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Following on from the December announcement from Wes Streeting, some details of the funding has come out finally. The 2025-2026 General Medical Services (GMS) contract introduces significant changes aimed at modernizing general practice in England, enhancing patient access, and improving working conditions for General Practitioners (GPs). This agreement, reached between the government and the British Medical Association (BMA), marks the first contract consensus in four years, signalling a pivotal shift in primary care.

The announcement by Wes Streeting to pump an extra £889 million a year into primary care is big news for GPs and patients alike. As a GP Partner, I can’t help but feel a mix of cautious optimism and skepticism about the whole thing. 

 The BMA’s Push for a 20% Pay Rise for Salaried GPs: What Does It Mean? The British Medical Association (BMA) recently proposed a 20% pay rise for salaried GPs starting next year. This bold request reflects growing concerns about the recruitment and retention of GPs, as well as the increasing pressures on primary care. But how realistic is this proposal, and how much funding is the government likely to provide to support it?

The recent increase in employer National Insurance (NI) contributions in the Autumn budget is creating serious challenges for GP partnerships in the UK. To understand why, it helps to look at how GP practices work and how they manage their money. What Are GP Partnerships? Most GP practices in the UK are run as partnerships rather than companies. This means the doctors who own the practice share both the profits and the responsibilities. These GP partners are in charge of paying for the staff, running the practice, and handling costs like employer NI contributions. Unlike employees, the partners take on personal financial risk to keep the practice running. What Is Changing with NI Contributions? The government has raised employer NI contributions from 13.8% to 15% . At the same time, the income threshold for paying NI has been lowered, which means more salaries are affected. This means GP practices will have to pay more for every staff member they employ, including receptionists, nurse...

In a resounding vote of no confidence, GPs in England have overwhelmingly rejected the proposed contract changes for 2024/25. The British Medical Association (BMA) held a referendum, with a turnout of over 61% and a staggering 99.2% of participating GPs voting "no" to the contract. 

The recent unveiling of the revised GP contract by NHS England has sent shockwaves through the healthcare community, igniting a fierce debate. While some elements of the contract have garnered cautious acceptance, the British Medical Association's General Practitioners Committee (BMA GPC) has expressed strong disapproval of several key points, raising concerns about the potential impact on patient care, workload management, and the overall sustainability of primary care.

The ever-evolving landscape of primary care finds itself at a crossroads when it comes to the role of Physician Associates (PAs). While some hail them as indispensable allies in tackling the physician shortage and improving access to care, others express concerns about potential compromises to quality and the dilution of the doctor-patient relationship. Examining both sides of this debate reveals a complex picture, demanding nuanced solutions rather than simplistic pronouncements.

The proposed 1.9% uplift to the GMS contract in England has ignited concerns within the general practice community, raising critical questions about its impact on both financial sustainability and patient care. Examining the details of this offer and its potential ramifications reveals a complex scenario with far-reaching consequences. 

Beneath the apparent calm of the UK's National Health Service, a low rumble of discontent vibrates between two pillars of primary care: general practitioners (GPs) and the wave of new roles funded by the Additional Roles Reimbursement Scheme (ARRS). While both share the noble goal of serving patients, they find themselves on opposing sides of an evolving landscape, where questions of territory, training, and the very definition of "good care" spark ongoing skirmishes.

The recent announcement of a substantial increase in the minimum wage (up to £11.44 from £10.42) has sent shockwaves through the healthcare sector, particularly among GP partners. While this move aims to uplift the lives of low-income workers, it could inadvertently jeopardize the financial stability of general practices, threatening the very foundation of primary care in the United Kingdom.

Everyone is striking these days. The train drivers are always doing it. The posties are doing it this month. There are barristers and firemen talking about striking. More interesting in our case is doctors. The government has reccommended a 4.5% pay increase to doctors. However, not to all doctors. GP partners and doctors in training are not included in this deal. 

Been busy with life so not posted for a while, so much has happened in the world since I last posted. Putin has gone true megalomaniac and invaded Ukraine, and if reports are true, they are doing a valiant job holding him back. Things were already very expensive prior to the war due to Covid but with sanctions flying from the western nations to Russia, it has made things like petrol very expensive. Certain foods are also set to rise, with the bulk of sunflower oil and wheat coming from these two countries, things like bread and livestock which need as feed, will become more expensive. Drivers have already noticed, with petrol prices through the roof, I'm sure we're a few weeks away from 200p / litre. Rishi Sunak tried to stem this tide with his announcement today, increasing the NI limit and taking 5p off fuel duty. Covid seems like a long lost friend...

