The latest changes to the GP contract for 2025/26, as outlined by the BMA, are yet another disappointment for general practice. While the headline figures might suggest a significant investment, the reality is that this contract fails to address the deepening crisis in primary care. Instead of providing meaningful support to struggling practices, it adds complexity, increases workload, and shifts money around without solving the fundamental issues that GPs face every day.
Sources close to the BMA state that whilst they are no longer in contractual dispute with the DoHSC, collective action should continue
At first glance, an additional £969 million sounds like a positive step. However, only £889 million of this goes into core contract funding, and when spread across the entire system, it simply doesn’t go far enough. The increase in the Global Sum per patient to £121.90 is unlikely to keep up with the rising costs of running a practice, particularly with inflation, increased patient demand, and ever-growing administrative burdens.
General practice remains critically underfunded, and this contract does little to reverse the damage caused by years of real-terms cuts.
One of the most notable changes in the contract is the expansion of the Additional Roles Reimbursement Scheme (ARRS) to include newly qualified GPs and practice nurses. On the surface, this may appear to be a step forward in addressing workforce shortages, but in reality, it could be a Trojan horse for government control over general practice staffing.
By funding these roles through ARRS rather than core GMS, the government is creating an NHS-employed, rather than practice-employed, workforce within general practice. This shift gradually erodes the independence of GP partnerships, moving towards a centrally controlled, salaried model, where pay and conditions for GPs and nurses are dictated by national contracts rather than determined by practices themselves.
Additionally, the eligibility restrictions remain deeply flawed. The scheme is still limited to GPs within two years of completing training (CCT), meaning that experienced GPs—who form the backbone of the profession—are deliberately excluded. This fails to address the real workforce crisis: the mass exodus of mid-career and senior GPs due to unsustainable workload and worsening conditions.
Rather than giving practices the autonomy to recruit the staff they actually need, ARRS funding forces them into a rigid, top-down employment model, which could ultimately pave the way for the government to take full control over GP and nurse pay—without properly funding the system. This is not a genuine workforce solution; it is a shift towards a salaried service by stealth.
Another headline change is the introduction of a £20 payment per ‘pre-referral’ Advice & Guidance (A&G) request. On paper, this looks like a positive move, but in practice, it risks adding yet another administrative burden to already overstretched GPs.
The effectiveness of this system will depend entirely on whether specialists are able to respond quickly and reliably, something that has been a persistent challenge in secondary care. Additionally, there is a capped budget at the Integrated Care Board (ICB) level, meaning GPs may not even be able to access these payments consistently. Ultimately, this initiative could result in more unpaid work rather than genuine support for practices.
The Quality and Outcomes Framework (QOF) is also undergoing changes, with 32 indicators being retired. While reducing bureaucracy should, in theory, be a positive step, the funding from these indicators is simply being redistributed rather than reinvested into general practice.
Much of it is now tied to nine cardiovascular disease (CVD) indicators, with thresholds being raised. This means practices will have to do even more work just to secure the same income. This isn’t simplification—it’s just shifting the goalposts.
Another major concern is the new requirement for practices to offer online access for routine, non-urgent appointment requests, medication queries, and admin requests from October 2025.
While digital access can be helpful for some patients, this change risks overwhelming practices with an influx of online queries, without any additional funding or workforce support to manage them. There is also a very real danger that urgent cases could be missed if patients use the system incorrectly.
Despite assurances that safeguards will be put in place, this feels like yet another example of a policy being introduced without proper consideration of how it will impact frontline staff.
In both cases, these increases fail to reflect the true cost and workload involved in delivering these essential services.
Beyond funding concerns, there are also significant changes to record-sharing. From October 2025, pharmacy professionals will be able to update patient records through GP Connect, while other NHS and private providers will have read-only access, subject to patient consent.
While record-sharing can improve continuity of care, there are still serious unanswered questions about data security, GP liability, and exactly which providers will be included in this initiative. Yet again, this is a significant change being introduced without any additional funding or staffing support for practices to implement it.
The Primary Care Network (PCN) funding structure is also being adjusted, with part of the Capacity and Access Improvement Payment (CAIP) now being used for population health risk stratification.
This means practices will be expected to identify high-risk patients and prioritise continuity of care. While this may sound logical, it is yet another example of a workload shift rather than a genuine investment in primary care services.
Perhaps the most damning aspect of this contract is the clear disconnect between the General Practitioners Committee (GPC) of the BMA and the will of the LMC Conference. The LMC Conference, which represents grassroots GPs, has repeatedly called for:
✅ PCN DES funding to be redirected into core GMS
✅ A real-terms funding uplift
✅ A contract that genuinely supports long-term sustainability
Yet, the GPC has failed to deliver on these demands.
For years, the LMC Conference has sent a clear message:
Yet, rather than standing firm on these principles, the GPC has agreed to a contract that largely ignores these resolutions and continues to push general practice down an unsustainable path.
At a time when general practice needed bold leadership and a strong negotiating stance, the GPC has accepted a contract that fails to meet the profession’s core demands. There is:
❌ No significant investment in core GMS
❌ No meaningful workforce plan beyond the flawed ARRS scheme
❌ No real effort to tackle the growing workload crisis
By failing to deliver a contract that aligns with LMC resolutions, the GPC has effectively turned its back on the very GPs it is supposed to represent.
As a result, confidence in GPC leadership is at an all-time low. If this trend continues, the divide between the LMC Conference and the GPC will only widen, raising serious questions about who is actually standing up for general practice—because right now, it certainly isn’t the GPC.
When you step back and look at the bigger picture, it’s clear that this contract fails to deliver what general practice truly needs. The funding uplift is insufficient, the ARRS scheme remains flawed, and the introduction of new digital and administrative requirements will only increase pressure on already stretched practices.
✅ GPs are being asked to do more for the same, if not less
✅ The long-term sustainability of general practice is once again being ignored
If policymakers truly want to support primary care, they need to listen to the profession and deliver a contract that genuinely values and supports the vital work that GPs do every day.
Unfortunately, this is not that contract.