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All you need to know about the GP contract imposition at a glance

All you need to know about the GP contract imposition at a glance

NHS England sent a letter to GPs today (Monday 6 March) with details of the new contract. This was a contract imposition, as it was not agreed with the BMA’s GP Committee. Here are the main points of the contract, which you can read in more depth elsewhere on PulseToday. This will be continuously updated


Prospective record access to be offered by 31 October 2023 after being postponed last year because of safety fears raised by GPs, the BMA and the RCGP.

The majority of the IIF – worth £246m – will be focused on improving patient experience of contacting their practice and providing appointments within two weeks. It says 70% of the total funding, equating to £172.2m, will be provided as a monthly payment to PCNs during 2023/24.

The remaining 30% of this funding will be assessed against an access improvement plan. At the end of March 2024 ICBs will assess for demonstrable and evidenced improvements in access for patients and then award funding.

Patients should be offered an ‘assessment of need’, or signposted to an appropriate service, at first contact with the practice. Practices will therefore ‘no longer be able to request that patients contact the practice at a later time’.


Changes to the childhood immunisations payment system, with lowered thresholds for the QOF targets.

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In 2023/24, all the QOF register indicators points – which include will be awarded to practices, based on 2022/23 results – will be income protected. This will release £97m of funding and reduce the number of indicators in QOF from 74 to 55.

Two new cholesterol indicators (worth 30 points, around £36m) will be added to QOF along with a new overarching mental health indicator.

One indicator AF007 – the record of a CHA2DS2-VASc score of 2 or more, the percentage of patients who are currently treated with anti-coagulation drug therapy – will be replaced with a similar indicator in the IIF in 2022/23


The number of indicators in the IIF to be reduced from 36 to five (worth £59m), focusing on flu vaccinations, learning disability health checks, early cancer diagnosis as well as the two-week access indicator.

Additional roles reimbursement scheme

Changes to the additional roles reimbursement scheme, including adding advanced clinical practitioner nurses to the reimbursable roles, increasing the cap on advanced practitioners to three per PCN and removing the caps on mental health practitioners.

Cloud-based telephony

Mandate use of the cloud based telephony (CBT) national framework: All practices need to be aware, that from the end of 2025, all analogue ISDN and PSTN lines will be removed for use in all home and business settings. From this point, only cloud-based platforms will be supported.



Please note, only GPs are permitted to add comments to articles

Anthony Gould 6 March, 2023 8:20 pm

Yawn … Glad I have left my GP partnership in 2017 and work as a Locum half time
I may be weary with age having been qualified for 45 years but …
Doctors should be working as doctors not chasing targets and the financial manipulations are of dubious use

David jenkins 7 March, 2023 12:54 am

Anthony Gould

well said !

however – i beat you !!

i retired in 2007, and i qualified 46 yrs ago…………..and i, too, am still doing locums at age 73 !

if i cease to enjoy it, i will pack it in !

Iain Chalmers 7 March, 2023 12:33 pm

Totally agree AG

I’m the baby however & left after 30 years.

Just nice civilised 4 sessions at local Hospice with more than adequate “me time”

Dave Haddock 7 March, 2023 4:30 pm

Remember this is where the money goes, next time some lefty halfwit suggests we should all pay more taxes for the NHS.

David Mummery 7 March, 2023 5:13 pm

Agree with AG and DJ : this may be about many things , but what it certainly isn’t about us being a good doctor or GP

David Church 7 March, 2023 9:39 pm

The £ 97 million ‘released’ is recycled money that we achieved QOF points for last year, but will be required to do new work for this year, as well as continuing to do what we did for it last year.
£ 36 million of this 97 million is being held back specifically unless the new cholesterol points are achieved.
This is ‘more new work for the same or less money’ at a time when inflation puts expenses up 25%, and we should probably put up prices similarly, to cover the staff salary increases.
Presumably, if one side can make unilateral changes to the ‘contract’, then so can the other : and GPs could start charging patients?
Just think what would happen if only a few practices decided to terminate patient registrations on 1st April, sending notes back to the LHBs, who would still have to provide services to patients! (and safely too).
What happens if GPs do not accept the new contract? Can they continue on the old contract terms, or sue for breach of contract?