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Commissioning GP services

Primary medical services in England are provided by general practitioners (GPs) under contracts with NHS England and NHS Improvement (NHSEI). These functions can also be delegated to clinical commissioning groups (CCGs), under co-commissioning arrangements, although NHSEI maintain overall responsibility for ensuring the quality of services. Further information on primary care can be found on the NHS England website.  Information on GP access is provided on the NHS website.

Under the Health and Care Bill responsibility for making the necessary arrangements to secure the provision of primary medical services will transfer from NHSEI (and CCGs) to Integrated Care Systems (ICSs) although NHS England (and the Secretary of State) will maintain some powers of direction.

GP practices have also begun working together with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas in primary care networks (PCNs). PCNs typically serve communities of around 30,000 to 50,000.

These NHS bodies work together to assess whether new GP surgeries or other healthcare facilities are required for a particular area. Where there is an increase in population, for example a new housing development, local planning authorities should engage with NHS commissioners (i.e. CCGs and NHSEI).

There is no recommendation for how many patients a GP should have, or a maximum list size per practice. The Government has noted that the demand each patient places on their GP is different and can be affected by various factors, including rurality and patient demographics. They also note that the workforce required for each practice to meet patient needs also includes a range of health professionals in addition to GPs themselves, and the best skill mix is for individual practices to determine.


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