Classification: Official
Publication reference: PRN02067i

To:

Integrated care boards (ICBs):

• primary care leads
• chief financial officers
• chief executive officers

NHS England regional:

• directors
• directors of commissioning
• directors of primary care and public health
• heads of primary care

Dear colleagues,

Financial implications and actions for integrated care boards (ICBs) following the mid-year updates to the 2025/26 GP contract

Following the government’s acceptance in full of the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) and NHS Pay Review Body (PRB), this letter sets out the financial implications of these decisions, details of the additional funding allocations to be issued in Month 4 and the actions required of ICBs. In addition, the government has also agreed to fund a 4% uplift to the locum reimbursement maximum entitlements available under Part 4 of the Statement of Financial Entitlements – as well as introducing a new provision (from 6 April 2025) which allows practices to claim locum reimbursement for GPs absent due to neonatal leave. It has also agreed to backdate uplifts to the ARRS maximum reimbursement amounts to 1 April 2025 and uplift the pay-related elements of the general practice workforce transformational (SDF) funding. Further details on how the backdating will be transacted and any SDF allocation changes will be provided in due course.

Additional funding allocations

The additional allocations supplement the 2025/26 ICB primary medical care baseline allocations and are detailed in Appendix A.

As with the additional funding provided for contract updates at the start of 2025/26, these allocations are based on each ICB’s share of total recurrent primary medical care allocations for 2025/26, except for the dispensing fee scale uplift, which is based on each ICB’s estimated share of total dispensing fees.

The GP contract has been amended to uplift the pay elements of the contract by 4%, backdated to 1 April 2025 (a further 1.2% in addition to the 2.8% already included in contract funding at the start of 2025/26).

The DDRB pay uplift will be implemented through an increase to the global sum, with payments backdated to 1 April 2025 in the August Primary Care Support England (PCSE) payment runs. The new global sum for 2025/26 is £123.34.

The additional ICB allocations include the expected uplift to dispensing fee scales, as detailed in Appendix A.

ICB responsibilities and actions for implementation

The 4% uplift to locum reimbursement rates and locum reimbursement claims for neonatal leave per Part 4 of the Statement of Financial Entitlements

ICBs need to:

• review all claims paid since 1 April 2025, and where the amount spent by the practice exceeded the original maximum reimbursable, the payment must be uplifted to the lower of the new maximum rate or the amount paid by the practice;
• make all future payments for any new or outstanding claims for locum reimbursements using the new maximum payment rates as set out in the updated Statement of Financial Entitlements; and
• approve claims for locum reimbursement for neonatal leave backdated to 6 April.

ICB colleagues have advised that the simplest way for ICB primary care finance teams to identify payments already made will be to:

• review the amounts charged to the relevant locum reimbursement subjectives and PCSE pay codes;
• calculate the uplifts due on them accordingly (the list of subjectives is included in Appendix B); and
• make backdated payments to cover the additional amounts due on any locum reimbursement claims paid from 1 April 2025 to date.

ICB responsibilities for further payments to practices and PCNs

During August 2025, PCSE will process global sum adjustments to backdate payments to 1 April 2025 for all General Medical Services (GMS) practices and Personal Medical Services (PMS) practices that are paid global sum equivalent (“global sum-like”) payments. They will also update payments for August to the new rate of £123.34 per weighted patient (pwp). This new payment rate will continue for the remainder of 2025/26.

PCSE will also calculate the backdated and future payments due to all PCNs within their remit in August. These payments relate to the uplifted PCN entitlements for the Enhanced Access Service in accordance with the details set out in Table 1 of the PCN DES specification.

For practices and PCNs not included in PCSE’s payment runs, ICBs need to:

• calculate the backdated global sum payments for any practices that are paid global sum or global sum equivalent (“global sum-like”) payments;
• make backdated payments as soon as is practical, along with the in-month payments that are to be paid at the new rate of £123.34 pwp;
• continue paying these practices at the new rate for any further payments due in 2025/26; and
• calculate the backdated and future payments due to PCNs in relation to the uplifted PCN entitlements for Enhanced Access set out in Table 1 on p61 of the PCN DES specification.

Updates to 2025/26 primary care networks DES payments

Table 1 below shows that additional resources continue to be available for the Additional Roles Reimbursement Scheme (ARRS). This gives a total of £1,711 million to cover GP and non-GP roles within the scope of the scheme as set out in the 2025/26 Network Contract DES.

Table 1 – Overview of funding for the Additional Roles Reimbursement Scheme (ARRS)

Increases in primary medical care workforce SDF allocations

Given the DDRB uplift, ICBs may need to increase the payment or reimbursement rates for the pay-related GP workforce SDF lines. Additional funding is available, enabling them to backdate uplifts to the pay-related elements for transformational GP workforce programmes to 1 April 2025 as appropriate. Further details and guidance on this will be provided shortly.

In the meantime, if you have any other questions, please email the team at england.pcfinancegroup@nhs.net

Yours sincerely,

Duncan Watson, Deputy Director, Finance and Planning Business Partnering
Secondary Care, Primary Care, Community Services, Vaccines and Screening
NHS England

Appendix A – additional ICB allocations for 2025/26

• Additional ICB allocations to support mid – year 202526 GP practice contract changes

Appendix B – list of locum reimbursement subjectives

• 5216101R C&M-PMS PCO Locum Adop/Pat/Mat
• 5216101T C&M-PMS PCO Locum Sickness
• 5216101V C&M-PMS PCO Locum Susp Drs
• 5216101Y C&M-PMS PCO Locum Prol Study Leave
• 521610WJ C&M-APMS PCO Locum Adop/Pat/Mat
• 521610WL C&M-APMS PCO Locum Sickness
• 521610WN C&M-APMS PCO Locum Susp Drs
• 521610WR  C&M-APMS PCO Locum Prol Study Leave
• 521610YS  C&M-GMS PCO Locum Adop/Pat/Mat
• 521610YU  C&M-GMS PCO Locum Sickness
• 521610YW C&M-GMS PCO Locum Susp Drs
• 521610YZ  C&M-GMS PCO Locum Prol Study Leave