The GMS contract for practices requires us to provide services to “patients who are, or believe themselves to be

1. ill, with conditions from which recovery is generally expected;
2. terminally ill; or
3. suffering from chronic disease,

which are delivered in the manner determined by the contractor’s practice in discussion with the patient.”

The contract does not place the responsibility on General Practices to provide preventative measures, unless this is separately commissioned such as vaccination or screening.

Thus, if practices are asked to perform preventative measures for which they are not separately contracted, they should decline, or agree an extra fee for carrying out these measures.

Examples of this which frequently arise are

• Post-exposure blood tests for patients possibly exposed to blood borne viruses
• Immunisation for people who are contacts of infectious diseases
• Immunisation for people at risk of infectious diseases e.g. patients with renal disease or cancers
• Provision of anti-microbial medications for contacts of patients with an infectious disease

It is the responsibility of public health and health protection to provide these services.  So if your practice is asked to perform any of these actions you can ask the ICB health protection team to either carry out the activity, or fund your time to carry out the activity on their behalf.