GP practices

GP practices are independent businesses that hold a contract with the NHS to provide primary medical care services. While NHS Kent and Medway commissions them to deliver these services, GPs are entirely responsible for running their own business, including day-to-day decisions such as:

  • how to organise appointments
  • which staff to hire
  • how to manage the premises they deliver services from and equipment they need.

They are organised into primary care networks.

Contract

This contract is held between the NHS and individual or partnerships of GPs and is the same contract across the country. GP practices can be run by individual doctors, partnerships, or limited companies. They provide services under one of three national GP contracts — General Medical Services (GMS), Personal Medical Services (PMS), or Alternative Provider Medical Services (APMS). These contracts are held between the NHS and the practice, setting out the services they must provide to patients.

They may have several smaller contracts for other services as well. They must follow NHS rules for safety and quality, and they need to talk to patients about any big changes.

What happens when a GP practice wants to make a change?

Who makes decisions about GP services in Kent and Medway?

NHS Kent and Medway does not run GP practices. It works with practices to make sure the practice is delivering what is set out contractually. NHS Kent and Medway can approve big changes, like if a practice wants to merge with another practice.

How can a GP practice apply for a change?

If a GP practice wants to make a big change (for example, move to a new building or close a branch), it must:

  1. Make an application explaining what they want to do and why.
  2. Send the plan to NHS Kent and Medway for approval.
  3. Show the practice has engaged with and spoken to patients, and listened to their views. This is a legal duty.
  4. Explain in the plan how the practice intends to respond to patient feedback and, if issues or concerns are raised, how they will be mitigated.

Talking to patients

Before proposing changes, GP practices must:

  • tell patients what is happening in clear language.
  • ask for feedback on their proposals through meetings, surveys, and their Patient Participation Group (PPG).
  • explain how the proposed change will affect people and what support is available.

What is NHS Kent and Medway’s role?

We are responsible for making sure GP practices deliver the services required under their NHS contract. It also has to balance the needs of each practice with those of the local community.

We have a duty to make sure due process has been followed, that patients and stakeholders have been engaged with and the proposed changes do not affect the delivery of the national contract. We can, however, ask the practice to put measures in place to address any patient concerns.

If a GP practice decides to hand back its contract and stop providing services, we would explore options and ensure that local people continue to have access to care.

How are decisions made?

Once an application from a general practice to change is received, NHS Kent and Medway will review the application, the patient engagement and how the practice intends to respond to any issues raised.

The application is considered by the General Practice Contract Oversight Group, an advisory group,  and then ratified - or challenged - by the Primary Care Strategic Oversight Committee. This committee has representatives from the primary care team in the ICB, from the Local Medical Committee (who represent all Kent and Medway GPs), the ICB's quality team and GPs. The outcome of the committee is communicated back to the applicant.