Implementing the 2018/19 GP Contract: letter to commissioners

This letter from confirms the outcome of the 2018/19 General Medical Services (GMS) contract negotiations.


NHS England has published a letter to commissioners which signposts all the guidance that is, or will shortly be, available to support implementation of contract changes for 2018/19.

CCGs with delegated commissioning responsibilities should work to amend local primary medical care contracts and implement changes at the earliest possible opportunity, backdated in effect from 1 April 2018, including any agreed enhanced services.


Commissioning primary care services

NHS England has updated the Primary medical care policy and guidance manual to reflect the changing landscape in primary care co-commissioning.   This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

The document is split into four sections:

Part A – Excellent Commissioning and Partnership Working

Part B – General Contract Management

Part C – When things go wrong

Part D – General

Decommissioning health care

The National Institute for Health Research has published Decommissioning health care: identifying best practice through primary and secondary research: a prospective mixed-methods study

This study identifies high rates of decommissioning in the NHS including relocation, removal and replacement of services, medicines and organisations. It also notes huge challenges in establishing the legitimacy required to make and implement these highly controversial decisions. For this reason the authors argue that decommissioning should be considered as the last step in a process in which the case for change and the absence of alternatives has been shared and argued widely. They study highlights a number of ways decommissioning could be successfully achieved.

The report can be viewed here

Provision of community care: who, what, how much?

This briefing from the Health Foundation analyses information on the community care contracts held by 78 per cent of CCGs in England to enable better understanding of the provision of these services. It finds that NHS providers hold more than half of the total annual value of contracts in the sample, while private providers held 5 per cent of the total annual value, but 39 per cent of the total number of contracts issued.

Full briefing available here

2017/18 NHS standard contract

The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services other than primary care.

Image source: NHS England

The Contract (in full-length and shorter-form versions) has now been updated from the 2016/17 to the 2017/18 – 2018/19 version. A summary of the changes we have made to the Contracts can be found in section 3 of the NHS Standard Contract Technical Guidance and in the Summary of key changes documents below.

The full –length NHS Standard Contract 2017/18-2018/19 comprises three parts:

The NHS shorter-form Contract 2017/18-2018/19 also comprises three parts:

Read the full NHS Standard Contract 2017/18 and 2018/19 Technical Guidance here

Read the full overview here

Options for selecting providers and awarding contracts

NHS Improvement guide: How to secure good outcomes for patients when awarding contracts

This guide supports CCGs to make good decisions by clarifying what they need to do when selecting providers and awarding contracts. It should be read in conjunction with guidance previously issued by Monitor and the Cabinet Office, as well as forthcoming guidance from the Department of Health on requirements from recent changes to general procurement law.

Image source:

Related content: Procurement, patient choice and competition regulations

‘Not true’ that CCGs must always use competitive tenders, says regulator

Williams, D. HSJ. Published online: 20 May 2016

  • NHS Improvement issues procurement guidance to CCGs
  • Briefing note confirms new EU rules will force new contracts to be advertised
  • Regulator emphasises alternatives to competitive tendering

NHS Improvement has told commissioners that competitive tenders are not always needed to choose a provider, following the introduction of a strict new EU procurement regime.

The regulator sent a briefing note to clinical commissioning groups late last week on selecting providers and awarding contracts.

The document, seen by HSJ, confirms that CCGs will be required to advertise new contracts and extensions or variations of existing contracts. This is the result of new EU procurement rules, which have applied to the NHS since April.

It adds that where CCGs receive a number of responses they should not discriminate between providers, and should run a process that enables them to select the best bid.

However, the letter says: “It is not true that all contracts must be awarded using a competitive tender process. There are lots of ways of [selecting a provider], including through an open process or by negotiation.”

Read the full article here