Written by Flemming Jensen, | Clinically reviewed by Rumela Medina, Clinical Lead, NorMed | Last reviewed: June 2026
Audience notice: This article is written for GP practice managers, practice partners, and PCN clinical directors. It does not constitute financial or contractual advice. Always verify current figures and requirements with your Integrated Care Board (ICB) before making operational or funding decisions.
GP contract 2026/27 changes represent the most significant restructuring of primary care funding and accountability in several years. For practice managers, these changes are not abstract policy shifts. They alter how practices receive funding, how workforce costs are reimbursed, and how performance is measured on a daily basis. This article translates the key contract changes into plain English, covering the removal of the Capacity and Access Payment, the new GP reimbursement scheme, updated ARRS rules, five new data metrics, and what continuity of care now requires at PCN level.
The End of the Capacity and Access Payment — and What Replaced It
The Capacity and Access Payment (CAP) has been removed from the Network Contract DES entirely and replaced with a new practice-level GP reimbursement scheme. For practice managers who built their access improvement planning around CAP funding, this change requires an immediate reassessment of how those activities are now funded. The CAP was worth £292 million nationally. That sum has been repurposed, not lost.
However, the new arrangement operates at practice level rather than PCN level. This is a structural shift. Practices now receive funding directly, rather than through the network. For PCN clinical directors, this changes how workforce and access investments are coordinated across member practices.
Furthermore, the conditions attached to the new scheme differ from those of the CAP. Practices should review the full requirements set out by NHS England in Changes to the GP Contract in 2026/27 before assuming existing processes are sufficient. Additionally, practices delivering access improvement activity that was previously funded via PCN infrastructure may need to re-examine how that activity is attributed and reported.
In contrast to the CAP model, the new scheme ties funding to population-adjusted metrics rather than network-wide access standards. This creates both an opportunity and an accountability risk for individual practices.
The New Practice-Level GP Reimbursement Scheme Explained
The new practice-level GP reimbursement scheme provides funding of up to £4.57 per practice adjusted population, replacing the Capacity and Access Payment at individual practice level. Therefore, practices with larger registered lists stand to receive proportionally more — but the adjusted population calculation means raw list size alone does not determine the final figure. Practice managers should obtain their adjusted population figure from their ICB to calculate their maximum entitlement accurately.
Additionally, the scheme comes with reporting requirements. Practices cannot simply claim the maximum amount without demonstrating compliance with the associated access and performance conditions. As a result, this scheme creates a direct financial incentive to invest in structured access improvement — including remote clinical triage and skill mix models.
The supplementary information published by NHS England provides worked examples that practice managers should study carefully. Similarly, PMS and APMS practices should refer to the dedicated implementation guidance for PMS and APMS contracts to understand how the scheme applies to their specific contract type.
Moreover, practices using total triage in general practice are likely better placed to meet the reporting conditions attached to the new scheme, given that total triage generates structured data on contact type, urgency, and outcome by default.
GP Contract 2026/27 Changes to ARRS — What Practice Managers Need to Know
The GP contract 2026/27 changes to ARRS include a significant increase in maximum GP reimbursement and a complete removal of the recently-qualified restriction. Previously, ARRS GP funding was limited to GPs who had qualified within a certain number of years. That restriction has now been lifted entirely. Consequently, practices and PCNs can now recruit GPs of any experience level into ARRS-funded posts.
The maximum reimbursable salary for ARRS GPs has increased substantially. Outside London, the new maximum is £118,759 — up from £82,418. In London, the figure is £120,921. The annual equivalent including on-costs is £152,900 outside London. These are significant uplifts that change the financial case for employing GPs through ARRS-funded posts versus using locum cover.
What This Means for Workforce Planning
For practice managers and PCN workforce leads, the removal of the recently-qualified restriction opens up a much wider pool of potential ARRS GP candidates. Furthermore, experienced GPs who previously fell outside the scheme can now be recruited into structured roles that reduce reliance on locum spend. That said, practices should ensure that ARRS GP roles are clearly defined and that clinical case management responsibilities are appropriately distributed across the skill mix.
