2025/26 GP Contract Changes: Impact on Primary Care and ARRS

• 29th March 2025

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1. Key Contract Changes for 2025/26
2. QOF Adjustments – More Focus on CVD
3. What This Means for PCNs and General Practice
4. CPS ARRS Model – How We Can Help

The 2025/26 GP contract introduces a £969 million investment alongside major reforms that will impact funding, workforce models, digital access, and service delivery. For GPs and Primary Care Networks (PCNs), this means changes to the Additional Roles Reimbursement Scheme (ARRS), the Quality and Outcomes Framework (QOF), and patient access requirements.

For the first time in four years, NHS England and the BMA’s General Practitioners Committee (GPC) have reached an agreement, signaling a shift towards stabilising general practice after years of financial strain and workforce shortages. The contract provides increased financial support for locum reimbursements, enhanced digital requirements for patient access, and a restructuring of QOF indicators, particularly focusing on cardiovascular disease (CVD) prevention.

This article breaks down the key contract changes, what they mean for GP practices and PCNs, and how Core Prescribing Solutions (CPS) can help navigate these updates, particularly in optimising ARRS funding and workforce planning.

Key Contract Changes for 2025/26

The 2025/26 GP contract introduces key financial and structural changes, impacting funding, workforce planning, and patient access. These updates aim to strengthen general practice, but they also come with new expectations for digital access and performance measures.

Financial Investment and Global Sum Increase

• Total additional investment: £969 million – This includes £889 million in core contract funding and £80 million for pre-referral advice and guidance services.
• Global Sum per weighted patient increases to £121.90, providing more direct funding to practices.
• SFE (Statement of Financial Entitlements) payments restored to reflect 2025/26 real-terms values, covering:
  • Locum reimbursements, increasing by 15.9–17.1%.
  • Parental leave cover for GPs and staff.
  • Childhood immunisation payments, rising from £10.06 to £12.06 per dose.

These funding adjustments help offset rising costs and ensure practices can continue delivering core services. However, securing full QOF funding will require meeting higher performance targets, particularly for cardiovascular disease (CVD) prevention.

ARRS Expansion – What’s Changing?

The 2025/26 contract expands the Additional Roles Reimbursement Scheme (ARRS), allowing more flexibility in workforce recruitment for PCNs. Key changes include:

• GPs now eligible under ARRS – Newly qualified GPs within two years of their CCT can now be recruited under the scheme, with no cap on numbers. This provides more opportunities for GPs to enter primary care while helping practices address workforce shortages.
• Practice nurses added to ARRS – PCNs can now recruit practice nurses, but only if they haven’t worked in a PCN or its member practices in the past 12 months.
• Salary uplift for ARRS GPs – The maximum reimbursable salary for ARRS-funded GPs increases to £82,418 (+ on-costs), aligning with the BMA’s recommended salary range for salaried GPs.
• GP ARRS funding is no longer ringfenced – Previously, funding for GP roles under ARRS was separate from other reimbursed positions. Now, PCNs can allocate funding more flexibly across different workforce roles.
• ARRS remains under review – A joint review of the scheme will take place in 2025/26, meaning further changes could be introduced in the future.

These updates make ARRS more flexible, but eligibility restrictions still apply, limiting recruitment to newly qualified GPs and nurses without recent PCN experience. Practices will need to plan carefully to make the most of these funding opportunities.

“The 2025/26 contract’s expansion of ARRS provides a crucial opportunity for PCNs to strengthen their workforce, but recruitment must be approached strategically. 

At CPS, we’ve seen firsthand how efficient workforce planning can transform service delivery. The inclusion of newly qualified GPs and practice nurses under ARRS is a positive step, yet the eligibility restrictions mean PCNs need to think long-term. Our role is to help PCNs not just access funding but ensure they’re investing in the right mix of professionals to create sustainable, high-impact teams that improve patient care.”

Adeem Azhar: Clinical Pharmacist, Co-founder and Chief Executive Officer of Core Prescribing Solutions

QOF Adjustments – More Focus on CVD

The 2025/26 contract permanently retires 32 QOF indicators that were previously frozen, shifting the focus towards cardiovascular disease (CVD) management.

• £198 million is being reallocated to nine key CVD indicators.
• 141 QOF points are now tied to CVD outcomes, increasing the incentive for practices to improve prevention and management.
• Upper performance thresholds for these indicators will increase, meaning practices must meet higher targets to receive full funding.

These changes align with NHS England’s focus on preventing heart disease and stroke, but they also place more pressure on practices to improve CVD management while balancing other clinical demands.

New Advice and Guidance Service: £20 per Pre-Referral Request

A new Enhanced Service for Advice and Guidance has been introduced to encourage GPs to seek specialist input before making referrals.

• GPs will be paid £20 per A and G request sent to secondary care.
• Integrated Care Boards (ICBs) will receive funding based on activity, ensuring they have no financial incentive to restrict GP access to specialist advice.

This aims to reduce unnecessary hospital referrals and improve patient management within primary care. However, there is a risk that secondary care providers may shift more responsibility onto GPs, increasing their workload. The impact of this service will be reviewed in Spring 2025.

