GP practices

A suite of information for GP partners, practice managers and doctors to use to ensure your practice is compliant and delivering the best patient care.
COVID-19: toolkit for GP practices
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Declaring GP earnings over £150,000

Eligible GPs will need to declare any NHS earnings over the threshold annually. Read who the rules on pay transparency affects, what it means for you and the BMA's position.

About pay transparency

BMA support services for GP practices

GP employer advisory service

We provide an employer advice service for GP partners, practice managers and medical managers.

Interpersonal mediation service for GP partners in dispute

We’re here to support GP partnerships through when disagreements arise between partners. We offer free mediation as part of your BMA membership.

Primary care networks

Primary care networks (PCNs)

Primary care networks (PCNs) are groups of practices working together to focus local patient care. Read our guidance for clinical directors on running them and access BMA services to guide you.

Primary care network funding

Information on the amended DES (directed enhanced service), the additional roles reimbursement scheme, the investment and impact fund and financial entitlements for PCNs.

Funding and contracts

Global sum allocation formula

We remind GP practices how funding for GMS practices is calculated using the Carr-Hill formula, and what is taken into account.

GMS contract and PMS agreement differences

To help GP practices make an informed decision, we set out the similarities and differences that exist between a contractors’ obligations whether they hold a GMS contract or PMS agreement.

Minimum practice income guarantee (MPIG) phase out

This page explains what MPIG is, how it is being phased out and what practices should be doing. The BMA is on hand if you have any concerns.

Quality and outcomes framework (QOF)

QOF is a voluntary annual reward and incentive programme for GP practices in England, Wales and Northern Ireland. Find the latest frameworks for 2020/21.

Trading in goodwill

This guidance is to help GPs and local medical committees (LMCs) with decisions relating to trading in goodwill and to better understand the sale of goodwill regulations.

Vaccinations

Vaccinations fees and arrangements

Vaccinations and immunisations guidance for GP practices, including new charges and changes to programmes and the vaccine schedule.

Hepatitis B vaccinations

Our guide for GPs clarifies where practices can charge, in three areas: travel, occupational health and for medical/lifestyle reasons.

Travel vaccinations

Advice for GPs and LMCs on the regulations for travel immunisations – some must always be given with no fee, some cannot, and some can be given as either an NHS or private service.

Prescribing

Prescribing in general practice

This guidance covers the most asked questions around prescribing in primary care and informs GPs of the BMA general practice committee’s policies in prescribing.

Principles for dispensing doctors and community pharmacists

We signpost you to guides and principles to follow when dispensing medications.

Prescribing over-the-counter medicines

NHS England published revised commissioning guidance on reducing prescribing of over-the-counter medicines. Read what conditions are included, what prescribers need to do and if you are in breach of the contract.

Anticipatory prescribing for end-of-life care

Anticipatory prescribing and ‘just in case’ boxes are an important part of end-of-life care. This guidance is designed to help GPs prescribe, use best practice, and consider potential issues.

The falsified medicines directive

The EU-wide falsified medicines directive means all medicines have a unique code that must be tracked, verified and decommissioned when dispensed to a patient. Read about the impact of Brexit on this for GP practices.

Patient group and patient specific directions

This guidance is for GP practices to check the situations in which you should use a patient group direction. Get examples and definitions of when you should use a patient group or patient specific direction to administer prescription only medicines.

Prescription direction to certain pharmacies

'Prescription direction' is when a patient is directed to a certain pharmacy for their prescription. Read our best practice guide on what to avoid when directing to pharmacies.

NHS electronic prescription service

The NHS EPS allows you to send prescriptions to a pharmacy of the patient's choice. Read about the benefits, issuing paper tokens and making a nomination.

Managing workload

Pushing back on workload from secondary care

The NHS standard contract 2017-19 has put requirements on hospitals to shift workload onto GP practices. We provide guidance on this and letters you can use if you need to take action.

Prescribing over-the-counter medicines in nurseries and schools

GPs are often asked to prescribe over-the-counter medication to satisfy nurseries and schools. This is a misuse of GP time, and is not necessary.

Pushing back on inappropriate workload

We've created letter templates to help GP practices push back on inappropriate workload from CCGs, prescribers, hospitals and your area team.

Controlling workload in general practice strategy

Workload is, arguably, the most important factor in managing working conditions for GPs nationally. We've proposed a workload control strategy to address the factors involved.

