004/0629) can be found online .

14. NHS (GMS - Premises Costs) (England) Directions 2004
Chapter 4 of the DoH Guidance for GMS GPs included the principles to recognise Contractors' costs incurred to provide premises suitable for the delivery of new GMS services. Specific details of the arrangements to be used to calculate and make payments accordingly are set out in the Premises costs directions, which can be found on the DoH's website .

In addition, a general guidance note on the premises allocation policy can also be found on the DoH's website .

15. PMS “Sustaining innovation through new PMS arrangements” ("PMS guidance")
The PMS guidance was most recently updated on 18 March 2004 (the original version was published online by the DoH in December 2003) and is available on the Department of Health's website .

16. NHS (PMS Agreements) Regulations 2004
The PMS regulations are available from HMSO (SI 2004/0627) and can be found on the HMSO's website .

17. PMS Agreements (Payments for Specific Purposes) Directions 2004
These Directions concern conditions and rates of payments in relation to the NHS Golden Hello Scheme, the Flexible Careers Scheme, the Returners' Scheme, the Doctors' Retainer Scheme, and Prolonged Study Leave, effective from 1st April 2004. They can be found online on the DoH's website .

18. GMS contract revision guidance - from April 2006
This document gives an overview of the changes to the General Medical Services (GMS) contract for 2006/07. The GMS contract revision guidance can be read online .

New DES Directions and amendments to the SFE following revisions to the GMS contract can be found online .

Other valuable sources of information
19. Frequently asked questions (FAQs)
The new contract related FAQs, produced by the GPC secretariat can be found online .

20. ‘Focus on…’ guidance notes
Produced by the GPC secretariat, the ‘Focus on…’ series summarises the key topics relating to the new GMS contract and are sent via email to LMCs, then posted on the website.

The following ‘Focus on…’ guidance notes have been produced to date:
  • access 2006/07
  • agenda for change and practice staff (December 2005)
  • assessment of GP pensionable earnings (March 2005)
  • cash to accruals conversion factor (June 2004)
  • choice and booking DES (March 2006)
  • choice of nationally accredited systems (February 2004)
  • community hospital GPs (July 2005)
  • disease prevalence (May 2004)
  • dynamising factor (March 2005)
  • enhanced services (March 2004)
  • exception reporting (February 2004 - updated April 2005)
  • financial monitoring of enhanced services (March 2004)
  • funding for information management and technology (April 2004)
  • funding for the new GMS contract (October 2003)
  • GMS indicative contractor budgets (February 2004)
  • health service body status (January 2004)
  • nature of the contract and partnerships (September 2003)
  • out-of-hours (June 2006)
  • patient registration (April 2004)
  • payments of influenza and pneumococcal vaccinations (March 2006)
  • pensions: an overview (September 2004)
  • pension flexibilities (September 2004)
  • personal medical services (January 2004)
  • postgraduate education (July 2004)
  • practice staff under the new contract (August 2004)
  • premises costs (February 2004)
  • preparing for implementation (January 2004)
  • private practice (June 2004)
  • quality and outcomes framework management and analysis system (QMAS) (October 2004)
  • quality and outcomes framework (February 2006)
  • quality payments (October 2003)
  • review of the quality and outcomes framework (May 2004)
  • revisions to the GMS contract (March 2006)
  • role of LMCs (August 2004)
  • salaried GPs (July 2006)
  • sale of goodwill (June 2004)
  • seniority payments (Jan 2006)
  • SFE changes 2006-07
  • standard and default contracts (March 2004)
  • superannuation contributions (September 2004)
  • temporary residents (Jun 2004)
  • towards practice based commissioning DES (Feb 2006)
  • vaccinations and immunisations (April 2004).
The GPC is continuing to update and produce new guidance.

21. Partnership agreements guidance
This guidance was prepared by the GPC in consultation with the BMA's regional offices and legal advisors and the GPC's legal advisors. It was made available online in May 2004 and is intended to help GPs to identify matters they may wish to cover under a partnership agreement when practising either under the new GMS contract or under PMS.

22. GPC news
Following each monthly meeting of the GPC, the secretariat produces a circular summarising the main topics of debate, including issues surrounding the new GMS contract. GPC news is sent via email to LMCs then posted on the website.

NB. GPC News can be accessed both by BMA members and non-member, registered ‘guest users’. Register on the homepage here

23. PMS agreements: GPC guidance
The GPC produced guidance for PMS in GPs in September 2004, which mainly covers the changes to PMS resulting from the new GMS contract.

NB: You will need to be logged on to access this guidance, either as a BMA member or registered 'guest user'.

24. Appraisal
Guidance from the DoH relating to funding for appraisal, as agreed with the GPC and NHS confederation, was published online on 25 October 2004 and can be found on the DoH's website .

A summary by the GPC secretariat of the recently finalised appraisal funding arrangements can be found on the BMA's websiteRead the summary here

Guidance setting out the national appraisal scheme for GPs by the DoH was published online in March and updated in August 2004. The guidance can be found on the DoH's website (for logged on BMA) members or 'registered users')

Northern Ireland, Scotland and Wales
Northern Ireland
Further guidance on contract implementation in Northern Ireland.

Scotland
Further guidance on contract implementation in Scotland.

Wales
Further guidance on contract implementation in Wales can be found at the GMS Implementation Project website .

© British Medical Association 2008

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