Additional Services

General practices can choose to provide or opt out of certain additional services. These services were traditionally included in the General Medical Services (GMS) contract, with practices losing a percentage of their global sum if they opted out. However, recent changes have updated these provisions.

Previous Additional Services Structure

Previously, additional services that practices could opt out of included:

Contraceptive services (excluding IUCD fitting and checks)
Childhood vaccinations and pre-school boosters
Maternity services (excluding deliveries)
Minor surgery (including curettage, cautery, cryocautery of warts and verrucae, and other skin lesion treatments)

Opting out of these services resulted in a reduction in a practice’s global sum:

Contraceptive services: 2.4%
Childhood vaccinations and pre-school boosters: 1%
Maternity services: 2.1%
Minor surgery procedures: 0.6%

Current Additional Services Structure

Recent changes have affected both the scope of these services and their financial impact:

Some additional services have been reclassified or incorporated into core general practice contracts.
The funding model has shifted, with different financial implications for opting out.
New requirements and reporting structures may apply to practices providing these services

According to the August 2024 Standard General Medical Services (GMS) Contract, the additional services currently included in the contract are:

Minor Surgery (including procedures such as curettage, cautery, and cryotherapy for warts, verrucae, and other skin lesions)
Maternity Medical Services (excluding deliveries)
Vaccination and Immunisation Services
Contraceptive Services (excluding the fitting and implanting of intrauterine devices and implants).

Key Changes from Previous Versions

Childhood vaccinations and pre-school boosters are now part of the Vaccination and Immunisation Directed Enhanced Service (DES), rather than being an additional service under the core GMS contract.
Contraceptive services are now classed as an additional service, but IUCD fitting and implants remain excluded.
Maternity medical services remain an additional service, rather than moving to core services, as previously suggested in contract discussions.

Financial Implications of Opting Out of Additional Services

According to the August 2024 Standard General Medical Services (GMS) Contract, practices that choose to opt out of providing certain additional services will face deductions from their global sum funding. The financial penalties for opting out are as follows:

Minor Surgery – 0.6% reduction
Maternity Medical Services – 2.1% reduction
Vaccination and Immunisation Services – 1% reduction
Contraceptive Services – 2.4% reduction

Key Considerations

Maternity services remain an additional service, contrary to prior discussions about making them a core service.
Childhood immunisations have been moved into the Vaccination and Immunisation Directed Enhanced Service (DES), meaning payments are based on performance rather than an opt-in/opt-out basis.
The financial impact of opting out remains similar to previous contracts, but some services now have new reporting and compliance requirements.