Managing your practice list

Removing patients from your practice list

Both practices and patients have the right to end a patient-doctor relationship that isn't working. We outline the reasons and procedures for removing a patient from a GP list.

Removing violent patients and the special allocation scheme

GP practices may find themselves in a situation where they are faced by a violent or aggressive patient. In such cases the patient can be immediately removed from the practice list, and the special allocation scheme can provide GP services in a secure environment.

Out-of-area GP registrations and patient choice

GP practices can register patients who live outside their practice area, with home visit services provided separately. Our guidance explains the regulations, registration process and key concerns.

Closing your patient list

This guidance is to help GPs decide whether they should formally apply to close their practice list, or if informal list measures would be better suited to their situation.

Patient registration

Practices should know the rules regarding temporary residents, homeless patients, overseas visitors, the duty to give treatment, and when they can decline to register a patient.

Practice list validation by PCSE

GP practices in England need to ensure that practice lists only include registered patients who they are providing services for. Follow our guidelines to ensure that patients are only removed from lists when appropriate.

Requirement for all patients to have a named GP

All registered patients must have a named accountable GP. Find out named GPs' responsibilities and what practices are required to do.

The CQC

How to prepare for a CQC inspection

A practical guide for GP practices preparing for their inspection by the CQC – including pre-inspection, what happens on the day, outcomes, case studies and essential resources.

What the CQC do

We have produced this guidance for GP practices to explain the CQC’s inspection model to help you prepare for when they visit your practice.

Employment advice

Training resource for GP practice staff

It can be difficult to know what mandatory and statutory training GP practice staff should do. Read our guidance to help you make informed decisions best for your staff and practice.

Employment status

Our guidance, prepared by BMA Law, states the factors which may be considered by HMRC when making deciding someone's employment status. We recommend seeking legal advice in individual cases.

Joint employment of shared staff in GP practices

This is a guide for GP practices on how to employ shared staff in a joint contract between employers and the doctor.

Managing the disciplinary process: guide for GP practices

Our guide will help you manage the process to resolution: from investigations through disciplinary hearing and appeals, to early resolution, settlement agreements and claims.

Employing clinical pharmacists in GP practices

Having a clinical pharmacist on the team can ease workload, reduce waiting times and improve effectiveness. In England, all GP practices in primary care networks can access funding to employ pharmacists.

Employing physician associates in GP practices

Advice for GP practices thinking of employing a PA (physician associate), including the role and remit, indemnity, recommended supervision, code of conduct and preceptorship programme.

Employing trainees on the 2016 junior doctor contract

What practices employing GP trainees under the 2016 contract must be aware of: work scheduling, exception reporting, guardians of safe working and transitional pay protection.

Guide to working conditions for salaried GPs and employers

This guide helps salaried GPs and employers to have a better understanding of what good looks like, and to provide tips on how to make improvements to employed doctors' experience at work.

Guide to annual leave for salaried GPs

This guidance gives employers of salaried GPs best practice principles in managing annual leave and therefore retaining staff.

Communication with patients

Duty of care when test results and drugs are ordered by secondary care

Guidance for GPs on duty of care communicating test results and who is responsible for communication when secondary care doctors recommend drugs for your patient.

Publishing GP net earnings

GP practices are required to publish their GP's net earnings on their website. Find out how to do it and what income and who to include.

Following the Accessible Information Standard

We give some simple tips on how to make your practice more accessible for your patients and ensure you are compliant with the standard.

Receiving gifts from patients

We talk through what considerations you should make as a GP if a patient or their relative offers to give you a gift, ethically and contractually.

GP service provision

What services GP practices can and cannot charge for

This guidance clarifies what GPs can and cannot charge for privately under the GMS contract, including travel vaccinations, becoming a limited company and the sale of goodwill.

The firearms licensing process

We set out the BMA position on firearms licensing and what to do when someone applies for a firearms licence, including responding to the police and conscientious objection.

Issuing fit notes

Guidance for GP practices on issuing fit notes to patients to declare they are not fit to work. Find out what to do and what considerations to make.

Enhanced services GP practices can seek funding for

Enhanced services are defined as primary medical services other than essential services, additional services or out-of-hours services. This page provides information about directed and local enhanced services in England.