The NHS England expanding our workforce guidance sets out the updated role definitions and reimbursement rules in full. Additionally, for practices considering how paramedics fit alongside ARRS GPs, the ARRS paramedic funding 2026 guide outlines how paramedic reimbursement works within the updated framework.
| ARRS GP Reimbursement | 2025/26 Maximum | 2026/27 Maximum |
|---|---|---|
| Outside London (salary) | £82,418 | £118,759 |
| London (salary) | Not separately specified at prior rate | £120,921 |
| Outside London (inc. on-costs, annual equivalent) | Not specified | £152,900 |
| Recently-qualified restriction | Yes — applied | Removed entirely |
The 5 New Data Metrics — What Practices Must Now Collect and Report
GP contract 2026/27 changes introduce five new mandatory data metrics that practices must collect and report against from April 2026 onwards. These metrics shift the contract accountability framework from activity-based compliance toward outcome-based access measurement. For practice managers, this means investing in the data infrastructure and clinical workflows needed to capture this information consistently.
The five metrics are as follows:
- Call waiting time between 8am and 10am — measuring patient experience during the peak demand window
- Call waiting time during core hours — a broader measure of telephony access across the full working day
- Percentage of clinically urgent cases seen same day — directly linked to clinical safety and triage quality
- Percentage of non-clinically urgent cases seen within one week — measuring planned access responsiveness
- Percentage of non-clinically urgent cases seen within two weeks — capturing the tail end of the access queue
Practices using structured remote clinical triage will find these metrics easier to capture, because clinician-led triage naturally generates documented urgency classifications at the point of first contact. In contrast, practices still operating traditional GP appointment booking models may struggle to attribute urgency retrospectively. For practices exploring how triage can support these requirements, understanding what GP triage is and how it works in practice provides a useful starting point.
How to Prepare Your Practice
First, audit your current telephony and appointment system data against each of the five metrics. Second, identify where data capture gaps exist — particularly around clinical urgency classification. Third, ensure your EMIS or SystmOne configuration supports the necessary coding at the point of triage. Additionally, practices should document their processes now, before the next reporting period, so that evidence of compliance is already available if requested.
Continuity of Care as a Core PCN Requirement in 2026/27
GP contract 2026/27 changes make continuity of care a core PCN activity, with networks now required to identify and prioritise cohorts for continuity using risk stratification tools. This is no longer an aspirational standard — it is a contractual expectation. PCN clinical directors and practice managers must therefore have a clear, documented approach to risk stratification and cohort management.
In practice, this means identifying patients with complex or long-term conditions who would clinically benefit most from continuity with a named clinician. Risk stratification tools — many of which are already embedded in EMIS and SystmOne — can support this process. However, having access to the tool is not sufficient. PCNs must be able to demonstrate that the outputs are being acted upon.
Furthermore, continuity of care requirements interact directly with workforce planning. If practices are managing high GP workloads with locum or rotational staff, maintaining meaningful continuity becomes structurally difficult. As a result, practices should consider how their skill mix — including AHP and Allied Healthcare Professional roles — can absorb routine and lower-complexity contacts, freeing GP capacity for the continuity-designated cohort. The Network Contract DES from April 2026 sets out the continuity of care requirements in full.
The Network Contract DES in 2026/27 is worth up to £2.606 billion nationally, equating to approximately £2.00 million per average network. That scale of investment makes the contractual requirements attached to it operationally significant. PCNs that cannot demonstrate delivery risk both financial and reputational consequences.
What GP Contract 2026/27 Changes Mean for Paramedic Workforce Planning
GP contract 2026/27 changes create a direct case for expanding paramedic-led capacity within general practice and PCN workforce models. The five new data metrics place measurable pressure on same-day urgent access, telephony performance, and planned appointment availability. Meeting those metrics requires sufficient clinical capacity at the right points in the day — and paramedics are well-positioned to provide that capacity cost-effectively.
