The impact of the harmonised education tariff on undergraduate general practice education in England: a qualitative interview study

BACKGROUND: The harmonised undergraduate medical tariff, introduced in 2022, is a national (England) funding policy that provides consistent reimbursement for clinical teaching across all healthcare settings. For the first time, GP education is funded on a par with secondary care. There is no published evidence on its impact. This study examined how the tariff has affected the organisation, delivery, and sustainability of undergraduate GP education in England. METHODS: Semi-structured interviews were conducted with twelve Heads of Undergraduate GP Teaching (HUGPTs), each from a different UK medical school; the findings are based on the ten interviews with HUGPTs at English medical schools (10/38, 26%). Data were analysed using Braun and Clarke's reflexive thematic analysis. RESULTS: Six themes were identified. Participants consistently reported that the harmonised tariff improved transparency and reallocated budgetary authority to HUGPTs, enabling curriculum expansion, growth of central GP teaching teams, and the development of new educational initiatives. Better remuneration was perceived to improve recruitment and retention of teaching practices and enhance teaching quality, while accountability frameworks, including the Annex C guidance and reporting tool, provided external legitimacy and supported consistent implementation across medical schools. CONCLUSION: The harmonised tariff has been associated with reported improvements in undergraduate GP education. As oversight responsibilities transfer from NHS England to the DHSC, maintaining transparent budget-holder arrangements and accountability frameworks will be important to sustaining these improvements.