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.

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BMA support services for GP practices

Employer Advisory Service

We provide specialist HR and employment law advice for GP practices, GP partners and practice managers.  BMA service

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. BMA service

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. BMA guidance

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. BMA guidance

PCN DES opt-out guidance

The purpose of this document is to provide guidance for independent contractor doctors who may be considering opting out of the Primary Care Network Directed Enhanced Service (PCN DES). It does not constitute legal or financial advice.  BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

The sustainability crisis in GP practice in Scotland

This page details the background to the current sustainability crisis in GP practice in Scotland as a result of an inability to implement the commitments of the 2018 contract.

Handing back a GMS/PMS contract

This guidance is for GP practices considering handing back their GMS/PMS contracts and winding up their businesses.

PCSE (Primary Care Support England) Seniority Payments Reconciliation Exercise 2023

This guidance is for all practices who may receive, or have received, letters from PCSE regarding the Seniority Payments Reconciliation Exercise 2023.


Vaccination and immunisation programmes

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

Hepatitis B vaccinations

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

Travel medication and vaccinations

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


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. BMA guidance

Principles for dispensing doctors and community pharmacists

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

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

Managing workload

Safe working in general practice

The BMA’s England GP committee (GPCE) has generated the following guide to enable practices to prioritise safe patient care, within the present bounds of the GMS contract. BMA guidance

Safe workload guidance for GPs in Scotland

Read about how to manage your workload safely. BMA guidance

Safe working for GPs in Northern Ireland

Read about how to manage your workload safely as a GP in Northern Ireland.

Safe workload guidance for GPs in Wales

Read about how to manage your workload safely as a GP in Wales.

Workload and overtime guidance for salaried GPs

This guidance offers practical advice and resources for salaried GPs to use when approaching their employer to discuss their workload. BMA guidance

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. BMA guidance

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. BMA guidance

Pushing back on inappropriate workload

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

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. BMA guidance

Care navigation and triage in general practice

This guidance is designed to support GP practices in implementing triage systems that can be adapted to their individual practice's circumstances.   BMA guidance

General practice responsibility in responding to private healthcare

GPC England has written the following guidance to help practices reduce extra workload generated by requests from private providers. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance


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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

Employing registrars on the 2016 junior doctor contract

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

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. BMA guidance

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. BMA guidance

GPs outside of traditional practice

A toolkit designed for GPs whose roles fall outside of traditional practices. BMA guidance

Gift payments to GP registrars during industrial action

Guidance for GP practices on financially supporting their registrars during junior doctor industrial action. 

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

Spirometry in general practice

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

NHS primary care medical services in institutions and care homes in the UK

This guide explores what you should do when your GP practice is asked to provide primary care medical services to patients residing in institutions where the types of services expected may not fall under your contractual obligations.  BMA guidance

Providing court reports

We set out the BMA position on court reports and what to do if you are asked by a court to provide a medical report. BMA guidance

Pharmacotherapy and community treatment and care services in Scotland

This guidance explains the limits on practice responsibilities for providing Pharmacotherapy and community treatment and care services (CTACs) in Scotland in the absence of any transitionary service to cover gaps in Health Board provision.

Accelerated access to GP-held patient records 2023

From 31 October 2023, practices are contractually obligated to provide online records access for their patients. GPC England has written guidance to address common questions, key deadlines and practical considerations to extending online access.

Exploring innovation in general practice

BMA report on innovation in general practice. BMA guidance

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. BMA 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. BMA guidance

Partnership guidance for GPs in Scotland

This guidance provides general guidance on medical partnerships under the NHS in Scotland. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA guidance

Disposing of clinical waste

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

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. BMA guidance

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. BMA guidance

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 based on recent successful legal action supported by the BMA. BMA guidance

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. BMA guidance

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. BMA report

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. BMA guidance

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. BMA guidance

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. BMA guidance

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. BMA views