This page sets out guidance and links to further resources to support implementation of changes to General Medical Services (GMS) contractual arrangements that will apply in England in 2020/21.
NHS England Enhanced Service Specifications
These enhanced service specifications outline more specialised services and those additional services provided by all General Medical Services (GMS) practices.
- COVID-19 Enhanced Service Vaccination Collaboration Agreement
- Enhanced Service Specification: COVID-19 vaccination programme 2020/21
- Enhanced Service Specification Shingles (catch-up) vaccination programme 2020/21 NHS England
- Directed Enhanced Service Specification Seasonal influenza and pneumococcal polysaccharide vaccination programme 2020/21
- Enhanced Service Specification Pertussis (pregnant women) vaccination programme 2020/21 NHS England
- Enhanced Service Specification Meningococcal freshers vaccination programme 2020/21 NHS England
- Enhanced Service Specification Childhood seasonal influenza vaccination programme 2020/21
Update to the GP contract deal: 2020/21-2023/24
NHS England and NHS Improvement and the BMA have agreed and jointly published an “Update to the GP contract agreement 2020/21 to 2023/24”. This agreement updates and enhances the existing five-year GP contract deal: Investment and Evolution.
The main features of the agreement include:
- Major enhancements to the Additional Roles Reimbursement Scheme to help secure 26,000 additional staff
- A raft of measures to aid GP recruitment and retention to help deliver 6000 more doctors working in primary care
- Improvements in access for patients: More people working in general practice will help achieve 50 million more appointments in general practice
- Further improvements to the Quality and Outcomes Framework
- Reforms to vaccinations and immunisations payment arrangements to improve vaccination coverage
- A new universal 6-8 week post-natal check for new mothers
- Three new services in 20/21: Structured Medication Review and Medicines Optimisation, Enhanced Health in Care Homes and Supporting Early Cancer Diagnosis service.
- New incentives under the Investment and Impact Fund to increase uptake of learning disability health checks, seasonal flu jabs, social prescribing referrals, and improve specific aspects of prescribing.
Claiming reimbursement for reasonable additional costs for flu delivery
- Claiming reimbursement for reasonable additional costs for flu delivery – Guidance for NHS regional teams, clinical commissioning groups and GP practices
National Seasonal Influenza Immunisation Programme 2020/21: primary care frequently asked questions
Update to the GP contract agreement: 2020/21-2023/24: Financial implications
- additional funding allocations
- funding the costs of other contract increases
- enhancements to the Additional Roles Reimbursement Scheme.
This letter provides an update on the new GP payment system GP payment changes letter – 16 September 2020
Statement of Financial Entitlements and Directed Enhanced Services Directions
Legislation underpinning the GP Contract
A number of legal documents, published by the Department of Health and Social Care (DHSC), formally set out the detail of the GP contract.
The Statement of Financial Entitlements (SFE) sets out payment conditions for General Medical Services contractors, which are replicated by commissioners for local Primary Medical Services (PMS) and Alternative Provider Medical Services (APMS) contractors. The SFE (Amendment 2) Directions 2020 sets out updated terms from 1 April 2020.
The Primary Medical Services (Directed Enhanced Services) Directions 2020 sets out the requirements for contractors choosing to provide Directed Enhanced Services, including the Primary Care Network DES, from 1 April 2020.
The NHS (GMS Contracts) Regulations, NHS (PMS Agreements) Regulations and Alternative Provider Medical Services (APMS) Directions set out the most recent contractual amendments for GMS, PMS and APMS contractors from 1 April 2020.
In addition the NHS (Amendments Relating to the Provision of Primary Care Services During a Pandemic etc) Regulations 2020 give NHS England the power, with the agreement of the Secretary of State, to temporarily suspend certain parts of the GP contract to assist in management of the Covid-19 outbreak. Details of any contract suspension are on our COVID-19 update for general practice page.
Primary Care Networks additional roles reimbursement scheme: Update to Commissioners
- Primary care networks additional roles reimbursement scheme: Update to commissioners: Letter from Ed Waller: 20 February 2020
- Primary care networks additional roles reimbursement scheme: Update to commissioners: Letter from Robert Kettell: 9 October 2020
- Standard Alternative Provider Medical Services Contract
- Standard Alternative Provider Medical Services Agreement Variation Notice
- Standard General Medical Services Contract
- Standard General Medical Services Contract Variation Notice
- Standard Personal Medical Services Agreement
- Standard Personal Medical Services Agreement Variation Notice
General Medical Services Quality and Outcomes Framework 20/21
We have published a letter and guidance which detail the revised QOF requirements for 2020/21, including information about the:
- increased points and amended payment terms for flu vaccination and cervical screening indicators
- indicators which will be paid on an achievement basis
- indicators and points which will be subject to income protection arrangements and the conditions upon this income protection
- revised quality improvement (QI) requirements for the 2020/21 modules: early cancer diagnosis and care of people with a learning disability.
The QOF guidance replaces the QI topic guidance published earlier this year although this is still available on the website as a further resource for practices:
- Quality improvement module document: improving care of people with a learning disability
- Quality improvement module document: supporting early cancer diagnosis
- QOF quality improvement case studies
The letter also sets out the revised requirements for the Dispensing Services Quality Scheme – which is relevant for dispensing practices only.
- Cover note for GPs and Commissioners: Revised Network Contract DES 2020/21
- Investment and Impact Fund Implementation Guidance 2020-21
- Network Contract Directed Enhanced Service (DES) Contract Specification 2020/21 – PCN Entitlements and Requirements
- Network Contract Directed Enhanced Service (DES) Guidance 2020/21
- Structured medication reviews and medicines optimisation: guidance
- Network Contract Directed Enhanced Service (DES) Participation Form 2020/21
- Network Contract Directed Enhanced Service (DES) Additional Roles Reimbursement Scheme Claim Form 2020/21
- PCN Workforce Planning Template 2020/21
- Network Contract Directed Enhanced Service (DES) Frequently Asked Questions 2020/21
- Network Contract Directed Enhanced Service (DES) Early Cancer Diagnosis Guidance
- Framework for Enhanced Health in Care Homes
- Transition between COVID-19 care home support and the Enhanced Health in Care Homes service in the Network Contract DES and training requirements for personalised care roles
- Mandatory Network Agreement
- Network Agreement Schedules
- Template Data Sharing Agreement
- Template Data Processing Agreement
- The Network Contract DES and VAT Information Note