General practice and public health: assessing the impact of the new GMS contract

Peckham, Stephen and Hann, Alison (2008) General practice and public health: assessing the impact of the new GMS contract. Critical Public Health, 18 (3). pp. 347-356. ISSN 0958-1596. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not available from this repository. (Contact us about this Publication)
Official URL


Over the past 30 years, the important role of primary care in public health has been widely recognised, and in the UK a range of measures to support public health in general practice have been introduced since the late 1980s. In 2004 a new general medical services contract was introduced changing the way general practitioners are reimbursed in the NHS. The new contract shifted the emphasis from the individual practitioner to the practice and introduced a new performance incentive framework, the Quality Outcomes Framework, which rewards performance through targeted financial payments. The performance framework identifies specific areas of clinical and organisational performance and patient experience activities – including a number of health promotion activities – and practices attract points for attaining performance targets. This paper examines the experience and impact of the new GMS contract on public health activities in general practice. While the contract has only been operating for three full years, there is emerging evidence to suggest that it may have a negative impact on public health activities in general practice. The use of financial incentives appears to be skewing practice towards areas that are rewarded, which may not be those that maximise health outcomes, and there is some emerging evidence suggesting that there is a negative effect on health inequalities. This paper reviews current evidence on public health incentives in general practice within a wider context of the impact of incentives for public health.

Item Type: Article
Uncontrolled keywords: health promotion; primary care; governance
Subjects: R Medicine > R Medicine (General) > R729 Types of medical practice > R729.5.G4 General practice
R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 04 Jul 2012 09:16
Last Modified: 17 Oct 2014 10:07
Resource URI: (The current URI for this page, for reference purposes)
ORCiD (Peckham, Stephen):
  • Depositors only (login required):