GP Contract Changes 2026/27

 

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1. Finance and workforce

  • Global contract uplift: +£485m (3.6% cash; 1.4% real-terms).
  • New practice-level GP reimbursement scheme:
    • £292m repurposed from PCN Capacity & Access Payment (CASP/CAIP now removed).
    • Practices funded to recruit additional GPs / buy extra GP sessions specifically for same-day clinically urgent demand.
  • ARRS changes (Network DES):
    • Restriction to “recently qualified GPs” removed.
    • Reimbursement cap increased to top of salaried GP scale + on-costs.
    • Scope to recruit a broader range of ARRS roles by agreement with commissioner.

 

2. Access requirements (core contract)

  • Same-day response for clinically urgent requests:
    • All requests you classify as clinically urgent must be dealt with the same day.
  • Non-urgent contacts:
    • Patient must receive an appropriate response (i.e. know plan/next steps) by end of next core-hours period (not necessarily an appointment).
  • No “call back tomorrow”:
    • Contract explicitly prohibits asking patients to call back / make contact another day.
  • No capping of online consultation volumes:
    • Online consultation systems must not cap submissions during core hours.
  • Access metrics data collection (5 measures at practice level):
    • Call waiting times 8–10am and across core hours.
    • % clinically urgent seen same day.
    • % non-urgent seen within 1 week.
    • % non-urgent seen within 2 weeks.

3. QOF changes (clinical content & incentives)

  • General:
    • Scheme updated to align with latest NICE; 18 extra QOF points (~£25m).
    • Some indicators combined/streamlined; several IDs retired and replaced.
  • Key new/changed indicators (see Annex B table, p.10–11):
    • Diabetes: new indicator for all 8 care processes; more points for primary and secondary prevention statin use.
    • Blood pressure: new age/frailty-stratified BP control indicators (CD001, CD002), replacing separate CHD and STIA BP indicators.
    • Heart failure: new indicator for “4-pillar” therapy in HFrEF.
    • Obesity:
      • New indicator for referral of adults with obesity to structured weight-management programmes.
      • New indicator for shared decision-making on pharmacotherapy for obesity.
      • Weight Management Enhanced Service retired.
    • Vaccinations (childhood): indicators updated for MMRV; asthma/COPD register rules tweaked.
  • Vaccination improvement thresholds (childhood VI001–3):
    • Existing thresholds unchanged, but extra route to earn points via improvement against 2-year baseline (5–18/23/30 percentage-point ranges).

 

4. Vaccinations and screening

  • RSV programme: expanded to all ≥80 yrs and all older-adult care-home residents, with SFE IoS payment.
  • PCN care-home vaccination duty (Network DES):
    • PCNs must ensure eligible care-home residents are identified and offered routine/seasonal vaccinations (delivery may be by registered practice, another PCN practice, or subcontractor).
  • Collaboration for seasonal vaccinations:
    • Flu/COVID now explicitly allowed within collaborative arrangements under Network DES.
  • Cancer requirements (Network DES):
    • Clearer expectations re referral quality against NICE NG12, safety-netting (incl. electronic tools), and proactive work on screening uptake.
  • Lung Cancer Screening Programme:
    • Practices must share data to support the programme.

5. Digital, data and registration

  • Online registration mandatory:
    • All registrations must use the national online system; paper forms must be transcribed into it.
    • Practice boundary changes via digital catchment tool must be ICB-approved.
  • Access/consultation data:
    • Practices required to supply timely data from online and video consultation systems to align with CBT data for monitoring access/variation (not framed as performance management).

 

6. Pharmacy interfaces

  • Patient choice of pharmacy:
    • Practices must reconfirm nominated pharmacy whenever a new (non-repeat) prescription is issued.
    • Community pharmacy referral/triage tools must offer full choice of providers.
  • Dedicated GP email for pharmacy comms:
    • Practice must have a monitored email (can be an existing address) for occasions where GP Connect is unavailable / not yet supports specific pharmacy activity, and keep it updated on DoS.

7. Workforce experience, oversight and governance

  • General Practice Staff Survey:
    • Participation now a contractual requirement for both practices and PCNs; staff contact details to be shared with ICB to issue personalised links.
  • Requirement to engage with ICB support:
    • Where unwarranted variation or risk of breach is identified (e.g. not seeing clinically urgent same-day), practices must engage with ICB support.
  • PMS subcontracting rules aligned with GMS:
    • Commissioners gain mirrored powers to object to subcontracting where there are concerns about safety, finance, or contract delivery.
  • Opening times transparency:
    • Practices must display opening times for all modes (walk-in, phone, online) on website, leaflet and in-practice; at minimum core hours.

 

8. PCN / neighbourhood changes

  • Continuity of care (core PCN requirement):
    • PCNs must use risk-stratification tools to identify and prioritise cohorts for continuity.
  • PCN–neighbourhood alignment:
    • PCNs required to work with ICB to bring PCN footprints closer to defined neighbourhoods where there is a clear mismatch (not intended as widespread reconfiguration).

Action for Practice – GP Contract 2026/27

1. Access & Appointments

☐ Define “clinically urgent” and agree a standard triage script for all staff
☐ Map current same-day capacity vs demand; agree how to flex capacity on busy days
☐ Remove “call back tomorrow” from all protocols / messages / staff scripts
☐ Check online consultation system has no caps/closures during core hours
☐ Confirm online consultation flows align with urgency rules
☐ Agree process and owner for access metrics (call waits, same-day, <1 week, <2 weeks)

2. Finance & Workforce

☐ Quantify expected extra funding (uplift + access-related funding)
☐ Decide how to use new GP capacity funding (sessions vs recruitment vs locums)
☐ Review skill mix in light of ARRS changes and agree any role changes
☐ Update workforce plan to prioritise same-day demand and continuity cohorts

3. QOF & Clinical Delivery

☐ Run baseline searches for: diabetes 8 care processes and statins
☐ Run baseline searches for: age/frailty-stratified BP control
☐ Run baseline searches for: HFrEF on 4-pillar therapy
☐ Run baseline searches for: obesity referrals and pharmacotherapy discussions
☐ Allocate clinical leads for each QOF priority and agree improvement actions
☐ Retire processes linked to removed indicators / Weight Management ES

4. Vaccinations & Screening

☐ Confirm care-home vaccination arrangements and document responsibilities
☐ Confirm RSV, flu and COVID delivery model (practice / PCN / collaborative)
☐ Check systems support NG12-compliant referrals and cancer safety-netting
☐ Confirm how data will be shared for the Lung Cancer Screening Programme

5. Digital, Data & Registration

☐ Confirm use of national online registration for all new patients
☐ Define process for entering paper registrations into the online system
☐ Check website shows correct opening times for phone, online and in-person
☐ Agree owner for new access / consultation data submissions (incl. online/video)

 

 

6. Pharmacy Interfaces

☐ Build “confirm nominated pharmacy” into workflow for all new (non-repeat) scripts
☐ Check pharmacy referral tools offer full choice of providers to patients
☐ Confirm and monitor dedicated email for pharmacy comms; keep DoS entry updated

7. Workforce Experience & Governance

☐ Plan internal comms for mandatory General Practice Staff Survey
☐ Provide ICB with required staff contact details for survey links
☐ Agree internal process to respond to ICB concerns re access / variation
☐ Review any subcontracting arrangements for compliance with updated rules

8. PCN-Level Actions

☐ Set up continuity of care workstream and agree priority cohorts
☐ Review PCN footprint vs ICB “neighbourhoods” and note any likely changes
☐ Refresh PCN plans for care homes, vaccinations and cancer screening