This guidance is intended to help practices better understand how to work through the requirements associated with the funding. The BMA has consistently stated that this funding deal is to stabilise General Practice, and the Cabinet Secretary for Health has repeated this. Stabilisation means safe workloads and job plans to reduce unnecessary clinical risk and prevent burnout. It means expanding clinical capacity where possible, to meet rising demand. Practices should refer to the BMA safe workload guidance and if they have not yet adopted it are encouraged to use this funding to support the transition to the safe workload guidance’s recommendations.
As part of the requirements to secure tranche 2 workforce funding, practices will need to set out a plan for how they will look to use the funding available to them across the coming year by mid-May 2026. It is particularly important that a practice’s intentions for quarter 2 of 2026/27 are achievable as the practice’s workforce survey return for the end of that quarter are required to demonstrate intentions for that quarter have been achieved to unlock tranche 2 funding. Practices will have the opportunity to adjust their intentions for the funding on a quarterly basis as part of the workforce survey return and if a practice has not achieved what it set out to by the end of quarter 2, it will be able to access its tranche 2 funding at whatever subsequent date their intentions are achieved.
Practices will want to consider the level of funding they will receive in each of the three years and in particular what their financial position will be when funding in the final year is achieved. It will be important to have a clear plan for what level of workforce expansion a practice is seeking to achieve in year three and what progress they can make towards this each year.
The table of options for how the workforce money can be used is intended to be considered in sequence, but the priority is to find the right model of expansion that works for an individual practice.
| Option | Description |
|---|---|
| A | GPs: practices create new permanent GP roles:
(i) GP partners (ii) salaried GPs |
| B | GPs: practices increase Whole Time Equivalent (WTE) of current GPs working in practices through expanding sessional commitment of existing GPs to deliver extra sessions |
| C | GPs: practices reduce pressure in short-term through extra GP locum sessions |
| D | GPs: Practices recruit through new Board-run fixed-term GP fellowship posts. SG would part fund these posts, with practices funding their clinical time in general practice. Fellowships can be used by Practices/Boards to fill posts which are perceived to be more difficult to recruit to (e.g. in rural / deprived areas). |
| E | Other clinical roles and administrative roles: practices increase WTE and / or create new headcount. Where practices cannot increase GP capacity or the assessed need is for another role they may consider recruiting to other clinical staff (e.g. general practice nurses) or administrative roles. |
Working through the options
If a practice will receive sufficient funding over the three years for one or more new GP roles as per Option A and can accommodate this expansion, it should seek to recruit to these roles. If successful and this has utilised all available funding then that practice will not need to go further down the table.
If a practice’s funding will be insufficient for external recruitment or a practice faces other barriers such as premises capacity or unsuccessful recruitment, or it has surplus funds after recruiting externally, then it should consider Option B.
For some practices, particularly those with premises constraints, this option may be more attractive where practice sustainability would be better served by increasing internal capacity, or where there is a lot of work being done outside agreed sessional commitments. This work can then be recognised through the allocation of additional contracted hours or sessions to existing practice GPs. It is important that practices consider the entirety of work done by GPs when looking at how much work is done outside of contracted time, not just direct clinical activity.
If the practice will not receive sufficient funds in year one to provide for Option A, and there is no option for permanently increasing internal capacity as per Option B, then using internal or external locums to provide additional capacity may be the sensible choice.
This can enable practices to wait until the year 2 or year 3 funding arrives creating a pot of money sufficient for a new permanent role and can enable extra internal capacity to be spread equitably across existing GPs on an interim basis.
It may also enable additional capacity to be put in place at particularly pressured points of the year, such as school holidays.
In areas where external locum cover can be harder to obtain but is vital to enable annual leave, such as small rural practices, additional funding for locums could make engaging one more likely, and therefore improve the sustainability and wellbeing of the permanent GP. Another alternative would be buying remote locum support to free up the substantive postholder’s time for other activities related to the running of the practice or participation in education.
Option D on creating posts for GP fellows may be particularly suitable for rural or high deprivation practices where recruitment is harder. There are past examples of rural fellows being shared between sites in order to provide additional clinical support. GP fellowships are likely to still be limited in numbers, and therefore only an option for a limited number of practices.
Finally, Option E on recruiting other clinical or administrative staff should be used where options A to D have been worked through. You may arrive at Option E because of insufficient funds to increase GP hours or a balance that is left over, or if you identify that this will be the best way to release existing GP capacity. Alternatively, you may have identified a need for increased administrative support for example due to more substantive GP posts, or that more practice nursing hours are required to increase clinical capacity and the sustainability of the practice.
Specific examples
1) Large practice
A large practice may be able to create new GP posts as well as expanding internal capacity by fully recognising hours worked, including by ensuring they are included in the partnership agreement/salaried GP contracts or by existing GPs providing further clinical sessions. It may also be able to utilise locums more freely, expand the practice nursing team or increase admin staff hours.
2) Medium Practice
A medium sized practice may not gain enough money to employ new GPs in year one, so could instead increase internal capacity temporarily or permanently, and/or use a larger number of locums. In year 2 or 3, the practice may have accumulated enough funding to make creating new GP posts viable.
3) Small Practice
A small practice may not be projected to receive enough money for a substantive new GP post until year three of the funding package. It may therefore use locums or increased internal capacity temporarily until sufficient funding for a substantive post becomes available. Or depending on their particular needs, they may prefer to increase nursing and/or admin hours instead.
4) Single-handed
It is unlikely that creating an additional GP post in most single-handed practices would be appropriate, or viable with the funding received. They may instead look to use the funding to reflect the work done outside of contracted hours by the GP or to use the funding to increase their ability to secure locum cover for annual leave.
In any of the above examples, practices may find themselves with active recruitment but no suitable applicants. The funding may therefore need to be used for locum cover or temporarily increased internal capacity until such time as recruitment is successful. It is important that practices reflect this in their intentions reporting for the money, making clear that the resource may be used in one way until such time as an advert is filled, at which point it will be used in another. This is important to ensure that any mismatch between actual use of the money and a practice’s reported intentions for it does not result in difficulties accessing tranche 2 funding.