A step in the right direction for the 2025/26 GP contract?

2025/26 GP contract

This month has seen the initial announcements on the 2025/26 GP contract, following months of negotiations. This deal marks the first agreed, rather than “imposed”, contract in England in four years, which is certainly a step in the right direction for general practice.

What are we going to see over the next 12 months?

£889 million is being put into additional core contract funding, which includes the following:

• £745m invested into the global sum
• £104m into Additional Roles Reimbursement Scheme (ARRS)
  • Ringfence around GPs under ARRS removed
  • Reimbursable salary for GPs increased by £9,305 to £82,418
  • No change to the eligibility for GPs under ARRS
  • Practice nurses added to the scheme, but there are conditions
• Increase of £17.8m for some vaccines and immunisations, and further £12m of uplifts to the Statement of Financial Entitlements (SFE)
  • £2 increase to item of service fee for routine childhood immunisations
  • Inflationary uplift to locum reimbursement claim amounts
• £13m to PCNs for business pressures

Global sum

We don’t yet have a breakdown of the £745m investment in the global sum and what that means for funding per patient and the Out of Hours opt-out deduction.

QOF

While the investment in the global sum sounds positive, you should be aware that part of this funding will come from the removal of 32 QOF indicators, which were protected in 2024/25. This equates to 212 points, worth around £298m. Of the 212 points, 71 points (worth around £100m) will be removed outright and invested into global sum and into increases in the Item of Service fee for routine childhood vaccinations, and locum reimbursement rates in the SFE.

The remaining 141 QOF point will be targeted towards cardiovascular disease prevention.

The shift in funding from QOF to the global sum will have varying impacts on practices, depending on the patient mix. A practice with a higher disease prevalence, but lower weighting for global sum, is likely to be disadvantaged.

Enhanced services

Many sources of income haven’t had any uplifts, including PCN participation payments and learning disability health checks alongside many other enhanced services.

Routine childhood immunisations will see an increase in the item of service fee of £2, to £12.06. The SFE will detail which vaccinations and immunisations are included in this increase.

There will be a further investment of £80m for a new enhanced service for the use of Advice & Guidance (A & G) between GPs and Consultants. 

Practices will be able to claim £20 item of service fee per pre-referral A & G requests, to promote closer working between primary and secondary care.

Funding will be distributed to each ICB on activity levels. Some areas have already been in receipt of this funding, so it will have varying results across the country.

ARRS

Funding for GPs will continue into 2025/26, and is no longer ringfenced, however, the GP must still be within two years of CCT and must not have held a substantive post in general practice.

Practice nurses have now been included within ARRS, but they must not have held a post within a PCN or its member practices within the last 12 months.

Although the majority of the increase in ARRS funding comes from the increase in reimbursable salary for GPs, as this role is no longer ringfenced, PCNs can decide to spend more or less of their total budget on GPs.

Employer National Insurance

One area that still lacks some clarity is the impact of the rise in Employer National Insurance to 15%, as announced in the Autumn Budget 2024. There was some hope for GP practices to be exempt from the rise following a vote by the House of Lords, however, it’s anticipated that the funding boost will be expected to cover the extra costs.

It’s important that practices understand the impact of the increase in Employer National Insurance in terms of increased payroll costs, as well as increases to the National Living Wage. This may impact decision making about staff pay rises.

How can we help?

Whilst this contract is a welcome boost to general practice, there’s still some way to go to get general practice back to where many feel it should be. If you’re unsure of what this means for your practice, please get in touch and we can guide you through the changes.

If you’d like to discuss this in more detail, please get in touch with your usual Larking Gowen contact. You can find contact details in the Our People section of our website. Alternatively, call 0330 024 0888 or email enquiry@larking-gowen.co.uk.

Louise Dean