The GP contract letter landed on 24 February 2026. Here's what it means for your practice.
The number
Investment rises by £485 million, bringing the total contract value to £13,863 million. That's 3.6% cash growth and 1.4% real terms growth relative to the GDP deflator.
For context, last year's uplift was £889 million (7.2% cash). This year is roughly half that in cash terms. The 2025/26 increase was a catch-up; this year returns to a more typical level. The contract includes a 2.5% pay assumption, subject to the pay review body's recommendations later in the year.
Five things you need to know
1. £292 million moves from PCN to practice level
The Capacity and Access Support Payment (CASP) and Capacity and Access Improvement Payment (CAIP) are being abolished at Primary Care Network (PCN) level. In their place, a new practice-level GP reimbursement scheme will allow individual practices to recruit additional GPs or increase sessions from GPs already working in the practice.
The purpose is to support clinically urgent same-day access. This is a fundamental shift: money that previously flowed through PCN Clinical Directors now goes directly to practices.
The application process, per-session rates, and practice-level caps have not been published. Guidance is expected in the coming weeks.
2. Same-day urgent is now in your contract
If your practice decides a patient is clinically urgent, they must be dealt with on the same day. This is no longer guidance or an aspiration. It is being written into the core practice contract as a binding obligation.
It is for the practice to determine which patients are clinically urgent. But the definition of "dealt with" has not been published, and there is no legal precedent for the phrase in NHS primary care contracts.
Separately, practices are now explicitly prohibited from asking patients to call back or make contact on another day. For non-urgent contacts, the appropriate response deadline has actually relaxed slightly: from within the same core hours period to the end of the next working day. Patients must be told how their issue will be managed and what the next steps are.
3. Online consultation caps are now a contract breach
Online consultation systems must not cap the number of requests that can be submitted during core hours. Patients must be able to contact the practice throughout core hours via all routes of access, and online consultations must operate with the same parity as telephone and walk-in.
If your system currently limits daily submissions, speak to your supplier before April.
4. QOF grows by 18 points with major clinical updates
An additional 18 QOF points (c. £25 million) are being added, with significant clinical changes:
Obesity: Two new indicators (OB004 and OB005) for weight management referrals and pharmacotherapy. The Weight Management Enhanced Service is retired.
Diabetes: A new indicator (DM037) requiring delivery of all 8 NICE-recommended care processes. This is all-or-nothing per patient.
Heart failure: A new indicator (HF009) for 4-pillar therapy in heart failure with reduced ejection fraction.
Blood pressure: New consolidated indicators (CD001, CD002) stratified by age and frailty, replacing separate CHD and stroke/TIA indicators.
Childhood vaccinations: Measles, mumps, rubella, and varicella (MMRV) vaccine added to VI001–3. New improvement thresholds reward practices that improve from their own baseline, even if they don't hit the standard achievement thresholds.
The Advice and Guidance Enhanced Service is also retired. The requirement to use Advice and Guidance (A&G) before planned care referrals is now a core contract obligation with no per-item payment. The £80 million previously ring-fenced for A&G is absorbed into the general uplift.
5. ARRS opens to all GPs
The restriction limiting Additional Roles Reimbursement Scheme (ARRS) GP recruitment to recently qualified doctors is removed. Any GP can now be recruited via the scheme. The maximum reimbursement is being increased to the top of the salaried GP pay range plus employment on-costs, which we estimate at approximately £148,000 to £151,000 (up from £106,000 in 2025/26). The Directed Enhanced Service (DES) specification with the exact figure has not been published yet.
The date you need in your diary
Monday 2 March 2026, 17:00 to 18:00 — NHS England webinar on the 2026/27 contract changes. Updated specifications and guidance will be published in the coming weeks.
What comes next from us
We'll be publishing detailed analysis over the coming days:
Follow the money — financial modelling for your practice, including what you're losing from the A&G and Weight Management Enhanced Services
The access ratchet — practical compliance guide for the tightening access requirements
QOF 2026/27: what your clinical system can't tell you yet — a head start on new indicators before the business rules land
The PCN power shift — what the £292 million structural shift means for PCN Clinical Directors
10 things the contract letter doesn't tell you — the gaps in the letter and the questions to take to the webinar
Disclaimer: This article is for informational purposes only and reflects understanding as of 24 February 2026. It does not constitute legal, financial, or medical advice. Practices should refer to the latest official NHS England guidance and contractual documents.
Published by myPM, 24 February 2026.