The combined 2026/27 uplift for both practice core contracts and the PCN DES is £485m, bringing the total to just under £13.9 billion, including Advice and Guidance funding. This is a 3.6% cash increase, or 1.4% real-terms growth relative to the GDP deflator & CPI inflationary measures. This includes:

1. a pay assumption of 2.5% in 2026/27, to revisit post-DDRB recommendations, and;

2. some funding to cover the costs nationally of other cost growth pressures, including from premises and list growth.

A series of refinements to the Quality and Outcomes Framework for 2026/27 to align with updated NICE guidance. This includes:

• updating the childhood vaccination indicators to reflect the introduction of the MMRV vaccine,
• introducing a new diabetes indicator requiring delivery of all eight NICE recommended care processes,
• adding two new obesity related indicators to support referrals into structured weight management programmes and medicines optimisation
• updating the Heart Failure indicators to reflect the NICE recommended ‘four pillars’ of treatment, and
• streamlining by combining and simplifying existing measures.

These changes are supported by an additional 18 QOF points (c.£25m).

Updated QOF guidance will introduce additional improvement thresholds for the three childhood vaccination QOF indicators (VI001, VI002 and VI003) for 2026/27. Intended to recognise and reward practices, particularly those in more deprived areas, that may not meet the existing achievement thresholds but demonstrate meaningful and sustained improvement in vaccination uptake.

GP contracts will be updated to specifically set out the requirement that practices must not ask patients to call back, or make contact, on another day. In parallel, they will amend the existing ‘appropriate response’ requirement to provide greater flexibility for non-clinically urgent contacts. Practices will still need to provide patients with a timely appropriate response confirming next steps, but this will be required by the end of the next working day (rather than within the same core-hours period). This does not mean the patient’s non-clinically urgent request must be fully dealt with by then; rather, the patient should understand how and when their issue will be managed.

The GP contract regulations will be amended to explicitly require that requests identified as clinically urgent, as determined by the clinical judgement of a GP or appropriately trained professional, must receive a same-day response.

The GP contract regulations will be amended to explicitly require that online consultation tools must not cap the number of requests that can be submitted during core hours.

The GP contract regulations will be amended to require that practices offer RSV vaccination to all registered older adult care home residents and all patients aged 80 and over who have not previously been vaccinated, in line with JCVI recommendations. Practices will receive an Item of Service fee for each vaccination.

Practice contracts will be amended to embed Advice and Guidance within core funding, requiring practices to use A&G prior to or in place of a planned care referral where clinically appropriate and to follow locally agreed referral pathways, including Single Point of Access models once introduced.

The GP contract regulations will be amended to align with existing Cloud Based Telephony (CBT) requirements, to require practices to provide timely data and information related to online and video consultation services, enabling consistent monitoring of access, patient experience and system performance.

The GP contract regulations will be amended to require practices to share data with the Lung Cancer Screening Programme to support the operation of the programme.

The GP contract regulations will be amended to mandate the use of online registration in all cases of registration. Practices will be required to enter information from paper registration forms into the national online registration system and ensure that changes to practice boundaries which are submitted through NHS England’s digital catchment tool, are approved by the ICB.

The GP contract regulations will be amended to expand the provisions on nominated dispensers, requiring practices to reconfirm the nominated pharmacy whenever a new prescription (not a repeat prescription) is issued.

The GP contract regulations will be amended to require practices to have a dedicated, monitored email address for receiving information from community pharmacies in the event that GP Connect is unavailable and for new or emerging pharmacy activity that is not yet supported through GP Connect, e.g. the introduction of independent prescribing in community pharmacy. The email address must be kept up to date and shared with the Directory of Services.

The GP contract regulations will be amended to require practices to engage with support from their ICB where unwarranted variation has been identified in contractor performance, including where practices are not meeting their requirement to see all clinically urgent patients on the same day, or where a practice is at risk of contractual breach.

The PMS contract regulations will be amended to mirror the GMS contract regulations to give commissioners equivalent powers to object to sub-contracting arrangements where patient safety, financial risk or delivery of contractual obligations may be affected. Supporting guidance will be issued to clarify expectations.

The GP contract regulations will be amended to require practices to display opening times for all modes of access (walk-in, telephone and online consultation) on their website, in their practice leaflet and within practice premises. As a minimum this must be core hours for all modes of access.

Both the GP contract regulations and the Network Contract DES will be amended to require that practices and PCNs participate in the General Practice Staff Survey, including sharing staff contact details with their ICB so personalised survey links can be issued.

Both the GP contract regulations and the Network Contract DES will be amended to require that practices and PCNs participate in the General Practice Staff Survey, including sharing staff contact details with their ICB so personalised survey links can be issued.

The Network Contract DES will be amended to include explicit requirements for PCNs to ensure that eligible older adult care home residents are identified and offered seasonal and routine vaccinations in line with national recommendations, with supporting guidance to clarify roles and responsibilities.

The Network Contract DES will be amended to provide clearer requirements for improving cancer referral practice, early diagnosis, and screening uptake. The updated wording introduces explicit expectations around reviewing referral quality against NICE Guideline NG12, strengthening and standardising safety-netting (including use of electronic tools), and setting out clearer responsibilities for proactively identifying and supporting eligible patients to engage with cancer and non-cancer screening programmes.

It will become a core requirement for PCNs to identify and prioritise cohorts for continuity of care using risk stratification tools as part of their core activities.

The Network Contract DES will be amended to remove the restriction that ARRS funding can only be claimed for recently qualified GPs and increase the maximum reimbursement amount that can be claimed for GPs via the ARRS (up to a maximum of the top of salaried GP pay range plus employment on costs).

The Network Contract DES will be amended to require PCNs to work collaboratively with their ICB to achieve greater alignment between the PCN registered list and the neighbourhood, where an ICB, working with the Local Authority, defines a neighbourhood around a natural community that does not match current PCN geography.