One of the central commitments of the 2018 GMS contract was for health boards to deliver certain services to GP practice patients. This included Health Boards being contractually responsible for providing pharmacotherapy and community treatment and care services (CTACs).

The establishment of health board responsibility for these services was largely implemented in changes to the GMS regulations that took effect on 28 May 2022. However, as boards were not yet ready to fully provide these services to patients, practices were funded via transitionary services to fill the gaps in health board provision of these services until 1 April 2023.

Despite previous contractual commitments to provide transitionary services until such time as services are provided by the board, Scottish Government has decided not to continue funding these beyond 1 April 2023. In addition, Scottish Government has also not issued directions to Health Boards setting out the extent and manner of the Pharmacotherapy and CTAC services they must commit to provide in individual practice contracts.

This decision means that health boards’ contractual requirement to provide pharmacotherapy or CTAC services is not fully established. In addition, GP practices are not obliged to provide pharmacotherapy or CTAC services under the GMS contract. This means the actions of Scottish Government have created a considerable contractual gap in the provision of Pharmacotherapy and CTAC services for patients.

To help practices navigate this difficult situation, the BMA has prepared guidance for practices. We fully expect that our guidance for practices will go too far for some practices to feel comfortable implementing and not far enough for many others. Each practice will need to consider that guidance in the context of their own individual circumstances when looking at how to apply it.