Introduction

1. NHS England is committed to an equitable and consistent approach to funding the core services expected of all GP practices.
2. Following the changes agreed to the General Medical Services (GMS) contract for 2023/24, this document sets out the approach to the funding changes that NHS England will apply to Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts.
3. Commissioners will update local PMS and APMS contracts as soon as possible, applying the funding changes identified in this guidance with effect from 1 April
4. Correspondence containing specific pieces of guidance was issued prior to this document being prepared, as below:
   4.1 March 2023: General practice contract arrangements in 2023/24

Delivering a common increase to core funding

Increases to GMS global sum

Global sum funding and uplift

5. New investment paid via global sum for 2023/24 totals a net £161m for uplifts to pay, staff and other expenses.
6. The net effect is that:
   6.1 Global sum payment per weighted patient increases from £99.70 to £102.28; and
   6.2 GMS OOH deduction remain at 4.75% in 2023/24, equating to £4.86.

7. In addition, there has been an increase in the value of a Quality and Outcomes Framework (QOF) point from £207.56 to £213.43, resulting from the updated Contractor Population Index (CPI).
8. These revised values take effect from 1 April 2023 as detailed in the Statement of Financial Entitlements (SFE).
9. A ready-reckoner has been developed, which GMS practices can use as a rough guide to estimate the change in their funding as a result of the contractual changes in 2023/24. The ready-reckoner is indicative only and does not constitute financial advice to practices. Nor does it reflect any national modelling for assessing practice-level impacts of contract changes.

Global sum funding and uplift

10. To deliver an equitable and consistent approach to uplifting PMS and APMS contracts, commissioners will apply increases for those GMS changes that also impact on these arrangements for PMS and APMS contracts that are equivalent to the value of the increases in the GMS price per weighted (Except where local agreements with contractors set out a different approach to secure equitable funding).
11. In summary, GP practices will see changes in core funding as set out in table

Table 1

12. Commissioners will need to apply the tariff(s) identified in table 1 above to calculate the increases due to individual PMS and APMS practices.
13. Calculating the increase due will require the appropriate tariff(s) to be multiplied by the weighted list size of the practice (or raw list if the local contractual agreement requires). Typically, this will be the list size at the beginning of the quarter prior to the commencement of the financial year e.g. 1 January 2023 (unless the contractual agreement specifies otherwise).
14. Inflationary – net uplift is the GMS price increase per weighted patient resulting from the uplift on pay, along with an appropriate uplift to That leads to a GMS contract uplift of 2.6 per cent. Commissioners will apply the corresponding appropriate uplift to PMS and APMS practices as shown in table 1 above.

Out of Hours (OOH) ‘opt-out’ deduction

15. Where no OOH deduction is made in PMS or APMS contracts (i.e. OOH opt out never featured in the contract or was permanently removed) no further action is required. Where there is an agreed deduction, this should be consistent with the revised GMS OOH deduction.
16. The cash value of the PMS OOH deduction per weighted patient for 2023/24 is therefore also £4.86.
17. Commissioners will apply the OOH deduction of £4.86 per weighted patient to the weighted list size (unless the contractual agreement provides for raw list size) of the PMS or APMS practice to calculate the value of the OOH opt out deduction.

Other funding changes

18. The funding/payment changes below also apply in 2023/24 following changes to the GMS SFE and commissioners will need to replicate the terms set out in the SFE in PMS and APMS contracts as appropriate:
    18.1 Quality and Outcomes Framework – as set out above, the pound per point value increases from £207.56 to £213.43 as a result of the Contractor Population Index (CPI) adjustment.
19. Commissioners should refer to the ‘Update to the GP Contract agreement 2023/24: Financial Implications’ letter which will be available on the GP contract pages of the NHS England website by the end of March.

The Network Contract DES

20. In 2023/24, up to £2.423 billion will flow nationally through the Network Contract DES – or £1.91 million per average network. The updated Network Contract DES specification provides full details and will begin on 1 April The table below sets out the payments that will relate to this DES for 2023/24.

*based on patient numbers at 1 January immediately preceding the financial year.

**as per local payment arrangements (to account for where Regions do not have a payment run on the last day of the month)

Note

All costs – for practices including the Network Contract will be payable from Primary Care Medical allocations.