ABSTRACT
This chapter outlines the current policy context for the English National Health Service (NHS) and examines the current contractual arrangements for general practice. It discusses the potential impacts on general practice in the UK. In England, most interest has been paid to the developing market reforms incorporating patient choice, Choose and Book, payment by results, Foundation Trust status, developing a provider market and practice based purchasing (PbC) although the supply side reforms in Northern Ireland, Scotland and Wales provide useful comparative context within the UK. Aspects of the new contractual arrangements for general practice that are less discussed include Personal Medical Services (PMS), Alternative Provider Medical Services (APMS) and Specialist Provider Medical Services (SPMS) contracts. The Quality Outcomes Framework (QOF) provides financial incentives for general practices to meet a range of clinical, organisational and patient experience criteria.
