Topic guide to: General Practice Services

The following publications can be found on the Information Centre website.

GP workforce census

More detail on this can be found in the Workforce, Finance and Performance topic. This publication can be found on the Information Centre website.

GP practice vacancies

The GP Practice Vacancies Survey collects data directly from GP practices in England and Wales and produces estimated three-month vacancy and total vacancy figures at national level for different staff types.

The survey samples 2,000 randomly selected GP practices in England stratified by Strategic Health Authority (SHA), and 200 practices in Wales, stratified by Welsh Government Office Region. Practices were asked to fill in a questionnaire and the report relates to the data provided by respondents. In England 48 per cent of practices sampled returned a completed questionnaire representing around 12 per cent of all English Practices. In Wales 58 per cent of practices returned a completed questionnaire representing around 24 per cent of all Welsh Practices.  Due to the sample sizes comparisons at SHA level have not been published.

GP workload

The last GP workload survey was undertaken in 1992/3, and considered the workload of GPs. Staff in a representative sample of 329 practices completed diary sheets for one week in September or December 2006. As the survey was targeted at work in the practice it excludes work done elsewhere as well as any work identified as out-of-hours not relating to the practice contract.

GP patient survey

The survey measures practices’ performance against the standards set out in the Directed Enhanced Services known as the ‘Improved Access Scheme’ and ‘Choice and Booking’. These one-year agreements were applied in 2006/07 and repeated for 2007/08. Fieldwork took place from January to March 2008. For the Access part of the survey, questionnaire forms were mailed directly to a sample of patients from each practice. For the Choice part of the survey, GP practices were asked to give a questionnaire form to every adult patient who was referred to secondary care for a condition where the Choice policy applies. Completed questionnaires were returned directly by patients.

Quality and Outcomes Framework (QOF)

The QOF has four domains (clinical, organisational, patient care experience and additional services, plus a holistic care component). Each domain consists of a set of achievement measures, called indicators, against which practices score points according to their level of achievement. The QOF was introduced on 1 April 2004. Participation rates are very high.

GP earnings and expenses

Earnings and expenses information are based on a sample from HM Revenue and Customs’ (HMRC) tax self-assessment database. All analyses are carried out on anonymised data; only aggregate non-disclosive information is published.

All UK NHS GPs for whom information are available, and who have an accounting year ending in the final quarter are included in the sample. The results relate to NHS and private work, for both full and part time GPs. The results for salaried GPs for 2006/07 are provisional pending investigations on the effect of employee superannuation contributions on earnings of salaried GPs. Comparable figures for earlier years are not available for salaried GPs due to methodological changes.

Investment in General Practice

The latest report details the investment in General Practice from 2003/04 to 2006/07, and draws on information obtained from country level financial monitoring reports. It contains some financial flows that do not reach the GP, but contribute towards Primary Medical Care investment. For the period 2003/04 to 2005/06, the figures are a measure against the Gross Investment Guarantee (GIG). The GIG no longer exists and recorded levels of investment from 2006/07 is measured using total spend. While the measures used in 2003/4 to 2005/6 and the measure used in 2006/7 are very similar, it is not possible to draw exact comparisons between the figures.

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• Alternative Provider Medical Services (APMS)

  Primary medical services commissioned from non-GMS or non-PMS providers, for example from the voluntary sector, commercial sector, other NHS trusts or other PCTs.

• Contractor GP

  Previously referred to as a principal GP, a contractor GP is a practitioner who has entered into a contract with a Primary Care Organization (PCO) either as an individual or part of a practice to provide primary care services. This may be as a single-hander, or as part of a partnership. A contractor GP may employ salaried GPs.

• Expenses

  These refer to the GPs’ outgoings, and relate to business costs, for example premises, employees, and interest on business loans. These are also known as allowable expenses.

• General Medical Services (GMS)

  A GMS practice is one that has a standard, nationally negotiated contract. Within this, there is some local flexibility for GPs to 'opt out' of certain services or 'opt in' to the provision of other services.

• Income before tax

  Income before tax is the difference between gross earnings and expenses. It can be considered as the ‘profit’ element of gross earnings for contractor GPs relates to pay before tax deductions.

• New GMS contract (nGMS)

  The new General Medical Service contract was designed to improve the way that Primary Medical Care services (GMS, PMS, APMS and PCTMS) were funded and to allow practices greater flexibility to determine the range of services they wish to provide, including through opting out of additional services and out-of-hours care.

• Personal Medical Services (PMS)

  The PMS contract was introduced in 1998 in England and Scotland (as in the Section 17c agreement) as a local alternative to the national GMS contract. PMS contracts are voluntary, locally-negotiated contracts between PCOs and the PMS Provider, enabling, for example, flexible provision of services in accordance with specific local circumstances.

• Primary Care

  Primary care includes medical, dental, ophthalmic and pharmaceutical services, and also NHS Direct and NHS walk-in centres. In the UK, all these services are managed at a local level by Primary Care Organisations (for example, Primary Care Trusts in England). They are responsible for ensuring that the Primary Care services available meet the needs of the patients.

• Primary Care Trust Medical Services (PCTMS)

  Primary medical services provided directly by the PCT, for example through directly employing a salaried GP.

• QMAS

  The Quality Management Analysis System (QMAS) is a national system developed by NHS Connecting for Health. QMAS uses data from general practices to calculate individual practices’ QOF achievement.

• Salaried GP

  A salaried GP is employed by the contractor GP(s) of a practice; they may also be employed by the Primary Care Organisation (PCO). The cost of employing a salaried GP could form part of the employee expenses of contractor GPs. If the salaried GP is employed directly by a PCO then the ‘employer’ GP's tax return will not have incurred the expense.