Community paramedics operating within GP practices can manage acute home visits, urgent same-day assessments, and long-term condition reviews — reducing the demand that falls on GP time and supporting the continuity of care requirements now embedded in the DES. Community paramedics in GP practice provide a cost-effective route to increasing clinical capacity without increasing GP headcount.
Similarly, remote clinical triage delivered by paramedic-led teams directly addresses the urgency classification and same-day access metrics. When a trained paramedic triages every contact at the point of first call, the practice generates the urgency data required for metric reporting as a natural output of the triage process. For practices managing rising GP appointment demand, understanding why GP appointment demand keeps rising in 2026 provides essential context for workforce planning decisions.
NorMed provides paramedic-led remote clinical triage and community paramedic services to GP practices and PCNs across the UK. Our services are designed to operate within the ARRS framework and to support compliance with the new contract metrics — without adding to your permanent headcount or fixed staffing costs. Speak to us about how our clinician-led model fits within the 2026/27 contract landscape and what it could mean for your practice’s capacity, compliance, and cost base. Visit the NHS England GP contract main page for the full contract documentation.
For practices considering how remote triage can address both access performance and data metric requirements simultaneously, total triage in general practice offers a structured model that delivers on both fronts.
Frequently Asked Questions
What are the main GP contract 2026/27 changes that practice managers need to act on?
GP contract 2026/27 changes include the removal of the Capacity and Access Payment, introduction of a new practice-level GP reimbursement scheme worth up to £4.57 per adjusted population, updated ARRS rules including removal of the recently-qualified GP restriction, five new mandatory data metrics covering call waiting times and appointment access, and a new contractual requirement for PCNs to deliver continuity of care using risk stratification tools. Practice managers should review all five areas and assess their current operational readiness against each one.
How does the new practice-level GP reimbursement scheme work?
The new practice-level scheme replaces the Capacity and Access Payment, which has been removed from the Network Contract DES. It provides funding of up to £4.57 per practice adjusted population directly to individual practices rather than through the PCN. Practices must meet associated access and performance conditions to claim the full amount. The adjusted population figure — not raw list size — determines the maximum entitlement. Practice managers should contact their ICB to confirm their specific figure and the reporting requirements attached to the scheme.
Can any GP now be employed through ARRS funding following the 2026/27 contract changes?
Yes. One of the most significant GP contract 2026/27 changes is the complete removal of the restriction that previously limited ARRS GP funding to recently qualified GPs. The scheme is now open to GPs of all experience levels. The maximum reimbursable salary outside London has increased to £118,759, and to £120,921 in London. The annual equivalent including on-costs outside London is £152,900. PCNs and practices should update their workforce planning models accordingly and review the full ARRS guidance on the NHS England website.
What are the five new data metrics practices must report under the 2026/27 contract?
The five new mandatory metrics are: call waiting time between 8am and 10am; call waiting time during core hours; percentage of clinically urgent cases seen same day; percentage of non-clinically urgent cases seen within one week; and percentage of non-clinically urgent cases seen within two weeks. Practices must collect and report against all five. Structured remote clinical triage, particularly paramedic-led models using EMIS or SystmOne, is one of the most effective ways to generate this data consistently at the point of first patient contact.
How does the continuity of care requirement in the Network Contract DES affect PCNs?
The Network Contract DES from April 2026 makes continuity of care a core PCN activity, not a voluntary standard. PCNs must now identify and prioritise patient cohorts for continuity of care using risk stratification tools. This means having documented processes that demonstrate the outputs of risk stratification are being acted upon — not simply that a tool is in use. For PCNs managing high locum dependency or fragmented workforce models, this requirement may necessitate a review of how GP and AHP capacity is allocated across the network.
