Capacity and Access Payment 2026/27: what practices need to do now

Capacity and Access Payment 2026/27: the funding matters, but the access rules matter more

The Capacity and Access Payment is moving from PCN level to practices from April 2026, but this is not just a funding redistribution exercise. It is also a clearer practice-level access requirement, with new reporting expectations and less room to treat urgent demand loosely.

The headline number is familiar: £292 million is being repurposed into a new practice-level GP reimbursement scheme. The harder question is what practices are expected to do with it, how access performance will be judged, and which parts of the operating model need tightening before the detail is fully published.

This guide sets out what is changing, what is confirmed, what is still unresolved, where the ARRS changes fit in, and what practice leaders should get in order now rather than later.

What this change actually is

The Capacity and Access Support Payment and Capacity and Access Improvement Payment are being removed from the Network Contract DES. In their place, NHS England is introducing a practice-level GP reimbursement scheme funded by the same £292 million.

The stated use of that money is straightforward: practices are expected to recruit additional GPs or increase sessions from GPs already working in the practice in order to support clinically urgent same-day access.

That makes this more than a movement of money from one organisational level to another. It pushes access responsibility and access scrutiny closer to the practice, at the same time as the contract becomes more explicit about urgent demand handling.

How much money is involved

NHS England’s contract letter says that the funding currently allocated to the PCN-level Capacity and Access Payment will be repurposed into the new practice-level scheme.

Divided across roughly 6,200 GP practices in England, that works out at around £47,000 per practice as a simple arithmetic average. That number is useful for scale only. It is not the published allocation and should not be treated as one.

NHS England has not confirmed how the money will be distributed. It may be based on list size, deprivation, another weighting approach, or a combination of factors.

What is confirmed

What is not confirmed

The broad direction is clear, but the operating detail is not fully published. That matters because the unknowns affect workforce decisions, financial modelling and access planning.

That uncertainty means practices should avoid overcommitting to a single funding assumption. It does not mean they need to wait passively before tightening the parts of their access model that are already clearly in scope.

What practices are expected to fund with the scheme

The contract letter is clear on purpose, but leaves room on delivery. The money is intended to increase GP capacity in support of same-day urgent access.

The important limit is that this is not framed as general practice funding. It is tied to urgent same-day access and should be planned as access capacity, not as a general budget cushion.

The five access metrics are not the payment rules, but they still matter

NHS England will collect practice-level data against five access measures from 2026. The contract language describes this as a way to support understanding of demand and encourage service improvement. It does not explicitly say that payment depends on hitting a threshold.

That distinction matters, but so does the likely direction of travel. Data collected now may shape what is mandated, incentivised or challenged later.

Why the practice definition of clinical urgency matters so much

The contract explicitly leaves clinical urgency to the judgement of the practice. There is no national threshold, no required triage algorithm and no universal definition.

That flexibility is helpful, but it also creates a measurement problem. Your same-day urgent access figure will only ever be as meaningful as the definition that sits behind it. A narrow definition may improve the metric. A broader one may create more operational pressure. The key point is not which version is easier. It is whether the practice applies the definition consistently.

If urgency is defined loosely, inconsistently or differently across teams, the data will drift and the operational model underneath it will drift too.

The real shift is the same-day urgent access rule

The central contractual change is simple to state and harder to operationalise: requests identified as clinically urgent must be dealt with on the same day.

Three related rules make that requirement more concrete.

The unresolved issue is the phrase “dealt with”. The contract letter does not define it. It may mean face-to-face review, telephone contact, clinically informed triage with a management plan, or another valid handling route. Until that point is clarified, practices need a local definition that is explicit enough to guide operations and defensible enough to support reporting.

This is where the funding change and the access change meet. More GP capacity may help, but only if the practice is clear about what counts as compliant urgent handling in the first place.

ARRS and the practice-level scheme now sit side by side

The Capacity and Access changes land at the same time as a significant widening of GP eligibility under ARRS. Until April 2026, ARRS funding for GPs was restricted to recently qualified GPs. That restriction is now removed.

From April 2026, any GP can be recruited through ARRS regardless of how long they have been qualified, provided they have not been substantively employed in a Core Network Practice of the PCN at any point in the previous 12 months.

The practical consequence is that practices and PCNs now have two potentially complementary routes to increase GP capacity. The practice-level reimbursement scheme may support direct practice funding for recruitment or extra sessions, while ARRS offers a separate PCN route for eligible GP recruitment.

The right answer will depend on the final scheme mechanics and on local workforce circumstances, but practices should already be thinking in terms of route comparison rather than assuming the new practice-level scheme is the only lever that matters.

What the DES specification confirms and what it does not

The 2026/27 Network Contract DES specification confirms the removal of CASP and CAIP from the DES and sets out the updated PCN requirements for the year. It also confirms the revised ARRS reimbursement amounts.

What it does not do is provide the detailed rules for the practice-level GP reimbursement scheme. That sits outside the DES. So the most important practice-level financial questions still remain open: allocation formula, sessional rates, any funding cap, application process and full operating detail.

What practices should do now

The missing scheme detail limits how precise financial planning can be. It does not prevent practical preparation.

Remaining open questions

Several issues still need formal clarification before practices can treat the new scheme as fully specified.

Those are genuine gaps, not minor drafting omissions. Practices should plan around them carefully, while still taking the access and reporting changes seriously from the outset.