For nearly fifty years, general practice taught medical students at a discount. By the 2010s, GP placements made up around 15 per cent of clinical teaching but received only about 7 per cent of the funding. Teaching practices were withdrawing. Placements were shrinking. And all the while, government policy depended on half of medical graduates choosing general practice as a career.
In 2022, that changed. The harmonised education tariff funded GP teaching on a par with hospital teaching for the first time.
Now, the first study of the tariff’s impact – led by researchers at the Nuffield Department of Primary Care Health Sciences, University of Oxford – finds it has delivered: more placements, stronger teaching teams, better-supported GP tutors, and practices that no longer say they cannot afford to teach.
The findings, published in BMC Medical Education, arrive as Parliament scrutinises the Health Bill, which will abolish NHS England and transfer its functions – including oversight of education funding – to the Department of Health and Social Care. The study sets out what needs to survive that transition.
What the researchers found
Catharina Savelkoul, a DPhil researcher in the department, and Professor Sophie Park, Professor of Primary Care and Clinical Education conducted this study, analysing interviews with English medical school Heads of Undergraduate GP Teaching between June and August 2025.
These educators lead undergraduate GP teaching at their institutions, and under the new tariff they formally hold its budget. With visible, protected funding, teaching leads could expand GP placements in the curriculum, grow their central teaching teams to support and coordinate this, and launch new initiatives, from simulated clinics to clinical humanities projects. They could pay teaching practices closer to the true cost of hosting students – and practices responded.
Several participants reported that practices which had been wavering, or threatening to withdraw, now say yes. One observed that before the tariff, practices would tell them teaching was no longer affordable; since its introduction, that has not happened once.
Participants also described a subtler change. Medical school culture has long treated general practice as the lesser path – the persistent question put to students, 'Are you going to be just a GP, or are you going to specialise?' Funding parity, several participants said, signalled that GP teaching is core to medical education, not peripheral to it.
The study is qualitative, and the researchers are careful about its limits: the findings reflect the reported experiences of those leading GP teaching, who gained authority under the new funding model, and quantitative research is needed to provide additional measures of the scale of the changes. But as the first empirical evidence on a major change in funding policy, it fills a gap that mattered – until now, there was none.
Why it matters now
Research has consistently shown that medical students' exposure to general practice shapes whether they choose it as a career – a finding reinforced by a systematic review published last month in the British Journal of General Practice, led by the same researchers. England faces a projected shortage of around 15,000 GPs by 2036/37, and the Government's 10 Year Health Plan depends on shifting care from hospitals into the community – which means it depends on a workforce trained, and inspired, in that setting.
The study makes three recommendations for the transition of oversight from NHS England to the DHSC:
- the national accountability framework and reporting tool ensure funding reaches GP teaching – it should be continued, and has potential to be adapted for use in other settings (e.g. secondary care);
- preserve the formal budget-holder status of the heads of undergraduate GP teaching – this ensures the funds are dedicated to general practice education, while enabling flexibility to meet local needs of curriculum design and delivery;
- keep budget decisions linked to teaching quality. Connecting budgetary accountability with educational quality assurance maximises the agility and relevance of education.
'For the first time, GP education is funded on a par with secondary care, and the difference it has made is clear,' said Catharina Savelkoul. 'Heads of GP teaching now have the budget control and the legitimacy to expand placements, invest in their teams, and hold the system to account. That matters for students, for the profession, and ultimately for patients.'
'With NHS England being abolished, it is crucial that these improvements are sustained. This research helps to make visible the potential benefits of these funding arrangements and accountability frameworks, providing clear evidence that they should be carried through the transition.'
The study, 'The Impact of the Harmonised Education Tariff on Undergraduate General Practice Education in England: A Qualitative Interview Study', is published in BMC Medical Education.
It was funded by an Industrial CASE Studentship supported by the Medical Research Council and Optum, with recruitment facilitated by the Society for Academic Primary Care.