Key takeaways
£889m boost for general practice
Largest investment in over a decade confirmed.
QOF indicators retired, funds redirected
£298m reallocated to vaccinations and disease prevention.
ARRS scheme expands with added flexibility
No cap on roles, nurses and GPs now eligible.
NHS England has published its changes to the GP contract for 2025/26
How best can your practice and PCN prepare?
Following extensive negotiations with the BMA, NHS England announced its changes to the GP contract on 28th February 2025. The changes have been described as the largest investment into general practice in over a decade and according to Wes Streeting are the “first step to fixing the front door to the NHS”. In short, the changes indicate a shift of resources into the community and are largely welcomed by general practice. For our previous article on these changes, please see here.
Some of the headline points include:
Increased funding: There will be an increase of £889 million in investments across the core practice contract and the Network Contract Directed Enhanced Service (DES). NHS England provides that this will take the combined estimated contract value to £13,176 million in 2025/2026 .
Removal of QOF indicators: 32 QOF Indicators will be permanently retired in 2025/26. These retirements will equate to 212 QOF points worth approximately £298m to be invested into the Global Sum. Of this approximately £100m (from the removal of 71 points) is to be invested into increases relating to childhood vaccinations and locum reimbursement rates, with the remaining 141 points (approximately £198m) to be targeted to cardiovascular disease prevention
ARRS scheme flexibility: There will be no cap on the number or type staff a PCN can employ under the ARRS scheme and the salary element of the maximum reimbursable amount for GPs will increase to £82,418 –though the eligibility requirements for GPs will remain the same. Practice nurses have also been added to the scheme.
New Advice and Guidance Enhanced Service: The full specification is still to be published but the new e-referral service should result in a £20 payment to practices per A&G request as part of an additional £80m funding pot.
National Insurance Contributions (NIC) and minimum wage: While no additional funding is earmarked specifically to address concerns around the imminent increase GPs are going to be expected to pay their employees as a result of changes introduced to NIC and the minimum wage following last year’s budget, the expectation (from Government) is that the overall increase in funding should cover these costs. The concern however is that this will simply mean a large proportion of the new funding will have to be diverted from other much needed areas. There may however be some comfort on the horizon given the House of Lords favourable vote last week to extend the exemption from the NIC rise to NHS general practices.
GP Connect and online services: With effect from 1 October 2025 practices will be required to keep their online consultation tool for non-urgent appointment requests, and medication and administrative queries, operational throughout the core hours. All practices will also need to ensure GP Connect functionally (relating to access to patient care records and Community Pharmacy consultation summaries) is enabled.
GMS Contract termination on dissolution: The GP contract regulations are to be amended to make it clear that GMS contracts can be terminated in the situation where there is no clear successor to the contract following a partnership’s dissolution. There was some confusion surrounding this point following the case of Vikram and Geetha Bhat v the NHS Litigation Authority - please refer to our previous article for further details (Dissolution of GMS partnerships – new guidance | Hill Dickinson).
To prepare for these changes, we recommend:
Reviewing your partnership agreements
A comprehensive and robust partnership agreement is a must for any practice – detailing as a minimum your agreed approach on decision-making, assets, and succession planning. Without a partnership agreement in place, your partnership operates as a “partnership at will” which is a risky structure for any business but in particular those operating GMS contracts. For further details, please refer to our previous article (The perils of a partnership at will | Hill Dickinson).
Your partnership agreement should also detail the role your practice plays in your PCN – which becomes increasingly important as funding and workforce liabilities grow. We would recommend including:
How your core network practice representative is appointed and removed;
How each partner will share in any losses the practice faces under the PCN network agreement schedules;
If your PCN is incorporated, who will hold shares in the company and how will you ensure that the shareholder holds any dividend payments on trust for their partners?
Ensuring your network agreement schedules are fit for purpose
A larger workforce means greater risk of employment liabilities. You should ensure that your network agreement schedules clearly document how liabilities relating to employees (in addition to service delivery) are shared between the members.
Is incorporation right for you?
We continue to see an increased number of individual practices and PCNs forming limited companies. For PCNs, these companies sit alongside their core network practices. Historically, the motivation to incorporate was to protect practices from the employment risks associated with an ever-growing ARRS workforce and more recently to act as a vehicle bringing together primary care across Place.
Integrated Neighbourhood Teams (INT) are looking to build on the structures of primary care networks to assist in the collaboration with other providers across primary care – not just general practice. Forming a limited company gives primary care providers a “single voice” across Place meaning that the company can be a single point of contact for commissioners and act as a contracting vehicle for services commissioned to INTs.
How our health and social care lawyers can support you
If you’re experiencing any issues in relation to the GP contract, our experienced primary care lawyers can provide invaluable guidance and ongoing support.
From addressing complex legal issues, to providing clear and practical advice, our team will be by your side, wherever you are, to guide you toward the best outcome for your business. Contact us today to get started.
