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Healthcare: 2023/24 update to the GP contract

The GP contract update for 2023/24 was published on 6 March 2023 and, for the second time, was an imposed update due to a breakdown in discussions. The update has attracted a mixed reception from stakeholders from tentative positivity to bitter cynicism.

Focus of the changes

The general flavour of the changes appears to be an effort to help practices meet the national target priorities with patient access and recruitment featuring heavily. For example, it is now written into the contract that “patients should be offered an assessment of need or signposted to an appropriate service at the first contact with practice.”

The contract appears to be facilitating patient access and supporting the current, unprecedented demand, by stripping back the quality and outcomes framework (QOF) and impact and investment fund (IIF) targets. For QOF, the number of indicators will reduce from 74 to 55 and for IIF, the number of indicators will reduce from 36 to five.

Patient access

IIF, received by primary care networks (PCN), in particular will be heavily focussed on patient access with one of its five indictors relating to this, (the other four being for flu vaccinations (2), learning disability health checks and early cancer diagnosis). IIF will become very much like QOF funding with 70% received as a monthly payment and 30% being assessed against an access improvement plan. There will also be changes to childhood immunisation targets with the penal repayment for achieving less than 80% coverage being removed.


The contract also appears to facilitate meeting targets by providing more flexibility with recruitment.  This is seen with additional roles reimbursement scheme (ARRS) with the number of reimbursable roles increasing and caps on the number of roles within a PCN being removed. For example, there will be no cap on the number of mental health practitioners. There is also clarification that PCNs should be recruiting staff into permanent contracts in a possible nod to the future of PCNs.  In addition, support, in the form of reimbursements will also be forthcoming for PCN practitioners to take time out for education and training and the four session cap for the GP retention scheme has been removed.


Again, to presumably help with patient access, all practices are being strongly pushed to adopt cloud based telephony systems where practices will have to procure their systems from the ‘better purchasing’ framework when their current telephony contracts expire.

New to partnership payments

No changes are mentioned in relation to the ‘new to partnership’ payments or the GP publication of earnings requirements. This therefore indicates that the new to partnership scheme will likely end on 31 March 2023 and that the previously postponed reporting requirements for GPs whose pay exceeded £156,000 will come into effect for the 2021/22 year – with reporting required by 30 April 2023.

Further details and information are expected in the coming weeks. A full copy of the changes can be viewed here.

Katie Skea, ACA BSC (Hons), is a partner working in the Healthcare team of the Truro office. Katie looks after a large number of our… read more
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