You may have heard in the news that GPs are going to be getting a large money boost in the form of £250 million to help with the winter pressures. This hasn't been received very well by GPs and the BMA as they feel it's not enough and doesn't really solve one of the main issues in this, lack of doctors. I had a quick read through of the plan released by NHS England, and found some interesting points. You can have a full read of the plan here .

The new to partnership scheme has an attached £3,000 bursary attached to it for new partners. It's meant to teach new partners the non-clinical skills that should serve them well in their new role. It requires you to pay for the course, and then NHS England will pay your practice back on your 1 year anniversary of being a partner. There are several options available that I'm aware of, listed below.

I don't read the Daily Mail regularly but occasionally I get sent a interesting news articles by friends and colleagues. This time, I got sent the annual GP bashing article as the annual pay report is released, titled Rise of the £100k GPs . The actual financial report is published here . 

I briefly mentioned the proposed 1% pay rise for NHS workers in the maternity pay post but now the government has actually come out that there will be a 3% rise for NHS workers  in England. This will include consultants, dentists, nurses, paramedics and salaried GPs. This will not include doctors in training or GP partners however. This is actually more than I thought it would be, but for some, they want more. Consultants are being balloted to see if strike action is warranted as they didn't get the 5% they were looking for. Nurses will get roughly £1000 extra annually on average but they wanted 12.5% (which would be £4000 extra) and may strike as well. Other union NHS staff may also stage a strike if they don't get the pay rise they want.  Seems a bit ungrateful this sign A lot of their arguments are that it's still a below inflation pay rise (which is predicted to go reach near  4% this year ) and wont make up for the years of below inflation or non-existent pay rise...

After introducing this new scheme , there have been problems with new partners getting their payments. Hurdles that were put in the way had been that the probationary period of fixed-profit that a lot of practices put in place when a new partner joins. This period has new partners paid a fixed salary rather than a share of the profits for a short amount of time. When these partners have gone to apply to the scheme, they've been told that they are no eligible for the payment, as they are not profit sharing and also because when do become profit sharing after their probation then they will still not be eligible as they wont be 'new partners'. 

Details have come out about a new fellowship scheme which will be available to all newly qualified GPs (and nurses) working in Primary Care. It will be offered to all newly qualified GPs in a fellowship scheme which will provide at least 1 hour of mentor-ship every 4 weeks and at least 6 sessions of coaching over the 2 years. Locums cannot apply, it is aimed for salaried GPs though partners can apply. It is also offered to nurses interested in primary care but I will not cover that here. You would sign up to a 2 year scheme   and participants receive funded mentor-ship and funded CPD opportunities of one session per week (pro rata), and rotational placements within or across PCNs to develop experience and support transition into the workforce. To allow this to happen, the NHS will pay £10,200 to the practice to release their GP fellow out for a session a week for their CPD and also mentor-ship. Over the 2 years, it will form a sort of curriculum which I assume will mak...

When GP's qualify, they have a possible decision to make. Do I try find a salaried post or do I locum (work ad hoc)? Nowadays with Covid19, a lot of GP work has shriveled up and there is a shortage of locum and salaried jobs, with news that some have had to go on benefits ... however in this discussion I'll be assuming a pre-covid time when locum jobs were abundant and there was a shortage of GPs. I'll be mainly looking at these roles from a financial stand point in a GP surgery, there are numerous other pros and cons to these roles which are outside the scope of just the money however.

Following on from my last post , an article from GP Online  has suggested that there may be hidden costs for GP practices. An accountant that was interviewed has said that there may be issues if the new partner was to leave or change his hours, and that if NHS England would claw that money back from the surgery.  'If someone leaves or reduces their working hours then there is a clawback off the practice contract. So it’s tricky in that practices are expected to pay over the full amount to the new partner but they may then need to recover money if they leave.' He also feels there would be thousands of pounds that needed to be spent on the partnership agreement to add a new partner and avoid this issue.