Initial response and analysis: GMS Contract changes 2026/27

Total 2026/27 GP contract funding (including the PCN DES) is £13,863 million:

• Total 2025/26 GP contract funding (including the PCN DES A&G funding, repurposed QOF points and capacity and access improvement payment) is £13,541.6 million.
• Allowing for a 2.4% inflationary increase to the total budget the equivalent of the 2025/26 budget today would be £13,866.6m which is more than the current contract value, meaning that in real terms the contract value has reduced by 0.26%.

There is a total uplift for 2026/27 of £485million (£416m GMS and £69m PCN DES):

• This includes the A&G funding (£80million in 2025/26) and an additional 18 QOF points (£25 million).
• As such the real term uplift is £380million or £5.96 per patient when excluding A&G and additional QOF funding.

Global Sum 2026/27 is £128.69 per weighted patient representing a £5.35 increase (reported as a 4.3% uplift):

• Global Sum 2025/26 was £123.34 per weighted patient (allowing for 2.4% inflationary uplift; this is equivalent to £126.30 today –1.9% real terms uplift).

QOF point value 2026/27 is £227.95:

• QOF point value 2025/26 was £225.49.
• This is not a true increase as it just reflects the increase in the Contractor Population Index (CPI).

Capacity and access funding of £292m (£4.58 per patient) within PCN DES to be transferred to practice level funding to employ GPs to support same day access:

• For many PCNs this will not improve their same day access capacity as this money is already being utilised at a PCN level to provide these practices with same day access GP appointments.

Chronic disease management:

• 8 key care processes for diabetes.
• Heart failure 4 pillars of treatment.
• Changes to BP targets for those without frailty.
• Adding 2 new obesity indicators.
• These changes may impact on local enhanced services in areas that have commissioned local services for these purposes.

Vaccinations:

• Currently QOF rewards practices for hitting specific target uptake levels which will remain as indicators.
• The new additional indicators will provide an alternative incentive to achieve improvement from baseline; practices will be paid according to the higher achievement (hitting threshold targets or improvement from baseline).
• This is beneficial for practices in areas with low uptake (London is a significant outlier) as most practices missed out significantly on this indicator, particularly because there was no ability to ‘exception report’ for example when there was informed dissent from parents.
• The RSV vaccination programme will be extended to all adults aged 80 and over, and all residents in care homes.

• The major change to ARRS relates to removing the restriction on GP employment to recently qualified GPs and enable a broader although undefined range to ARRS roles to be recruited.
• Despite a further investment of £69m (£1.08 per patient) into the PCN DES after £292m CAIP monies being repurposed into a practice level fund, there is a net decrease in PCN funding of £223m. This is in line with BMA policy to move PCN funding into core GP funding, however as this is ring-fenced funding, practices will lose their autonomy on how this funding is utilised.
• ARRS funding is already well utilised so this change may not enable any significant increase to the number of people employed through ARRS or could result in redundancies for ARRS staff.
• There is now a requirement for PCNs to have arrangements in place for care home residents to receive seasonal and routine vaccinations:
  • The regulations are now enabling PCN member practices to collaborate in providing seasonal and routine vaccinations. This may be beneficial for practices in providing outreach vaccination clinics or clinics outside of core practice hours.
• There is a requirement for PCNs to work with ICBs to achieve greater alignment between the PCN population and the neighbourhood. This may cause some PCNs distinct challenges where they are not coterminous with LA boundaries or around a natural community.

Appointment demand:

• Clinically urgent requests, as determined by the practice, must be dealt with on the same day, clinically determined non-urgent contacts need to be responded to by end of the next working day explaining to the patient how the request will be dealt with.
• The inability to cap online consultations will now form part of the GMS contract regulations.
• Practices will need to consider how these new requirements affect them. There will need to be a system to monitor incoming online requests from 8am-6.30pm and have them clinically assessed to determine urgency.
• The information contained in the letter does not state that if judged clinically urgent the patient cannot be referred to or advised to contact another service to meet their health needs.
• It would be advisable for practices to review their appointment systems and check that they are limited to the 3 types of GP appointment (same day, 7 day and 14 day) as these alongside call waiting times (8-10am and throughout core hours) are now going to be monitored through data extraction.

Advice and Guidance funding is transferred into core funding and becomes a ‘should do’ requirement.

Patients will need to register using the online system:

• If patients are unable to do this it will create an administrative burden for the practice who will need to transcribe the paper information onto the online portal.

Practices will need to participate in the GP staff survey:

• To do so they will need to share staff contact details with their ICBs.
• There is no information currently available regarding how staff consent to the sharing of their contact information and how an individual to opt out of having their information shared.