Pressure is mounting on NHS England to loosen the rules around its £292 million GP reimbursement scheme, as the BMA warns that current restrictions are stopping practices from accessing funding they badly need.
The scheme was launched earlier this year with a clear aim: to boost GP capacity and improve patient access by helping practices fund new salaried GP posts or expand the hours of GPs already on their books. In practice, though, many practices have found the eligibility rules too rigid to be genuinely useful.
The BMA’s England GP Committee (GPCE) is now working with NHS England to look at ways of loosening those rules. One option under discussion is opening the scheme up to GP partners and locums, not just salaried GPs, which would give practices far more flexibility to staff according to their actual needs rather than a narrow set of criteria. Health minister Diana Johnson has confirmed that both NHS England and the Department of Health and Social Care are taking on board feedback from practices as they consider next steps.
Why the current rules aren’t working for everyone
Much of the criticism stems from where the money came from in the first place. The £292 million was reallocated from Primary Care Network capacity and access funding, a pot that practices previously had far more freedom to spend as they saw fit. Losing that flexibility has been a sticking point since day one.
The Association of Independent Specialist Medical Accountants (AISMA) has been vocal in calling for the rules to be relaxed, arguing that without change, much of the funding risks going unused.
Smaller practices and those in deprived areas appear to be feeling the strain most acutely. Leicester South MP Adam Shockat has raised concerns that limiting reimbursement to salaried GP posts could unfairly disadvantage practices that simply can’t sustain permanent roles, whether due to funding constraints or local recruitment difficulties. For many, taking on a new salaried GP isn’t a realistic option, and plenty of GPs would rather work flexibly as locums than commit to permanent employment.
The knock-on effects for practices
According to specialist medical accountant Katie Collin, a more flexible scheme would be a welcome change, since the current setup often makes it hard for GPs and practices alike to actually benefit from the funding on offer.
Part of the problem is structural: practices can only claim for additional costs once they’ve already been incurred, meaning they need to recruit first and seek reimbursement second. That’s a difficult ask in a recruitment market that’s already stretched thin.
There are also concerns that some practices are pushing locums onto salaried contracts purely to unlock reimbursement, a move that brings its own headaches, including IR35 complications and added employment costs. On top of that, practices have flagged ongoing confusion about how long the funding will last and inconsistent handling of claims between different Integrated Care Boards.
Where things stand
NHS England says it’s continuing to track how the scheme is being used, though no formal review has yet looked specifically at how the salaried-GP requirement affects smaller or more deprived practices. Ministers have indicated that feedback from the sector will feed into any future changes.
Should the BMA and NHS England reach agreement, practices could soon have considerably more flexibility in how they use the £292 million to tackle workforce pressures and grow GP capacity. Until then, practices will need to work within the current rules while talks continue behind the scenes.
Source: Adapted from GPonline: “BMA talks widening £292m GP reimbursement scheme to partners and locums