GPC England has agreed in principle to accept proposed amendments to the 2025/26 GP GMS contract following two months of intense negotiations with the Government. The contract, which includes an overall funding uplift of £969m for the 2025/26 contract will be accepted provided the Government commits to a full renegotiation of the new national contract, beginning within this Parliament.
We have stipulated that this commitment must be confirmed in writing ahead of the Special LMC Conference on Wednesday, 19 March 2025. The BMA is no longer in dispute with the Government and NHS England and more guidance around this will be forthcoming in the weeks ahead. As you’d expect from your union, the BMA continues to recommend ways for practices to manage patient care safely and ensure long-term sustainability.
The 2025/26 GP contract (England)
These are the key headlines from the 25/26 GP contract changes:
- £969 million new investment uplift – comprises £889m additional core contract funding and £80m for use of e-RS advice and guidance between GPs and consultants.
- This investment is on top of the £433m added to the contract during autumn last year.
- Enhancement of ARRS, with GPs and practice nurses added in to the main scheme, minimum GP salary + on-cost reimbursement increased in line with the BMA salaried GP pay range and with no caps on numbers
- Enhanced service for ‘pre-referral’ advice and guidance with a £20 item of service fee payment per request by GPs
- Restoration / uplift of SFE payments (sickness/parental leave cover) in line with 2025-26 real-terms values (compared to 2018/19), including locum reimbursements and childhood vaccination payments.
- Changes to requirements for patient online e-consultation access to general practice from October 2025
Funding
Global Sum
In total it’s estimated Global Sum per weighted patient will rise to £121.90.
SFE payments
Locum reimbursement amounts will increase by between 15.9 and 17.1%, to take into account DDRB increases over recent years.
Item of service fees for childhood immunisations will be uplifted by £2 to £12.06. This includes all childhood routine vaccinations set out within Table 1 of the SFE, plus Hepatitis B immunisations at birth/four weeks and 12 months and MMR for those 6 and over.
The Item of Service payments for all other vaccination remain the same.
QOF
The 32 indicators (worth 212 points) that were temporarily frozen for 2024/25 will be permanently retired. The funding for these will be split across the Global Sum and additional funding for a renewed focus on the 9 CVD QOF indicators. 141 points will be added to the nine CVD indicators (totalling an additional £198m). Alongside this the upper thresholds for these indicators will be increased, whilst the lower thresholds remain the same.
IT & Digital
Online Access to general practice
A new requirement will begin from 1 October 2025 for practices to allow patients to submit routine, non-urgent appointment requests, medication queries and admin requests via online consultation tools during core hours.
This will be subject to necessary safeguards being in place to avoid urgent clinical requests being erroneously submitted online. GPC England and the Joint GP IT Committee (JGPIT) will work with NHS England on the design and implementation of this over the coming months.
GP Connect (Update Record)
From October registered pharmacy professionals will have access to patient records via GP Connect (Update Record).
Other NHS providers and private providers (where patients have provided explicit consent) will be limited to read only access for the purposes of direct patient care.
GPCE will work with NHS England to determine exactly which providers will be included.
PCNs and ARRS
ARRS
The GP ARRS scheme, announced in the summer of 2024, will be amalgamated with the main ARRS, alongside requisite additional funding.
The reimbursable amount for GPs employed under the scheme will be increased by £9,305 to £82,418 (plus on costs), in line with the BMA recommended pay range for salaried GPs. There will be no cap on the number of GPs that can be engaged under the scheme, although it will continue to be limited to those within 2 years of their CCT date at the time of recruitment and have not been previously substantively employed as a GP in general practice.
Practice nurses will also be added to the ARRS scheme, provided that they have not held a post within the PCN, or its member practices, within the last 12 months
There will be a joint review on the future of the ARRS through 2025/26.
PCN Capacity and Access funding
The Capacity and Access Improvement Payment (CAIP) will be split into two parts. One will continue to focus on access (worth £58.4m) while one will be repurposed to focus on using intelligence from population health risk stratification tools (worth £29.2m) to risk stratify their patients in accordance with need- including to identify those that would benefit most from continuity of care
Vaccinations and Immunisations
In addition to the changes to the Item of Service (IoS) fee for routine childhood vaccinations described, there will also be the following changes in 25/26, in line with recommendations by The Joint Committee on Vaccination and Immunisations:
- two changes to the childhood vaccination schedule, necessitated by the discontinuation of the Menitorix (Hib/MenC) vaccine,
- the exchange of MenB and PCV vaccines within the childhood schedule (subject to final ministerial agreement) – to note this a change from our original proposal, reflecting a late recommendation from JCVI, but is a workload-neutral change.
