Talking General Practice

Nick and Emma look at the impact the current list cleaning drive has had on GP practices and explain why GP leaders have called for a pause in the process amid fears of inappropriate removals and a huge loss of funding for the profession.
They talk about prescribing for obesity, after the BMA warned that the funding practices will receive for new QOF targets on this is unlikely to cover the cost of the work involved, and the union warned that some ICBs are cutting back on locally commissioned services related to prescribing Mounjaro since it has been added to the QOF.
And they look at the additional roles reimbursement scheme after we found that millions of pounds earmarked for the scheme went unspent in 2025/26.
Our good news story this week is about those GPs who received awards in the King’s Birthday Honours List.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.

Useful links
GP funding 'siphoned off' by unprecedented scale of patient removals, warns BMA
LMCs demand urgent list cleaning review as fears rise over inappropriate removals
List cleaning chaos leaves popular GP practice on the brink
Where have GP practices been hit hardest by list cleaning?
GP practices could boycott underfunded QOF obesity target
More than £81m of ARRS cash unclaimed in 2025/26
GPs recognised in King's Birthday Honours List

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This week Emma speaks to GP Dr Emma Watts, a dispensing doctor based in Surrey and the chair of the RCGP's Rural Forum, about the distinct challenges facing rural general practice.

Emma discusses how urban-centric policies, mounting financial constraints, and operational pressures are driving rural practice closures. She also highlights hidden health inequalities in rural areas, such as homelessness, and explains why the government's proposed framework for a neighbourhood NHS fails to consider the reality facing remote, rural, and dispensing practices.

And she explains the Rural Minds Project, an innovative training programme using virtual reality headsets to support mental health in UK farming communities.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links
RCGP Rural Forum
Rural Minds Project
Talking General Practice episode with Dr Richard West from the Dispensing Doctors’ Association
Dispensing Doctors’ Association

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This week Nick and Emma talk about list cleaning, after an analysis by Nick showed that 350,000 patients have been removed from GP practice lists, resulting in a loss of around £45m from practice funding. Nick explains why this happens and the impact it has on individual practices.

They discuss GP contracts, looking at the first area in England that has agreed a local variation to PCN contracts, BMA fears about what neighbourhood and integrated health organisation contracts could mean for general practice and whether financial pressures on the current GP contract could make GPs back an alternative model.

And they look at the impact successive governments’ obsession with GP access has had, after a report from the House of Commons public accounts committee found that practices struggle to provide the care frail, older patients need because they are overwhelmed with targets linked to improving access.

Our good news story this week is about an initiative in Greater Manchester that has helped cut hazardous prescribing.

This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.

Useful links
'Aggressive' list-cleaning drive strips 350,000 patients from GP practices
'We're overwhelmed' - practices swamped by scale of patient removals
GPs agree first local PCN contract variation in £10m neighbourhood deal
Hospital-led general practice 'likely' outcome of government NHS plans, warns BMA
NHS England has overloaded GPs with access targets, MPs warn

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GP Money Matters is a series of special bonus episodes of Talking General Practice sponsored by Wesleyan where we look at key personal finance issues that affect GPs.

In this episode GPonline editor Emma Bower talks to Wendy Baillie, a chartered financial planner and the retirement lead for the medical division at Wesleyan, about the complexities of the NHS pension scheme and the specific challenges currently facing GPs.

Wendy provides a recap on the McCloud judgment, the high court ruling about unfair changes to public pension schemes, and explains why the resulting administrative backlog is making it difficult for doctors to get the finalised numbers they need to plan their retirement.

She discusses the risks of making decisions about retirement without full information on your pension and practical steps GPs can take at different stages of their careers to ensure their pension is in good health.

Wendy outlines what you need to consider to ensure you have the retirement you want, particularly if you hope to retire early.

This episode was produced by Czarina Deen.

Useful links
Find out more about Wesleyan

About Wesleyan
Wesleyan Financial Services supports doctors with advice shaped around the realities of the profession.

From complex income structures and portfolio careers to the NHS Pension Scheme and retirement options, its Specialist Financial Advisers work closely with doctors every day. Recognised by the NHS as able to give guidance on the NHS Pension Scheme, Wesleyan brings trusted expertise to key financial decisions. Combining financial planning, investment advice and protection, it helps doctors make confident, informed choices.

96% of doctors rated their specialist financial adviser as very good or excellent, reflecting a focused service that helps doctors protect their income, grow wealth and plan ahead with confidence.

Remember: The value of investments can go down as well as up, and you may get back less than you invest.

Wesleyan Financial Services Ltd (Registered in England and Wales No. 1651212) is authorised and regulated by the Financial Conduct Authority. Registered Office: Colmore Circus, Birmingham B4 6AR. Telephone: 0345 351 2352. Calls may be recorded to help us provide, monitor and improve our services to you.

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Emma speaks to Dr Nada Khan, a GP in Exeter and clinical lecturer in general practice at Exeter University, about her recent study on GP retention.

In this conversation, Nada explains how GP workload has become increasingly intense, fragmented, and risk-laden, and she describes the impact of hybrid access models and moral distress on GPs - all of which is causing experienced doctors to cut back on sessions they work or leave the profession altogether.

She also highlights the critical factors that help GPs stay in practice, including the importance of continuity of care, supportive practice teams, and establishing clear workload boundaries .

And Nada describes what national policymakers need to understand to address the retention crisis among mid-to-late career GPs, and the practical changes individual practices can make on the ground to support their staff.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links

Sustaining a career in general practice: A qualitative study of experienced GPs in South West England
Advice and guidance 'ping-pong' fuelling the GP retention crisis
Viewpoint: Why experienced GPs are leaving the NHS and how we can keep them



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