Digital Access and IT Changes

From October 2025, all GP practices must provide online access for routine patient requests, allowing:

• Non-urgent appointment bookings
• Medication queries
• Administrative requests

This is intended to improve patient access and reduce phone line congestion, but it also requires practices to implement safeguards to prevent urgent cases from being misclassified and delayed.

GP Connect Update Record

• Pharmacy professionals, such as pharmacists, will be able to update patient records, improving integration between community pharmacy and general practice.
• Other NHS and private providers will have read-only access, but only with explicit patient consent.

PCN Funding Changes

The Capacity and Access Improvement Payment (CAIP) is being restructured, with funding now split into two targeted areas:

• £58.4 million allocated for improving patient access, ensuring PCNs continue to focus on timely appointments and service availability.
• £29.2 million allocated for population health risk stratification, supporting practices in identifying high-risk patients who would benefit from continuity of care.

This shift encourages data-driven patient management, enabling PCNs to prioritise preventative care for those most at risk, particularly in areas like long-term conditions and multimorbidity. However, practices will need to integrate risk stratification tools effectively to maximise the benefits of this funding.

“With 141 QOF points now tied to cardiovascular disease, practices face both a challenge and an opportunity. The increased thresholds mean that traditional, reactive approaches to long-term condition management won’t be enough. 

At CPS, we support PCNs in proactively optimising CVD screening, medication reviews, and patient engagement strategies to ensure they meet targets while improving health outcomes. The key is integrating specialist pharmacists effectively within primary care teams—helping GPs manage workload while driving real improvements in cardiovascular prevention and management.”

Adeem Azhar: Clinical Pharmacist, Co-founder and Chief Executive Officer of Core Prescribing Solutions

What This Means for PCNs and General Practice

The 2025/26 GP contract changes impact workforce planning, financial stability, and patient care models within PCNs. While the funding boost and ARRS expansion offer new opportunities, restrictions and performance pressures remain.

Workforce Planning: More Flexibility, But With Restrictions

The inclusion of GPs and practice nurses in ARRS gives PCNs more options for workforce planning. However, eligibility restrictions still limit recruitment:

• Only newly qualified GPs (within two years of CCT) can be hired under ARRS, excluding experienced GPs who may be available for primary care roles.
• Practice nurses must not have worked in a PCN or its practices in the past 12 months, restricting the ability to recruit from existing local staff pools.

The removal of the GP ARRS funding ringfence allows more flexibility in how PCNs allocate resources, but ARRS remains under review for 2025/26, meaning further changes could be introduced. PCNs will need to monitor any adjustments closely to ensure long-term workforce stability.

Financial Relief – But Increased Targets for QOF

The additional funding in the 2025/26 contract provides financial relief, but meeting QOF targets will be more challenging.

• £198 million has been reallocated to cardiovascular disease (CVD) indicators, shifting the focus to prevention and management.
• 141 QOF points are now linked to CVD performance, with higher upper thresholds for full payment.

While this aligns with NHS priorities for reducing heart disease and stroke, it means practices must work harder to secure the same level of QOF funding. Those that fail to meet the new targets risk losing income, making it essential for PCNs to optimise CVD screening and patient management strategies.

Digital Transformation – A Double-Edged Sword

The mandatory introduction of online patient access from October 2025 is designed to improve convenience and efficiency, but it also brings new risks.

• Practices must allow online requests for non-urgent appointments, medication queries, and admin requests, reducing pressure on phone lines.
• Without proper safeguards, urgent clinical issues could be misclassified, leading to delays in critical care.

Advice and Guidance Service: Will It Reduce Referrals or Add Work?

The new Advice and Guidance (A&G) service aims to reduce unnecessary hospital referrals by encouraging GPs to seek specialist input before referring patients.

• GPs will receive £20 per AandG request sent to secondary care.
• ICBs will be funded based on activity, ensuring they have no incentive to restrict A&G access.

While this could help speed up decision-making and prevent avoidable referrals, there is a risk that hospital specialists may shift more responsibility onto GPs. If secondary care increasingly relies on GPs to manage complex cases through A&G rather than accepting referrals, it could increase GP workload instead of reducing it.

The impact of this system will be reviewed in Spring 2025, but in the meantime, practices must carefully monitor how it affects workload and patient outcomes.

Related Read: The impact of ARRS GPs on Primary Care Teams

CPS ARRS Model – How We Can Help

At Core Prescribing Solutions (CPS), we provide a tailored GP ARRS model to help PCNs maximise workforce funding and streamline recruitment. With the 2025/26 contract expanding ARRS to include GPs and practice nurses, PCNs must ensure they recruit efficiently and utilise funding effectively.

We support PCNs by:

• Recruiting eligible GPs: Ensuring compliance with ARRS criteria while identifying the right candidates for long-term workforce stability.
• Optimising ARRS funding without the administrative burden: Managing reimbursement processes and funding allocations so PCNs can focus on patient care.
• Ensuring smooth workforce integration: Helping new ARRS hires settle into PCN teams, reducing disruption and improving service delivery.

With ARRS funding now more flexible, PCNs need a clear strategy to allocate resources effectively. Our expertise in workforce planning and ARRS management allows PCNs to recruit the right staff while maintaining financial efficiency.