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General Practitioners are independent contractors to the NHS and work under legal agreements that determine the services that must be delivered to patients under their care and how. These contracts which are often referred to as the core contract are held between NHS England (the purchaser or commissioner of the service) and the primary care contractors or provider of the service.  Currently, the contracting mechanisms for the core contracts are the GMS, PMS and APMS contracts.

General Medical Services (GMS) contract

A nationally negotiated contract.  

This came into force in 2004 and has undergone annual amendments since its inception.  The annuals contract negotiations are held between the General Practitioners Committee of the British Medical Association and NHS England.

Personal Medical Services (PMS) contract

Locally negotiated contract.

Although the PMS contract is locally negotiated between a contractor and the Clinical Commissioning Group, the bulk of its content mirrors the GMS contract.

Alternative Provider of Medical Services (APMS)

Locally negotiated contract which allows flexibility to commission services from any contractor.

Contractors can also opt in to deliver extra services to their patients on top of their core services.  These include;

Additional Services

Quality and Outcomes Framework (QoF)

Local Enhanced Services

Directed Enhanced Services

GMS Contract and amendments

General Medical Services Contracts

GP Contract agreement 2020/21

Technical Requirements for 2017/18 GMS Contract Changes

GMS Contract amendments (2015-16)

GMS Contract summary (2015-16)

GMS Contract 2014

GMS Contract amendments (2013-14)

The GMS Contract 2004 (ORIGINAL)

APMS Directions

Alternative Provider Medical Services Contracts

APMS Directions (2015-16)

APMS Directions (2014-15)

APMS Directions (2013-14)

Statement of Financial Entitlements

The statement of financial entitlement, or SFE document outlines all of the finances that practices are entitled to under a GMS contract.

SFE (2017 Amendment)

SFE (2017 - Indemnity)

SFE (2015-16)

Contract Funding Summary (2015 - 16)

SFE (2014-15)

SFE (2013-14)

Premises Cost Directions

PCD 2013


Assignment of patients

Confidentiality and disclosure

Patient choice scheme

GP System of Choice