New GMS contract - cause for celebration?

Following on from the December announcement from Wes Streeting, some details of the funding has come out finally.

The 2025-2026 General Medical Services (GMS) contract introduces significant changes aimed at modernizing general practice in England, enhancing patient access, and improving working conditions for General Practitioners (GPs). This agreement, reached between the government and the British Medical Association (BMA), marks the first contract consensus in four years, signalling a pivotal shift in primary care.

Key Features of the 2025-2026 GMS Contract

1. Substantial Funding Increase: The contract includes a £969 million uplift, with £889 million directed to core funding and £80 million allocated for e-RS advice and guidance between GPs and consultants. This investment builds upon the £433 million added in the previous autumn, raising the Global Sum per weighted patient to an estimated £121.90. 

2. Expansion of the Additional Roles Reimbursement Scheme (ARRS): The ARRS now encompasses GPs within two years of their Certificate of Completion of Training (CCT) and practice nurses who have not worked in the Primary Care Network (PCN) or its member practices within the last 12 months. Notably, there is no cap on the number of GPs that can be employed under this scheme, and the reimbursable amount for GPs has been increased to £82,418 plus on-costs, aligning with the BMA's recommended pay range for salaried GPs. 

3. Enhanced Support for Parental and Sickness Leave: The Statement of Financial Entitlements (SFE) payments have been restored to real-terms 2025-2026 values, offering better reimbursement for locum cover during parental and sick leave. This adjustment aims to alleviate financial strain on practices managing staff absences. 

4. Focus on Cardiovascular Disease (CVD) Prevention: Thirty-two Quality and Outcomes Framework (QOF) indicators, worth 212 points, have been retired, with funding redistributed to emphasize nine CVD indicators. An additional £198 million has been allocated to these indicators, with 141 QOF points now linked to them. While this shift aligns with broader NHS prevention strategies, it also raises the upper thresholds for these indicators, necessitating higher performance from practices to secure funding. 

5. Introduction of a £20 Payment for Pre-Referral Advice and Guidance: A new Enhanced Service offers a £20 Item of Service fee per GP request for secondary care advice before a referral. This initiative aims to reduce unnecessary referrals and support better patient management, though it may also shift additional workload onto general practice. 

6. Digital Access Requirements: From October 2025, practices are mandated to allow patients to submit routine, non-urgent appointment requests, medication queries, and administrative requests via online consultation tools during core hours. While this move seeks to modernize patient access, practices must implement necessary safeguards to prevent urgent clinical requests from being erroneously submitted online.

Implications for Different Types of GPs

• GP Partners: The increased funding and expanded ARRS provide opportunities to bolster practice teams and improve service delivery. However, the heightened QOF thresholds may require additional efforts to meet performance targets, potentially impacting income.

• Salaried GPs: The inclusion of GPs in the ARRS with a reimbursable amount aligned to the BMA's recommended pay range may enhance job security and satisfaction. Nonetheless, the push for digital access and potential workload shifts could affect job roles and responsibilities.

• Locum GPs: Enhanced SFE payments, including better locum reimbursements, may improve financial stability for locum GPs. However, the emphasis on employing GPs within two years of their CCT under the ARRS could influence locum opportunities, depending on individual circumstances.

Future Outlook for General Practice

The 2025-2026 GMS contract represents a significant step toward modernizing general practice, with substantial investments and reforms aimed at improving patient access and GP working conditions. However, challenges remain, particularly concerning the implementation of digital access requirements and the potential for increased workloads due to higher QOF thresholds and the new advice and guidance system. Practices will need to adapt to these changes thoughtfully to ensure that the benefits of the contract are fully realized without compromising the quality of patient care or GP well-being.

In conclusion, while the contract offers promising advancements for general practice, its success will hinge on effective implementation and ongoing support for all types of GPs. Continuous evaluation and adaptation will be essential to navigate the evolving landscape of primary care and to ensure that these reforms translate into tangible improvements for both patients and practitioners. The next contract will be telling, as hopefully this is just a stepping stone to something more substantial for GPs everywhere.

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