Handbook of Practice Management > Volume 71, Number 0 > Pp. 3-01-3-136

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3. Contracts and finance

Although general practice has always held a family feel, contractual changes and government directives have presented ongoing challenges and as such changes to the way general practice operates. These days practices are businesses, some of which have a huge turnover. This chapter considers the way the practice earns its money. It is reasonable to assume even in these days of diversity that most standard general practices earn the majority of their income through their contract with the NHS. However, there are other options for bringing income into the practice, such as offering private services–we consider those too. There are presently four contracting routes for the provision of primary medical services. 1) The GMS contract revised in April 2004; 2) The PMS contract initially deemed a pilot, but became permanent in April 2004 (inclusive of specialist PMS); 3) The APMS contract (Alternative Provider Medical Services); and 4) Primary Care Led Medical Services (PCTMS).

The GMS contract is the contract of choice for approximately 60% of GPs in England, and provides a route for the Department of Health to contract with GPs to provide primary medical services. In addition to the core contract, there are other income generators that practices should consider, e.g. the Quality and Outcomes Framework (QOF) and enhanced services. We look at these too.

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