Guidance Note: GP Practices serving Atypical Populations

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Small numbers of GP practices provide services to a patient population which is sufficiently different (“atypical”) to result in workload challenges that are not always recognised in existing contracts or funding allocations. This document outlines challenges faced by providers and offers examples that may help articulate and/or address these pressures.


The General Medical Services (GMS) funding formula (Carr – Hill formula) is an attempt to fund practice workload, regardless of the population they serve. It is applicable to the vast majority of the UK, but there are some practice populations that are so significantly atypical that using the GMS funding formula would not ensure the delivery of an adequate general practice service. This working group has looked at three such atypical populations: unavoidably small and isolated; university practices and; those with a high ratio of patients who do not speak English.