The 2025/26 GP contract changes are summarised below.  Further details in some areas will follows, but Practices would benefit from becoming familiar with the high-level planned changes now.

In addition, here is a short video from the Chair of GPCE (Dr Katie Bramall-Stainer) on the latest contract developments.

The YouTube video is 5 mins long, but it’s important, and it explains the major changes..

Increased Investment in General Practice

• Total contract funding will increase by £889 million, raising the total contract value from £12.3 billion (2024/25) to £13.2 billion (2025/26).
• This represents 7.2% cash growth (4.8% real growth after inflation) and accounts for workforce costs, premises expenses, and increasing patient needs.
• An assumed 2.8% pay rise for staff is built into the funding.
• The Doctors’ and Dentists’ Review Body (DDRB) will make pay recommendations later in 2025, and if a higher uplift is advised, additional funding may be allocated to cover the increase.

New Enhanced Service: Advice & Guidance (£80m Investment)

• A new specialist advice and guidance service will be introduced to move more patient care from hospitals into the community.
• The service will enable patients to receive specialist input without requiring a referral to secondary care, improving efficiency and reducing hospital demand.
• This initiative also supports NHS elective recovery efforts by helping to clear waiting lists.

Changes to QOF & Redirecting Funding (£298m Affected)

• 32 QOF indicators permanently retired, reducing administrative workload for practices.
• 71 QOF points (£100m) will be removed and reallocated to the Global Sum, increased Item of Service fees for childhood vaccinations (from £10.06 to £12.06), and higher locum reimbursement rates in the Statement of Financial Entitlements (SFE).
• 141 QOF points (£198m) will be redirected to cardiovascular disease (CVD) prevention, with new targets aiming to reduce premature deaths from heart disease and stroke by 25% over 10 years.
• While lower thresholds for CVD prevention indicators will remain at 2024/25 levels, upper thresholds will increase in 2025/26.

Improving Patient Access & Digital Integration

• From 1 October 2025, practices must keep online consultation tools open throughout core hours (8:00 AM – 6:30 PM) for non-urgent appointment requests, medication queries, and administrative requests.
• GP Connect Integration must be enabled by 1 October 2025, allowing NHS providers read-only access to GP records and permitting community pharmacists to send consultation summaries directly into GP workflows.
• Safeguards will be put in place to ensure urgent medical requests are not incorrectly submitted online.

Introduction of the NHS Patient Charter

• A Patient Charter will be introduced to outline the standards patients should expect from their GP practice.
• All practices will be required to publish the charter on their websites, making it easier for patients to understand what services are available and how requests will be handled.

Workforce Flexibility & ARRS Expansion

• The Additional Roles Reimbursement Scheme (ARRS) will be made more flexible, with all funding combined into a single reimbursement pot that is no longer restricted to specific job roles.
• Practices will have greater freedom to recruit the staff they need, including GPs and practice nurses.
• The maximum GP salary reimbursement rate will rise from £73,113 to £82,418, supporting GPs in their second year of the ARRS scheme.
• Further salary adjustments may occur if DDRB recommends a higher pay uplift.

Changes to Capacity & Access Improvement (CAIP) Payment (£87.6m)

• The Capacity and Access Improvement Payment (CAIP) scheme will now focus on two key areas:
  • £58.4m to support improvements in general practice access.
  • £29.2m to encourage practices to identify and support patients who would benefit most from continuity of care.

GP Contractual Changes & Regulation Updates

• New safeguards will be introduced for Out-of-Area Registrations, requiring practices experiencing rapid growth in out-of-area patients to seek commissioner approval before continuing to register new patients.
• GP contracts will now include explicit rules on partnership dissolution, making it clear that a contract can be terminated if no clear successor is available.
• Rules on removing violent or threatening patients will be clarified, ensuring practices retain the right to immediately remove violent patients while preserving patient choice for those removed for other reasons.

Vaccination & Immunisation Updates

• The routine childhood immunisation schedule will be updated, introducing a new 18-month immunisation visit and moving the second MMR dose from 3 years 4 months to 18 months to improve uptake.
• Changes to MenB and PCV vaccines are under consideration and subject to ministerial approval.
• The eligibility criteria for the shingles vaccine will be expanded to cover a wider group of severely immunosuppressed adults.
• A varicella (chickenpox) vaccine may be introduced in late 2025, pending final approval.
• The Item of Service fee for childhood vaccinations will increase by £2, from £10.06 to £12.06 per vaccine, with funding for this drawn from retired QOF indicators.

Patient Safety Strategy & Mandatory Incident Reporting

• GP practices will be required to register with the Learn from Patient Safety Events (LFPSE) system, ensuring they actively report and review patient safety incidents.
• This will enable learning from safety events, recording concerns about unsafe hospital discharges, and supporting staff development through access to reporting records for appraisals and revalidation.
• The aim is to enhance safety culture in general practice and reduce system-wide patient harm.