- a change to the adult shingles programme, reflecting new evidence on the effectiveness of the vaccination for a broader severely Immunosuppressed (SIS) cohorts
- the potential introduction of a varicella vaccine, subject to final agreement, and;
- an amendment to the requirement to record the dried blood spot test for at risk babies, allowing that recording to take place between 12 and 18 months.
- changes to the SFE to address inconsistencies in treatment of patients that move practice as set out in paragraphs 15-17 of annex F of the proposals shared with GPCE on 20 December 2024. This will be consistent with the ‘swings and roundabouts’ approach to payments for departing patients taken elsewhere in the GP contract.
Advice and Guidance Enhanced Service
An Enhanced Service specification for Advice and Guidance will be agreed. This will provide a £20 Item of Service fee (IoS) per ‘pre-referral’ A&G request. ICBs will receive funding according to activity delivered so they are not incentivised to withhold it from general practice, with capped spend per ICB.
As part of this local systems will be required to review the availability of secondary care advice channels and the impact on GPs will be reviewed during Spring 2025.
GP collective action - staying safe, organised and united
GPCE continues to recommend that all colleagues work safely, and that where commissioning gaps exist or where commissioned pathways are failing practices and patients, these are raised with LMCs and ICBs (integrated care boards) and should be renegotiated locally. Practices should be appropriately resourced for the work they undertake in providing vital care for patients.
GPCE’s dispute with Government may be over – contingent upon written assurances around the renegotiation of the national GP practice contract for England in this Parliament, but the focus at a local and system-level continues. Patient care must be protected from gaps in local commissioning arrangements. Practices who are undertaking such work should either be resourced, to ensure patient care is sustainable or consider serving notice on them to ICBs. LMCs are central to this process of achieving a fair collective position for practices supported by our national advice and resources.
Our safe working guidance has been GPC England policy for a decade and continues to be so. We will continue to update our guidance in line with new contracts as they develop. Contractual asks, such as access to online consultations and requesting non-urgent /routine queries, does not mean GPs must find unlimited capacity that jeopardises safe patient care.
Should negotiations around a new contract fail to deliver what the profession needs, then GPCE will need to potentially discuss re-entering dispute and action escalation again, an outcome which is in nobody's interest. Many of the items on the collective action menu will potentially be superseded by the 25/26 contract agreement, and so we will publish updated guidance for members, practices and LMCs to provide the necessary clarity. We also still have the template letters available within our long-standing safe working guidance to help practices manage workload and limit capacity to deliver safe, high-quality care.
What we still need: our vision for general practice
The 2025/26 contract is a foundational step for further substantial reform, but we ultimately need that fully re-negotiated contract that offers the investment and workforce needed to restore General Practice and provide all patients in England with family doctors.
We are in ongoing liaison with the Secretary of State for Health and Social Care and Minister of State for Care, and shared our vision for the future of general practice with them after the 2024 General Election. We are committed to working tirelessly with them and their team to secure this vision, which was informed by our conversations with thousands of GPs across our roadshows in 2024. You can view the recording if you were unable to attend a roadshow.
The next phase of contractual and service reform includes:
- Setting out the investment plans for General Practice in the Government’s forthcoming three-year Comprehensive Spending Review
- Including what is needed for General Practice in the forthcoming NHS 10-year plan
- The Government working in partnership with us, within this Parliament, to secure a fully re-negotiated and resourced deal for GP practices across England, which delivers what our patients need.
Delivering what patients need will involve:
- Bringing back the family doctor – by seeing the same clinician, patients can build trust in who delivers their care and receive a better service
- More GPs and more Practice Nurses to meet the needs of our patients by delivering more appointments
- To put patient safety first by aiming for a gold standard of 1 FTE (full-time equivalent) GP per 1,000 patients by 2040 alongside a safe number of 25 appointments per GP per day
- A minimum general practice investment standard that protects and builds neighbourhood services
BMA representatives
We're here to stand up for your rights, support you in the workplace and champion the medical profession.