Introduction
- NHS England is committed to an equitable and consistent approach to funding the core services expected of all GP practices.
- Following the changes agreed to the General Medical Services (GMS) contract for 2026/27, this document sets out the approach to the funding changes that NHS England will apply to Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts.
- Commissioners will update local PMS and APMS contracts as soon as possible, applying the funding changes identified in this guidance with effect from 1 April 2026.
- Correspondence containing specific pieces of guidance was issued prior to this document being prepared, as below:
4.1 24 February 2026: General practice contract arrangements in 2026/27
Delivering a common increase to core funding
Increases to GMS global sum
- New investment paid via global sum for 2026/27 totalled a net £430 million for uplifts to pay, staff, other expenses and reinvesting the Advice and Guidance funding.
- The net effect is that:
6.1 Global sum payment per weighted patient increases from £123.34 to £130.07; and
6.2 GMS OOH deduction is 4.70% in 2026/27, equating to £6.11 - These revised values take effect from 1 April 2026 as detailed in the Statement of Financial Entitlements (SFE).
- The ready-reckoner has been updated, which GMS practices can use as a rough guide to estimate the change in their funding as a result of the contractual changes in 2026/27. The ready-reckoner is indicative only and does not constitute financial advice to practices. Nor does it reflect any national modelling for assessing practice-level impacts of contract changes.
Global sum uplift
- To deliver an equitable and consistent approach to uplifting PMS and APMS contracts, commissioners will apply increases for those GMS changes that also impact on these arrangements for PMS and APMS contracts that are equivalent to the value of the increases in the GMS price per weighted patient (except where local agreements with contractors set out a different approach to secure equitable funding).
- In summary, GP practices will see changes in core funding as set out in table 1.
Table 1
| GMS | PMS | APMS | |
|---|---|---|---|
| £/weighted patient | £/weighted patient | £/weighted patient | |
| Net uplift | £6.73 | £6.73 | £6.73 |
- Commissioners will need to apply the tariff(s) identified in table 1 above to calculate the increases due to individual PMS and APMS practices.
- Calculating the increase due will require the appropriate tariff(s) to be multiplied by the weighted list size of the practice (or raw list if the local contractual agreement requires). Typically, this will be the list size at the beginning of the quarter prior to the commencement of the financial year – that is, 1 January 2026 (unless the contractual agreement specifies otherwise).
- Net uplift is the GMS price increase per weighted patient resulting from the uplift on pay, along with an appropriate uplift to expenses. That leads to a GMS contract uplift of 5.5%. Commissioners will apply the corresponding appropriate uplift to PMS and APMS practices as shown in table 1 above.
Out of Hours (OOH) ‘opt-out’ deduction
- Where no OOH deduction is made in PMS or APMS contracts (that is, OOH opt out never featured in the contract or was permanently removed), no further action is required. Where there is an agreed deduction, this should be consistent with the revised GMS OOH deduction.
- The cash value of the PMS OOH deduction per weighted patient for 2026/27 is therefore also £6.11.
- Commissioners will apply the OOH deduction of £6.11 per weighted patient to the weighted list size (unless the contractual agreement provides for raw list size) of the PMS or APMS practice to calculate the value of the OOH opt out deduction.
Other funding changes
- The new practice-level GP reimbursement scheme includes a funding entitlement of up to £4.57 per practice adjusted population. For all other changes, commissioners should refer to the ‘Update to the GP Contract agreement 2026/27: Financial Implications’ letter, once published and available on the GP contract pages of the NHS England website.
The Network Contract DES
- In 2026/27, up to £2.606 billion will flow nationally through the Network Contract DES, equating to £2.00 million per average network. The Network Contract DES specification 2026/27 provides full details and begins on 1 April 2026. The table below sets out the payments that relate to this DES for 2026/27.
| Payment details | Amount | Contract types | Allocations | Payment made to | Payment timings** |
|---|---|---|---|---|---|
| Core primary care network (PCN) funding – continues to include Clinical Director and Leadership funding | £3.059 per patient per year*, comprising £2.311 per registered patient plus £0.748 per PCN adjusted population | GMS, PMS and APMS | Primary Medical Care (PMC) allocations | Primary Care Network’s nominated account | Monthly by the last day of the month in which the payment applies and taking into account local payment arrangements. |
| Staff reimbursements for the reimbursable roles set out in guidance | Actual costs to the maximum amounts per the updated PCN DES, paid from April 2026 – or following employment | GMS, PMS and APMS | PMC allocations | Primary Care Network’s nominated account | Monthly in arrearsby the last day of the month following the month in which the payment relates and taking into account local payment arrangements. Payment claimable following start of employment. |
| Enhanced Access | £8.903 per PCN adjusted population | GMS, PMS and APMS | PMC allocations | Network’s nominated account | Monthly by the last day of the month in which the payment applies and taking into account local payment arrangements. |
| Care home premium | £133.158 per bed* | GMS, PMS and APMS | PMC allocations | Network’s nominated account | Monthly by the last day of the month in which the payment applies and taking into account local payment arrangements. |
| Investment and Impact Fund (IIF) | Amount payable dependent on achievement | GMS, PMS and APMS | PMC allocations | Network’s nominated account | The details on how the IIF operates and associated payments can be found in section 10.6 and Annexes C and D of the Network Contract DES – contract specification and the separate IIF guidance. |
*Based on patient numbers at 1 January immediately preceding the financial year.
**As per local payment arrangements (to account for where integrated care boards do not have a payment run on the last day of the month).
Note: All practice and PCN costs are payable from 2026/27 Primary Medical Care allocations.
Publication reference: PRN02354i