Commissioning Intentions for GP Contract Plus – 2026/27

1.1      Commissioning Intentions for GP Contract Plus 2026–2027

A high-level review by NHS Dorset in collaboration with the GP Alliance and Wessex LMC has been completed. As a result, it has been agreed to remove two pathways from the GP Contract Plus: Pre-operative MRSA screening and Drug monitoring for the treatment of Alzheimer’s Disease.

Pre-operative MRSA screening.

This will no longer be delivered in Primary Care and will not be part of the GP Contract Plus specification.
Responsibility for pre‑operative screening will sit with the provider carrying out the procedure. This change is primarily driven by clinical governance: swab results must be returned directly to the clinician who requested them so they can take appropriate action.
In certain cases, Secondary Care or Dorset HealthCare may still work with GP practices to carry out swabs, but only through a subcontracting arrangement between providers. Both Secondary Care and Dorset HealthCare have been informed of these changes and are fully supportive.
To support conversations with patients suggested communications are attached at appendix 1.

 Drug monitoring for the treatment of Alzheimer’s Disease

This is being removed as dementia drugs will no longer be a shared care drug and any reference to shared care has been removed from the Dorset Formulary. Patients do not require any special drug monitoring and the remainder of patient needs are covered by Quality Outcome Framework indicator DEM004.

1.2      Use of Activity Data and budget

The budget for GP Contract Plus will remain unchanged for 2026/27, despite the removal of two pathways. This acknowledges the increased activity across the remaining seven pathways. The working group has agreed that the priority for 2026/27 will be to establish a baseline of activity for GP Contract Plus, which will support future commissioning decisions and demonstrate the left shift. A review of templates and Read codes is currently underway, and these will form an essential component of the GP Contract Plus. Communication will follow about this as soon as established.

1.3      Next Steps

Further detailed guidance on the standardised Read codes and reporting expectations will be issued.
If you have any queries regarding these commissioning intentions or the forthcoming contract variation, please contact the Primary Care Team at NHS Dorset.