The BMA has agreed a deal ‘in principle’ for the 2025/26 GP contract that will see almost £800m invested into the global sum.
The deal also includes other measures pushed for by the BMA’s GP committee, including:
- a removal of ringfences for additional roles reimbursement scheme (ARRS) funding for PCNs
- GPs and practice nurses permanently added to the ARRS (although still only covering recently-qualified GPs)
- Increased fees paid to GP practices for routine childhood vaccinations
- A new enhanced service worth £80m to fund advice and guidance (A&G)
However, 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.
But GPC England said that the deal is subject to an agreement, in writing by next month, from the Government for a wholesale renegotiation of the GMS contract within this parliamentary term.
The announcement from the BMA also indicated that it would now ‘pause’ GP collective action – however it did not specify what this would mean in practice as it has previously advised for its safe working guidance to become permanent.
GPCE 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.’
Read our coverage of the contract
All the coverage from the 2025/26 GP contract
At a glance: All the headlines from the 2025/26 contract agreement – Pulse Today
GP practices to publish ‘patient charter’ and receive continuity of care incentive
Large chunk of QOF retired to fund global sum and immunisation fees rise
Contract details new enhanced service to fund advice and guidance (A&G)
Dr Amanda Doyle: ‘Extensive talks were held to find a fair GP contract deal’
Editor’s blog: Streeting passes first GP test but the next few months will be pivotal
GP collective action paused as BMA ‘no longer in dispute’ with Government
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.’
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.
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
“GPs that can be engaged under the Arrs
scheme, although it will continue to be limited to those within 2 years of their CCT date” . Totally age discrimination and wrong showing a lack of appreciation for experienced GPs and their contributions to keeping general practice alive all these years. The continuing exodus of older experiences GPs will continue. How on earth can this even be legal?
There are positive changes here, but one key objection would be the punishment practices are subjected to in missing Vaccine targets based on individuals who opt not to have their children vaccinated. 5 families choosing not to follow the traditional vaccine schedule can be worth thousands of pounds and worth more in numerical value than 500 patient’s having a blood pressure to target!
Assuming the lords amendment re national insurance rises is defeated in the commons – which it will be- 1/3 of this increase will be swallowed up- and we also have the minimum wage to contend with. Add to that having to take requests during all core hours and more on line appts- then not looking so good now is it !
Im sorry but are we meant to be happy with 7.2%. Last year the Consultants and hospital doctors got 12-14% rise?
So this will only go to half of our current pay rise for the current staff, to get parity with wage repatriation.
First we need the rest of the payrise to get to parity.
Then if the government are serious about improvement, we need additional funding on top of that to employ new staff
Hooray! We are saved.
For some reason I am minded to think of Blackadder
P: Doomed. Oh wait a moment, that’s not Farrow!
BA: Isn’t it ?
P: No, that’s Ponsonby.
BA: My God, Ponsonby! That genius Baldrick has killed the wrong bloke.
We’re saved.
P: Saved.
BA: Then Farrow is alive and we’re saved.
P: Hooray!
BA: And when the queen gets back from seeing Ponsonby we’ll – Oh God!
P: Oh doomed! Doomed!
Older GPs sold down the river—25 years of experience worth nothing. Thanks a bunch. I will end up having to retire earlier than planned.
Unlimited core hours online access will sink many struggling practices.
Once patients cotton on to this, there will be no brakes on demand.
Elderly/poorer/technophobic/low IQ individuals will be massively disadvantaged, whilst the Worried Well flood our inboxes with long lists of symptoms and requests, presumably with an impossible deadline to respond by.
I predict a riot.
There are 1000 GP practices who will lose to the value of £100k or more due to the Carr Hill Formula.
They collectively are underfunded to the tune of £212,000,000 compared to an “average” practice.
They are being sacrificed to fund GP in other parts of the country.
Who knows how they can get out of this mess now.
Classic Labour, no coherent plan, tinker and throw other people’s money at it.
Possibly more money for GPs to take home (kerching! Thanks Wes), will not noticeably improve patient experience, and the minority who actually pay tax will all be a little bit poorer.
So global sum is going up but part of that is redistribution of QOF money (while making QOF CVD itself harder). What is the real increase then?
Adam H is so right, the vaccine payment cliff is a perverse disincentive