GP practices will see an average 4.2% increase to their funding per patient following 2025/26 contract changes, according to LMC analysis of the net impact.
New analysis from Berkshire, Buckinghamshire and Oxfordshire (BBO) LMCs has predicted that the net increase to bottom lines for local GP practices will be between £7.52 and £8.52 per patient.
The total uplift to GP contract investment will be £969m, including an advice and guidance enhanced service worth £80m, which equates to total cash growth of 7.9% compared to the 2024/25 contract.
But the LMCs sought to calculate the net funding position for local practices, taking account of losses from the impending National Insurance Contributions hike as well as changes to the QOF.
In response to the contract changes, LMC leaders also strongly advised practices to create waiting lists for non-urgent requests in order to meet the new requirements around online consultation, and to continue with collective action measures despite the BMA’s provisional acceptance of the new contract.
BBO LMCs said this net position equates to an average increase of 4.16% on the current financial year, which they compared with CPI inflation of 3% over the past 12 months.
The calculation for how much funding per patient will be lost due to the National Insurance Contributions and National Living Wage increases (£4.11) is based on a survey conducted by the LMCs towards the end of last year.
Similar analysis by the BMA suggested that the national cost of the tax changes would be slightly lower, at around £2.97 per patient.
But BBO LMCs chief executive Dr Matt Mayer told Pulse that their calculation includes practices who will have additional costs to reflect the maintenance of pay differentials across their workforce, even though this is not obligatory.
On QOF, the LMCs noted that although some indicators have been retired, the remaining points are more difficult to attain with increased maximum thresholds when compared to last year.
If practices did not achieve anything additional towards these increased thresholds, the net loss in a ‘worst case scenario’ would be £1.07 per patient.
But the LMCs said practices are ‘unlikely to leave their QOF practices unchanged’ next year, and that by increasing their workload, the loss of income would be lower.
‘We would therefore conservatively estimate the true financial loss to be a range between zero and up to a maximum of £1.00 per patient,’ the analysis said.
LMC advice to practices
- PCNs are advised to ‘review their workforce structures to take full advantage’ of the new ARRS flexibilities, particularly regarding newly-qualified GPs.
- A&G: if a response demands additional workload of the GP on the part of secondary care, the LMCs recommend converting it to a full referral
- £20 is only sufficient to cover the costs of a single clinical query.
- Practices should carefully consider their bottom line when considering any non-statutory pay uplifts (e.g. to maintain pay differentials).
- Practices are strongly urged to put systems in place to create waiting lists to manage the ‘anticipated increase in non-urgent demand’ related to online access requirements.
- Until a wholly new contract is in place ‘collective action should be considered to be permanent’.
BBO LMCs chief executive Dr Matt Mayer told Pulse that the new money – two-thirds of which is going into the global sum – is ‘necessary and essential’ to stop practice closures as a result of tax changes next year.
He said: ‘Otherwise, if there was an uplift comparable to previous years, practices would be closing because they’d actually be suffering a loss because of the NIC pressures from 1 April. So this is a very welcome uplift.’
‘However we would make sure practices are under no illusion that this is adding any stability or recovery for practices – this just allows them to stand still,’ Dr Mayer added.
He told Pulse that the Government’s expected assurance of a totally new GP contract is the ‘only reason’ the 2025/26 deal is not ‘totally objectionable’.
The BMA said the BBO LMCs analysis confirms that overall practice and PCN funding will increase from 1 April this year, but highlighted that the impact will be different for each practice.
A spokesperson for the union told Pulse: ‘The increases to employer National Insurance Contributions (ENICs) and the National Living Wage (NLW) will affect practices differently depending on how they organise and staff themselves and, given that practices will also not yet know whether they will achieve the Government’s new Quality and Outcomes Framework (QOF) targets in 25/26, funding increases for individual practices will vary from place to place.
‘As agreed with DHSC and NHSE, we will jointly monitor how practices are impacted as the year progresses.’
The BMA also stressed that for 2026/27 and beyond, there ‘must be substantial contract reform’, with a ‘minimum general practice investment standard’.
