GMS contract: 2018

This document is intended primarily to provide an accessible explanation to Scotland’s GPs of the changes we propose to effect in regulations.


Much of the content of this document has focussed on improving the terms and conditions for GPs in Scotland – in particular, maintaining income stability, reducing workload and reducing risk. The ultimate reason behind all these proposals is to improve patient care. There is clear evidence to link workforce morale with better patient experience – with the new contract we have the opportunity to create a virtuous circle that delivers a thriving future for GPs and for patients.

In itself, a contract can never be the sole answer to the challenges facing primary care. However, the manner in which a contract is developed, agreed and implemented can demonstrate underlying common aims and purposes for mutual benefit. In complex and challenging times, a collaborative approach to a common vision certainly appears, based on our experience, far more productive and more likely to succeed.

We hope that the collaborative relationship which we have created to agree this contract will set the tone for the future of primary healthcare in Scotland. We have developed what could be called a Scottish Negotiating Approach which we agree has been essential to delivering this significant change. We set out initially to both develop and agree a vision for general practice and its place in the Scottish NHS of the future. We had no difficulty in agreeing that the very strengths of general practice are those core values which we wish to enhance and support to meet the needs of the people of Scotland. This is a bold statement of confidence that Scottish general practice is the right kind of medicine for the future.

Both the contract, and the surrounding support structures of the primary care multi-disciplinary team, are intended to enable GPs to be GPs. This approach will underpin delivery of the new contract as well as setting the direction for future development beyond the first three years.

This document describes a very significant degree of necessary system change. It is essential that patient safety and confidence is maintained during this change. Successful delivery will therefore require the support and commitment of all those in the health and care system. We all have a vested interest in the success of general practice and the primary care system for our patients, our families and our communities.

We all have to be active in managing our own care and health. To support this the contract is intended to ensure that GPs are available when needed to help the people of Scotland achieve the best agreed outcomes for their health. GPs will also have a clear role in assessing how well the health and care system delivers these outcomes and advising on how we might better improve on them. There will be better primary care services for patients, more time with a GP when it is really needed, quicker access to other healthcare professionals in the community and a more convenient, wider range of services.

We believe that these changes will enable the GPs of Scotland to make the best contribution possible to achieving better health outcomes. For those who are, or may aspire to become, GPs in Scotland, we invite you to join us in delivering, for the people of Scotland, better health and better care.

Shona Robison
Cabinet Secretary for Health

Alan McDevitt
Chair, SGPC


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