Digital-first Primary Care: Policy consultation on patient registration, funding and contracting rules

Closed 23 Aug 2019

Opened 27 Jun 2019


All around us, a new generation of technology is changing our lives. Each year more of us choose online routes to book GP appointments, order repeat prescriptions or view personal health records. Digital innovations have the potential to support and empower patients, helping people to remain healthy and independent for longer. Used well, new technologies can also help to alleviate workload challenges in practices.

The NHS Long Term Plan commits that every patient will have the right to be offered digital-first primary care by 2023/24.

But the current GP contract rules weren’t designed for digital-first services, and cause problems for existing practices, the NHS and new providers alike.

We are engaging on proposals and options to:

  • Change how the system works so we can ensure the money follows the patient;
  • Make it easier for existing GP surgeries to expand and improve their own digital services;
  • Ensure that digital-first providers can register new patients in areas where people can’t currently access digital GP services.

This includes proposals to:

  • Amend the out-of-area registration rules so that where a practice exceeds a threshold number of out-of-area patients in any CCG, they would separately be awarded a local APMS contract in that CCG;
  • Change the allocations system to enable quarterly recalculation of CCG funding to reflect patient movements;
  • Amend the new patient premium so that it is only paid if a patient remains registered with a practice for a defined period;
  • Allow new digital-first practices to be established in the most under-doctored geographies to increase overall GP capacity and address the inverse care law in general practice.

Further information about the proposals are available in the document we have published to support this public engagement.

The consultation closes on Friday 23 August 2019.


  • Service providers
  • Patients


  • Primary care