General Practitioners are independent contractors to the NHS and work under legal agreements that determine the services that must be delivered to patients under their care and how. These contracts which are often referred to as the core contract are held between NHS England (the purchaser or commissioner of the service) and the primary care contractors or provider of the service.  Currently, the contracting mechanisms for the core contracts are the GMS, PMS and APMS contracts.

General Medical Services (GMS) contract

A nationally negotiated contract.  
This came into force in 2004 and has undergone annual amendments since its inception.  The annuals contract negotiations are held between the General Practitioners Committee of the British Medical Association and NHS England.

Personal Medical Services (PMS) contract

Locally negotiated contract.
Although the PMS contract is locally negotiated between a contractor and the Clinical Commissioning Group, the bulk of its content mirrors the GMS contract.

Alternative Provider of Medical Services (APMS)

Locally negotiated contract which allows flexibility to commission services from any contractor.

Additional Services

Contractors can also opt in to deliver extra services to their patients on top of their core services.  These include;

  • Cervical Screening
  • Contraception
  • Childhood vaccination and immunisations
  • Child health surveillance
  • Minor Surgery

General Medical Services Contracts

APMS Directions

Statement of Financial Entitlements

Premises Cost Directions


Print Friendly, PDF & Email