The NHS GP contract for 2025/26 marks a significant milestone in the ongoing evolution of general practice in England. As the final update within this five-year contract agreement cycle, these changes reflect NHS England’s commitment to addressing workforce pressures, enhancing patient care, and modernising primary care delivery. For general practitioners navigating these changes to the GP contract, understanding the contract’s key elements is crucial.
This blog explains the key updates of the 2025/26 GP contract changes, providing clarity on what GPs need to prepare for.
Understanding the NHS GP Contract
The NHS GP contract underpins funding, service delivery, and standards across general practice and primary care in England. Since its introduction in 2004, the contract has evolved to meet the growing and shifting demands of general practice. It includes core elements such as the Quality and Outcomes Framework (QOF) and the Additional Roles Reimbursement Scheme (ARRS). NHS England, in collaboration with the British Medical Association’s General Practitioners Committee (GPC England) and the Department of Health and Social Care (DHSC), manages this national contract. It supports sustainable GP funding, promotes effective primary care networks (PCNs), and ensures high-quality patient care.
Key Contract Changes for 2025/26
The 2025/26 contract changes conclude the current five-year contract that began in 2019, addressing challenges highlighted by the COVID-19 pandemic and the evolving needs of patients and practitioners. NHS England, the GPC England, DHSC, and Integrated Care Boards (ICBs) have all played significant roles in shaping this update. Following a consultation in March 2024, the final contract agreement was confirmed in spring 2025, with full implementation scheduled for October 2025.
£889 Million Additional Core Contract Funding
A cornerstone of the 2025/26 GP contract is the commitment of £889 million additional core contract funding. This includes £810 million for core contract funding and £79 million allocated specifically for capacity and access improvement payments. This injection aims to support general practice in expanding patient access and strengthening continuity of care.
Introduction of a £20 Item of Service Fee
One notable addition is the new £20 item of service fee. This payment incentivises GP practices to deliver appointments beyond baseline contractual requirements, encouraging practices to expand capacity and improve patient access across England.
Expansion of the Additional Roles Reimbursement Scheme (ARRS)
The ARRS has been expanded and reformed to include a broader range of multidisciplinary roles. This greater flexibility in recruitment aims to reduce GP workload and enhance patient care by supporting team-based approaches within primary care networks.
Streamlining the Quality and Outcomes Framework (QOF)
To simplify quality measurement, the 2025/26 contract reduces QOF indicators from 74 to 55. The updated framework focuses more sharply on key clinical priorities, including new measures for cholesterol management and cardiovascular risk, promoting meaningful outcomes rather than administrative burden.
Mandatory Online Consultation Tools by October 2025
All general practices will be required to implement online consultation platforms by October 2025, a key aspect of the evolving practice contract. This aligns with NHS England’s digital integration goals and is expected to improve patient access and streamline communication between patients and GP practices.
Enhanced Digital Integration via GP Connect
From October 2025, sharing patient records digitally through GP Connect will become mandatory, aligning with the goals of the practice contract. This is a significant step toward integrated care, allowing seamless communication across primary care networks, health, and social care providers, thereby supporting continuity of care and more coordinated patient management.
Standardised Advice and Guidance Pathways
New advice and guidance pathways introduced in 2024 enable GPs to access specialist support more efficiently. These pathways reduce unnecessary referrals and enhance patient care by promoting timely, informed decision-making within general practice.
Transparency in GP Pay and Workforce Data
To improve workforce planning and transparency, practices are now required to publish substantive GP workforce and pay data, which includes the salaried GP pay range. This measure supports NHS England’s broader efforts to address GP pay disparities and workforce sustainability within the primary care sector.
Stakeholders’ Perspectives on the 2025/26 GP Contract
NHS England views these contract changes as essential for strengthening general practice capacity, enhancing digital access, and improving patient care outcomes.
The British Medical Association’s General Practitioners Committee (GPC England) welcomes the increased funding and expanded workforce flexibility but advises caution regarding the tight timelines and the risk of additional workload pressures.
Both organisations recognise these updates as necessary responses to post-pandemic challenges, rising patient expectations, and workforce shortages.
Implications for General Practitioners
The GP contract changes present GPs with new opportunities to strengthen general practice through greater team collaboration and digital innovation. While the enhanced digital tools and reporting requirements may increase administrative tasks initially, GPs can proactively adapt by embracing these changes. Leveraging additional funding and the expanded multidisciplinary workforce will help GPs focus more on patient care and reduce individual workload over time.
What the Future Holds for GPs Under the 2025/26 NHS GP Contract
- Digital tools will become central to consultations, record sharing, and care coordination.
- Expanded multidisciplinary teams through ARRS will ease GP workload and improve care.
- Transparency in GP pay and workforce data will inform fairer planning and career paths.
- Integrated Care Boards will provide ongoing support to meet contract and clinical demands.
- Future contracts will focus on workforce challenges, patient access, and care continuity.
Professional Tips for GPs
- Stay informed on NHS England and BMA updates to understand how the 2025 GP contract changes impact your practice.
- Embrace new digital tools like online consultations and GP Connect to enhance patient care and efficiency.
- Collaborate closely with practice nurses and multidisciplinary team members to share workload and improve service delivery.
Conclusion
The NHS GP contract represents a pivotal moment for general practice in England. With increased funding, streamlined quality frameworks, and enhanced digital integration, the contract aims to support sustainable, high-quality primary care. As the October 2025 deadline approaches, GPs must prepare thoroughly to align their practices with these changes, ensuring they continue to deliver excellent patient care within the evolving NHS landscape.
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