Concerns raised as new practice-level scheme may only cover salaried GPs

Exclusive GP leaders have raised concerns that the new practice-level reimbursement scheme could be ‘prohibitively narrow in scope’ and only include salaried doctors.

Pulse understands that a draft proposal for an amended statement of financial entitlements (SFE), presented by the Government to the BMA’s GP committee, has described the scheme as only including salaried GPs.

As part of this year’s imposed GP contract, NHS England said it would ‘repurpose’ £292m from PCNs to fund ‘a new practice-level GP reimbursement scheme’ to ‘enable practices to recruit new GPs’ or ‘increase the number of sessions from GPs already working in the practice’.

Details of the scheme were not included in the SFE that was published earlier this month, as NHS England said that they were ‘being developed’.

The commissioner added that the details would be included in a subsequent amendment to the SFE and in accompanying guidance, to be published by 1 May.

The money will be ‘repurposed’ directly from PCN Capacity and Access Payments, which included incentives for PCNs to identify patients who would most benefit from continuity of care.

However, practices that have high patient-to-GP ratios and would like to access the scheme, would first need to engage with their local ICB to explain the ratio.   

GPC members told Pulse that they were initially told that the scheme would allow existing partners to increase their sessions as well as employ additional salaried GPs, and additional salaried sessions.

However, Pulse understands that the draft amendment indicated that the scheme would be purely for additional employment of salaried GPs.

A group of LMCs raised concerns that allowing reimbursement of only salaried GPs through the scheme could undermine its premise and the independent contractor model.

In its own analysis of the imposed contract, Berkshire, Buckinghamshire and Oxfordshire (BBO) LMCs said: ‘Concerns have also been raised as to the potential for this reimbursement scheme to be prohibitively narrow in scope, such as being restricted to only the recruitment of substantive salaried GPs, rather than being able to be used to resource additional clinical sessions by partners, or ad hoc cover by locums to increase capacity during annual leave or sickness absence.

‘Such a restriction of scope, if realised, would cynically appear to be another move toward an all-salaried service and undermining of the independent contractor model.’

According to NHS England, the GPC executive proposed a practice-level GP employment scheme, ‘potentially targeted by list size, recruitment challenges and demand’ in its consultation with the Government over the contract.

In a webinar on the GP contract last month, GPC deputy chair Dr Samira Anane said that the union had received ‘a lot of concerns’ around the scheme, and was pushing for it to ‘apply to all GPs’.

She said: ‘We have been in talks with NHSE around this, we have reinforced the need for flexibility, for the need to create capacity in sessions, and the need for it to apply to all GPs.’

The Department of Health and Social Care told Pulse that the details of the GP reimbursement scheme will be published in due course.

NHS England and the BMA declined to comment.

While some GPs welcomed the transfer of funds to the GP practice level, others warned reallocating and ringfencing the money in this way could be ‘disastrous’ for PCN finances and more restrictive for practices. 

NHS England DES guidance recently revealed GPs employed through CAP are eligible to transfer to the reimbursement scheme. 

Read all of our coverage of the 2026/27 contract here.