The Impact of the Harmonised Education Tariff on Faculty Development and Teaching Capacity: A Qualitative Interview Study

Background: Until 2022, undergraduate general practice (GP) placements in England received substantially less funding than hospital placements. The harmonised undergraduate medical tariff established equal funding for primary and secondary care education. There is no published evidence on its impact.Aim: To examine how the harmonised tariff impacted the opportunities and challenges in recruiting and retaining teaching faculty, and in coordinating, delivering, and sustaining undergraduate GP teaching in England.Design and setting: A qualitative interview study with Heads of Undergraduate GP Teaching (HUGPTs) at medical schools across the UK.Method: We conducted twelve semi-structured online interviews with HUGPTs from 12 different UK medical schools. We used reflexive thematic analysis: we coded inductively and iteratively, refining the topic guide as new themes emerged from early interviews.Results: Six themes were identified regarding the impact of the harmonised tariff: budget control and organisational change; curriculum changes; placement capacity; teaching quality and assurance; impact on student experience; and the use of accountability frameworks, including a formal use-of-funds policy (‘Annex C’) and a reporting tool.Conclusion: This study demonstrates that the harmonised tariff led to substantial improvements in undergraduate GP teaching and recruitment. Locating budgetary decision-making authority with HUGPTs increased transparency and budget allocation, and enabled the expansion of GP teaching in the curriculum and recruitment to the central GP team. Better remuneration improved recruitment and retention of placement providers and was perceived to increase the quality of teaching.