GP Contracts

GP Contracts

GPs work to a set of nationally determined contractual expectations that make it clear what the GP should do and how they should refer into and around the health and care system. The GP contract also specifies payments to GPs. Some GPs also have specific requirements set out in Alternative Provider Medical Services (APMS) contracts.

National Guidance

Following the announcement of the GP GMS contract changes for 2024/25, which were imposed on the 01st April 2024, the LMC has dissected the various contract documents and produced our guide to the changes, which can be found here. This includes a summary of when each of the changes will come into effect (not all changes came into effect on the 01st April 2024 and it is therefore important for practices to understand the various timelines).

For PCN arrangements, see our PCNs page.

Information about the 2023-24 contract announced in March 2023 can be found here:

Information about the 2022-23 contract announced in March 2022 can be found here:

The 2021-2022 contractual requirements and associated 2021-22 documents can be found here:

The 2019-2020 contractual requirements and associated 2019/20 documents can be found here:


Local Guidance


The BLMK Primary Care Framework 2024-25 is a parcel of extra local services (not part of the core national GMS contract) that a Bedfordshire practice may be paid to offer to their patients.


In Hertfordshire, local commissioners develop LESs (Local Enhanced Services) or LCS (Local Commissioned Services) to offer practices the opportunity to offer to their patients extra services that are not part of the core contract.

A list of potential LESs can be found on the BMA website.


QOF (Qualities and Outcomes Framework) 

This voluntary annual reward scheme for all GP practices in England centres around five main ‘domains’ (components): Clinical, Public Health, Public Health – Additional Services, Public Health – Vaccination and Immunisation, and Quality Improvement. Payment is by achievement measures in each category, known as indicators. The final annual payment is adjusted to accommodate the practice’s workload, local demographics, and the prevalence of chronic conditions in the area.



Primary Care Networks (PCNs) are groups of general practices working closely together with other primary and community care staff and health and care organisations, providing integrated services to their local populations.


The Network Contract DES regulates PCNs and sets out their rights and obligations. The 2024/25 Network Contract DES (PCN DES) specification can be found here, and the LMC’s guidance to the changes from 2023/24 is available here.