GP access: meeting the reasonable needs of patients

This guidance is for GP practices to be clear on your contractual obligations in being accessible to patients and what you can do if you are challenged by your commissioner.

Choosing an online GP consultation platform

To help practices make an informed choice, read our checklist of safety, governance, legal and regulatory requirements when choosing an online consultation platform.

Identification and management of patients with frailty

Practices are required to identify and manage patients living with frailty, as part of routine consultations. This guidance sets out what practices should do to fulfil these requirements.

Managing patients with gender dysphoria

Our guidance for all UK GPs explains the role of GPs managing patients with gender identity problems, including questions relating to patient records, confidentiality, prescribing and monitoring responsibilities.

NHS e-Referral Service: a guide for GPs

We've jointly written guidance to help GPs and practice staff get the best from the e-RS.

Patients presenting with dental problems

The number of patients seeking dental advice from their GP is increasing. This guidance informs GPs of their obligations to patients who request emergency dental treatment, or ask for an NHS prescription for drugs.

Spirometry in general practice

We discuss spirometry as an enhanced service in primary care and differences in how it is commissioned across the country.

GP partners

The importance of an up-to-date GP partnership agreement

Having a signed GP partnership agreement is vital. Make sure yours covers everything it needs to and learn the dangers of not having one in our guidance.

Practical guide for taking on new GP partners

This guidance looks at considerations to make when first appointing a new partner, including due diligence, documents you need and references.

Why you should think about taking on a GP practice partner

Bringing a new GP partner into your practice can mean new skills, ideas and investment, and it can be more cost-effective than employing a salaried GP. Consider the costs and benefits.

Locum GPs

NHSmail for locum GPs

If you're a locum GP you can now get an NHS email address – find out how to apply and what you need to do if you already have one.

Locum GP cover for parental and sickness leave

GP practices can recoup locum costs incurred when GPs are on parental or sickness leave. This guidance outlines the schemes that allow practices to access funding easily.

Employing locum GPs and deciding their fee

Our guidance for employers includes factors to consider when employing a locum, responsibilities, negotiations and what to pay.

Locum pension contributions: guide for GP practices

GP practices in England and Wales are legally required to pay 14.38% employer’s pension contributions to locums. Practices should be aware of these considerations and exceptions.

GP premises

Rent reimbursement for GP practices

GP contractors are eligible for rental reimbursements. The type of reimbursement applicable depends on who owns the building.

A guide to GP premises leases

An eight-step guide to the basics of GP premises leases, what they should contain, when you need to register with the Land Registry, and how to calculate your stamp duty land tax.

Disposing of clinical waste

GP practices' responsibilities, including checks, audits and disposal bags when it comes to disposing of clinical waste.

Template GP premises lease

The template lease has been developed to cover a situation where a GP practice is taking lease of a specific part of a larger building, such as a floor or unit. Read our view on issues with the lease.

Service charges for GP premises

As a tenant, it’s important to be aware of what costs can be recovered by the landlord through service charges and property management charges, what the law says, and what you can do if unfair demands are made.

NHS Property Services

Many GP practices in NHS Property Services (NHSPS) premises are facing serious difficulties related to increases in service charges. This is our guidance for practices, including tips for lease negotiations.

GP sustainability loan scheme

Guidance for practices that are considering formally accepting a GP sustainability loan offer, including what to consider first and repaying the loan.

Sustainable and environmentally friendly general practice report

Ways in which GP practices can develop, and can be helped to develop, environmentally responsible practices, as part of the campaign for carbon neutrality by 2030.

Complaints in primary care

Dealing with unfair online comments as a GP practice

Inaccurate and unfair comments on the NHS website and other sites can damage the reputations of providers and their staff. This guidance outlines the law of defamation, and steps that can be taken to have such comments removed.

Complaints in primary care

A guide to the complaints process for GP practices, GPs and LMCs in England, including how to address a patient’s complaint, third-party complaints, vexatious complaints and possible misuses of the system.

Dealing with abuse of practice staff on social media from patients

Steps that GP practices can take against patients who leave abusive comments on social media or websites - including what to do first, reporting content to the provider and criminal and civil actions.

Primary care support services

PCSE (Primary Care Support England) service failures

This guidance covers the issues GP practices have raised about Capita providing PCSE, guidance on how you can raise concerns and what the BMA is doing to help.