GPs in England have agreed new funding arrangements with the government for the next financial year that will see them receive a £889m uplift in core funding, as well as £80m in additional service fees for asking hospital teams for advice and guidance.
The new contract will also see GPs and practice nurses included within the main Additional Roles Reimbursement Scheme (ARRS), and the removal of the cap on the number of GPs that can be employed through ARRS.
Alongside a £969m ‘new investment uplift’, the contract details published by NHS England today state there will be an increase in the IoS (Item of Service) fee for routine childhood vaccinations for GPs.
This comes on top of the £433m added to the GP contract during autumn last year.
Among concessions from the BMA, all GP practices will be subject to a new requirement from October to allow patients to submit routine, non-urgent appointment requests, medication queries and admin requests via online consultation tools during core hours.
Practices will also be required to identify patients with the greatest need that should see the same GP at every appointment.
According to the BMA, the deal represents a 7.2% cash growth in contract funding and the Government and NHS England hailed their achievement in negotiating the first agreed – rather than imposed – GP contract for four years.
Today’s agreement also stipulates that the government must commit to a full renegotiation of the new national contract during this Parliament.
GPC England chair Dr Katie Bramall-Stainer welcomed the ‘agreed uplift to our annual contract’ as ‘the first step on the road to recovery of rebuilding general practice across England’.
But she said: ‘At the end of last year, the Government announced its funding package and GPCE is clear that its acceptance of these changes is contingent on the Government agreeing to renegotiate a new contract in this Parliament.
‘The green shoots of recovery will be seen when we start to see a fall in the numbers of practices being forced to close – closures that leave patients waiting far too long to see their GP. Our patients deserve the best care possible in a timely manner, and the Government needs to support GPs as the exemplar for productivity and efficiency within the NHS.’
Health secretary Wes Streeting said: ‘Today, we have taken the first step to fixing the front door to the NHS, bringing back the family doctor, and ending the 8am scramble.
‘Over the past decade, funding for GPs has been cut relative to the rest of the NHS, while the number of targets for GPs has soared. That’s why patients are struggling to get an appointment.
‘This government is cutting the red tape that ties up GPs time and backing them with an extra £889 million next year. In return, more patients will be able to request appointments online and see their regular doctor for each appointment. Through the Prime Minister’s Plan for Change, we will work with GPs to rebuild the NHS and make it fit for the future.’
NHS England primary care director Dr Amanda Doyle said: ‘This is the first time in four years that the GP contract has been accepted as proposed and I hope it will be seen as positive for practices, GP teams and patients when introduced in April.
‘It shows how NHS England and the Department of Health and Social Care have listened and delivered on the priorities that matter most to patients and general practice teams, including a significant increase in funding and extra flexibility in the additional roles reimbursement scheme to recruit more staff including GPs.
‘Other key changes include improved digital access for patients, setting out what patients can expect from their practice in a new charter and encouraging GP teams to identify patients with the greatest need that would most benefit from seeing the same clinician at every appointment.’
Ruth Rankine, primary care director at the NHS Confederation, hopes the deal is a step to ending collective action.
‘This contract sets out a range of welcome measures to support the sector, including confirming the biggest investment into general practice and primary care networks since the end of the five-year contract deal two years ago. This extra £889 million funding provides much needed relief to a sector that has borne the brunt of low financial uplifts over the last two years at the same time as significant cost pressures. The relaxation of rules around use of funding for the Additional Roles Scheme is particularly welcome and something we have been advocating for on behalf of our members for a number of years.
‘We hope the fact that the British Medical Association and government have agreed these proposals will be an important step to bringing collective action to a close. This is a useful first step on the journey of reform and our members look forward to continuing to support the Government’s agenda.’
The new deal was announced today follows an emergency meeting of the British Medical Association (BMA), though the full published GP contract is still awaited.
An initial offer for the 2025/26 contract was made to the BMA on 20 December 2024, sparking outrage among pharmacy leaders as negotiations had not at that point recommenced on the Community Pharmacy Contractual Framework (CPCF) for either the current financial year or the next.
Negotiations with Community Pharmacy England (CPE) on the 2024/25 and 2025/26 community pharmacy funding agreements then recommenced at the end of January, and are still in progress.
The discussions are understood to be underpinned by the findings of the economic review of community pharmacy.
Yesterday the Health and Social Care Committee (HSCC) asked NHSE to share when it anticipates the economic review will be fully completed, and if and when it intends to publish the analysis and accompanying data in full.
2025/26 contract changes (BMA’s summary)
Key headlines:
• £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 and 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
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
Source: BMA
A version of this story was first published on our sister titles The Pharmacist and Pulse.
