Primary care

NHS England is responsible for the direct commissioning of services outside the remit of clinical commissioning groups, namely primary care, public health, offender health, military and veteran health and specialised services. In addition some integrated care boards (ICBs) have fully delegated responsibility for the commissioning and contract management of primary medical care.

The following documents form part of a suite of policies and procedures to support commissioning and contract management of primary care.

These policies and procedures underpin NHS England’s commitment to a single operating model for primary care – a “do once” approach intended to ensure consistency and eliminate duplication of effort in the management of the four primary care contractor groups from 1 April 2013 (medical, dental, eye health and pharmacy). It is also important that all commissioners of primary medical care operate to one standard, therefore the medical policy book is designed to be used equally by those integrated care boards that have full delegated responsibility.

All policies and procedures have been designed to support the principle of proportionality. By applying these policies and procedures, local regional teams, and where relevant integrated care boards with full delegation, are responding to local issues within a national framework, and our way of working is to be proportionate in our actions.

Primary care professional bodies, representatives of patients and the public and other stakeholders were involved in the production of these documents. NHS England is grateful to all those who gave up their time to read and comment on the drafts.

The authors and reviewers of these documents were asked to keep the following principles in mind:

  • Wherever possible to enable improvement of primary care
  • To balance consistency and local flexibility
  • Alignment with policy and compliance with legislation
  • Compliance with the Equality Act 2010
  • A realistic balance between attention to detail and practical application
  • A reasonable, proportionate and consistent approach across the four primary care contractor groups.

This suite of documents will be refined in light of feedback from users. Please send your feedback to  clearly stating in the subject header “Policy feedback: policy name”. This email address should only be used by NHS colleagues and contractors. Members of the public, patients, and their representatives should contact our Customer Contact Centre:

Primary medical services policies

Please see below to access additional policies:

Note for avoidance of doubt – Out of hours training for GP Registrars

integrated care boards should be aware of their responsibility to commission training support for GP specialist registrars in the out of hours setting. This letter is a reminder of this responsibility in advance  of guidance from Health Education England (HEE) on our of hours (OOH) training requirements which is expected to be published ahead of the main intake of GP Specialty trainees in August 2018.